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Sample records for voriconazole-induced phototoxicity masquerading

  1. Voriconazole-induced psychosis in a case of acute myeloid leukemia with febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Hemendra Singh

    2015-01-01

    Full Text Available Voriconazole-induced psychosis is a rare side effect. It is important that clinicians are made aware of voriconazole-induced potential psychosis. We report a case of voriconazole-induced psychosis that responded to haloperidol.

  2. Voriconazole-induced periostitis in a patient with overlap syndromes.

    Science.gov (United States)

    Hirota, Keisho; Yasoda, Akihiro; Fujii, Toshihito; Inagaki, Nobuya

    2014-03-05

    A 52-year-old woman with overlap syndrome and interstitial pneumonia underwent immunosuppressive therapy and she was suspected to suffer from pulmonary aspergillosis. Oral voriconazole was initiated, and a rapid elevation of alkaline phosphatase (ALP) occurred after 4 weeks. After 2 months, the patient presented diffuse pain in bilateral skeletal regions, and bone scintigraphy revealed bilateral multiple areas of increased radiotracer uptake. We suspected the skeletal involvement as voriconazole-induced periostitis. Actually, the plasma fluoride level was increased. Voriconazole was replaced with itraconazole, and after 3 weeks, the patient stopped complaining of bone pain concomitant with the decrease in ALP. Voriconazole-induced periostitis is a rare condition but had previously been reported in solid organ or patients with bone marrow transplant who received a long-term voriconazole therapy. Our present case is distinctive of previous ones, because it occurred in a patient with connective tissue disease which had its rapid progression.

  3. Voriconazole-induced periostitis: beyond post-transplant patients.

    Science.gov (United States)

    Reber, Joshua D; McKenzie, Gavin A; Broski, Stephen M

    2016-06-01

    Voriconazole-induced periostitis (VIP) is a rare but increasingly encountered entity since Food and Drug Administration (FDA) approval of the second generation antifungal medication in 2002. Literature reports most commonly include transplant recipients on immunosuppressive therapy simultaneously requiring antifungal therapy. Nontransplant patients receiving long-term voriconazole have an equal risk of developing the disease, but may experience a delay in diagnosis due to a lack of familiarity with the process outside of the post-transplant and/or immunosuppressed population. We present a case of VIP in a nontransplant, immunocompetent patient on suppressive antifungal therapy for prior abdominal aortic stent graft fungal infection. Radiologist review of current medications and recognition of periostitis on multiple imaging modalities may hasten the diagnosis and lead to earlier treatment and resolution of symptoms.

  4. Food masquerade.

    Science.gov (United States)

    Bermingham, Ann

    2010-01-01

    Radishes cut to look like roses, watermelons carved into fruit baskets, apples made into swans, cakes frosted to look like dolls—when did this game of food masquerade start and how? This essay speculates about food's on-going history of disguise, of pretending to be what it's not. From the Renaissance courtier's delight in confections disguised as beasts, birds, and other fancies to our present day fascination with Japanese bento lunch boxes, food masquerade would seem to be a fanciful part of the history of food.Food masquerade injects some levity into our growing seriousness about food, our suspicion that most supermarket food is riddled with toxins and bad karma. It proposes that eating food should be fun. Food masquerade also gets to the very heart of artistic visual representation: the magical transformation of paint, clay or wood into an image of something else. It is a synecdoche for art itself.

  5. Voriconazole-induced periostitis causing arthralgias mimicking a flare of granulomatosis with polyangiitis.

    Science.gov (United States)

    Gladue, Heather S; Fox, David A

    2013-12-01

    We describe a case of voriconazole-induced periostitis that occurred in a 68-year-old woman with granulomatosis with polyangiitis. Our patient presented with months of severe hip pain limiting her daily activities, which was initially felt to be a flare of her granulomatosis with polyangiitis. However, upon further review, she had an elevated alkaline phosphatase and periostitis on her hip radiograph; voriconazole was held, and within 2 days she had marked improvement in her pain. Although this clinical syndrome is well documented in transplant patients, it is a rare complication in patients with autoimmune disorders. However, it is important because it may cause severe arthralgias that can mimic a flare of rheumatic diseases.

  6. Phototoxicity and the cornea.

    Science.gov (United States)

    Schein, O D

    1992-07-01

    The cornea is sensitive to the effects of ultraviolet (UV) light and can suffer both acute and chronic toxicity. Ultraviolet keratitis is associated with relatively short exposures to light sources such as welding arcs or tanning lamps. The corneal effects are seen within a few hours following exposure and typically will resolve within 72 hours. Chronic exposure to environmental UV light may lead to a variety of ocular surface abnormalities that rarely resolve in the absence of therapy. Ultraviolet light, while potentially destructive, also can be used therapeutically. Recently, the photoablative properties of the excimer laser have been used in corneal refractive surgery. This laser uses UV light to break chemical bonds and remove tissue. Corneal phototoxicity is a reflection of the sensitivity of the ocular surface to photochemical injury. Fortunately, effective protection in the form of UV-blocking lenses is widely available.

  7. Homicidal hanging masquerading as suicide

    DEFF Research Database (Denmark)

    Leth, Peter Mygind; Charles, Annie Vesterby

    1997-01-01

    Homicidal hanging is rare and presents special problems for the forensic pathologist. We report a case of homicide by hanging masquerading as suicide, in which the forensic evidence was of crucial importance. The victim was a 61 years old man, who was found in his house suspended by a rope around...

  8. Homicidal hanging masquerading as suicide

    DEFF Research Database (Denmark)

    Leth, Peter Mygind; Charles, Annie Vesterby

    1997-01-01

    Homicidal hanging is rare and presents special problems for the forensic pathologist. We report a case of homicide by hanging masquerading as suicide, in which the forensic evidence was of crucial importance. The victim was a 61 years old man, who was found in his house suspended by a rope around...

  9. Primary hypothyroidism masquerading pituitary macroadenoma

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    Agrawal Amit

    2014-03-01

    Full Text Available Diffuse and reactive pituitary gland enlargement secondary to primary hypothyroidism is an uncommon occurrence and that can masquerade many pituitary disorders. In present article, we report a case of 19 year female severe hypothyroidism presenting with diffuse enlargement of pituitary gland and hyperprolactinemia and review the clinical importance of this entity. Knowledge of this entity is very important to avoid unnecessary surgery and irreversible complications in this sub-group of patients.

  10. Transmutations in Masquerade Costumes and Performances: An ...

    African Journals Online (AJOL)

    Ike Odimegwu

    sometimes, color and concept combinations in the masquerade costumes ... the light of the fact that designers design to meet deadlines and conform to set ... eyes. Confirming the usual sally of the ancestors to the world of the living, Illah says:.

  11. Photodecomposition and Phototoxicity of Natural Retinoids

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    Peter P. Fu

    2005-04-01

    Full Text Available Sunlight is a known human carcinogen. Many cosmetics contain retinoid-based compounds, such as retinyl palmitate (RP, either to protect the skin or to stimulate skin responses that will correct skin damaged by sunlight. However, little is known about the photodecomposition of some retinoids and the toxicity of these retinoids and their sunlight-induced photodecomposition products on skin. Thus, studies are required to test whether topical application of retinoids enhances the phototoxicity and photocarcinogenicity of sunlight and UV light. Mechanistic studies are needed to provide insight into the disposition of retinoids in vitro and on the skin, and to test thoroughly whether genotoxic damage by UV-induced radicals may participate in any toxicity of topically applied retinoids in the presence of UV light. This paper reports the update information and our experimental results on photostability, photoreactions, and phototoxicity of the natural retinoids including retinol (ROH, retinal, retinoid acid (RA, retinyl acetate, and RP (Figure 1.

  12. Acute phototoxic reaction in a century cyclist.

    Science.gov (United States)

    Lampel, Heather P

    2015-01-01

    Medications can cause photosensitivity. Several of these medications, specifically the nonsteroidal anti-inflammatory medications (NSAIDs), may be taken by athletes to treat joint and muscle discomfort. Many athletic events occur outdoors, which in turn exposes athletes to sunlight. Athletes taking NSAIDs and performing extensive outdoor activities may be at higher risk for phototoxic drug reactions. Clinicians may wish consider the potential for patient photosensitivity when recommending prescription and non-prescription medications to outdoor athletes.

  13. Voriconazole-induced musical hallucinations.

    Science.gov (United States)

    Agrawal, A K; Sherman, L K

    2004-10-01

    1 Voriconazole (Vfend) is a second-generation azole antifungal that is increasing in popularity especially for the treatment of invasive aspergillosis as well as empirically for the febrile neutropenic patient. In addition, voriconazole tends to have a mild side effect profile with reversible visual disturbances being the most widely described effect. We describe a patient who had musical hallucinations secondary to voriconazole. The patient was a 78-year-old man admitted for induction of chemotherapy for acute myelogenous leukemia (AML) who began to have auditory hallucinations, specifically of Christmas music, the 2nd day of voriconazole therapy. His psychiatric evaluation was otherwise unremarkable. After discontinuing voriconazole the hallucinations decreased in intensity by the 2nd day and ceased altogether by the 3rd day. An extensive literature search, including Pfizer drug trial safety data, yielded no other reports of auditory hallucinations with voriconazole. Several other interesting cases of musical hallucinations secondary to a variety of causes have been reported in the literature, and are reviewed. Notably, musical hallucinations tend to occur secondary to temporal lobe insults and often are of a religious or patriotic theme.

  14. Development and construction of a specific chamber for phototoxicity test

    Energy Technology Data Exchange (ETDEWEB)

    Sufi, Bianca S.; Mathor, Monica B., E-mail: biancasufi@usp.br, E-mail: mathor@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Esteves-Pedro, Natalia M.; Kaneko, Telma Mary, E-mail: nataliamenves@yahoo.com.br, E-mail: tsakuda@usp.br [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Fac. de Ciencias Farmaceuticas; Lopes, Patricia, E-mail: patricia.lopes@unifesp.br [Universidade Federal de Sao Paulo (UNIFESP), Diadema, SP (Brazil)

    2013-07-01

    Phototoxicity corresponds to the acute toxic response induced after skin exposure 'in vivo' and 'ex vivo' to certain chemicals and subsequent exposure to irradiation. Phototoxicity 'in vitro' assay is determined by viability of fibroblasts BALB/c 3T3 exposed to chemicals in the presence and absence of light. Substances identified as phototoxic are susceptible to 'in vivo' phototoxicity (OECD 432, 2004). A chamber was developed and constructed according to the guidelines OECD Toxicity Guide - 432 and ®ECVAM DB-ALM: INVITTOX N. 78. The chamber was built in stainless steel frame, with UVA lamps and dark area for negative control. The tests to qualify the chamber were performed with Sodium Lauryl Sulfate, recommended by the guides aforementioned, as negative control; and Bergamot oil (Givaudan-Roche), as positive control. Bergamot, Citrus bergamia, has, as major component, Bergapten responsible for its photosensitive activity. Both samples were diluted in Phosphate Buffered Saline with concentrations between 0.005 and 0.1 mg/mL, which were calculated by the dilution factor 1.47. These tests were performed over fibroblast BALB/c 3T3 culture and submitted to phototoxicity assay with MTS dye, under spectrophotometric reading, which allows determining the Photo Irritation Factor (PIF), what suggests that a substance with a PIF<2 predicts no phototoxicity; PIF>2 and <5 provides likely phototoxicity and PIF>5 provides phototoxicity. Sodium Lauryl Sulfate presented a PIF=1, being in accordance with the OECD. Bergamot oil has shown to be likely phototoxic with a PIF=2,475. These results provide that the chamber is qualified to be used to perform phototoxicity tests with assurance and security. (author)

  15. Density-dependent predation influences the evolution and behavior of masquerading prey.

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    Skelhorn, John; Rowland, Hannah M; Delf, Jon; Speed, Michael P; Ruxton, Graeme D

    2011-04-19

    Predation is a fundamental process in the interaction between species, and exerts strong selection pressure. Hence, anti-predatory traits have been intensively studied. Although it has long been speculated that individuals of some species gain protection from predators by sometimes almost-uncanny resemblances to uninteresting objects in the local environment (such as twigs or stones), demonstration of antipredatory benefits to such "masquerade" have only very recently been demonstrated, and the fundamental workings of this defensive strategy remain unclear. Here we use laboratory experiments with avian predators and twig-mimicking caterpillars as masqueraders to investigate (i) the evolutionary dynamics of masquerade; and (ii) the behavioral adaptations associated with masquerade. We show that the benefit of masquerade declines as the local density of masqueraders relative to their models (twigs, in our system) increases. This occurs through two separate mechanisms: increasing model density both decreased predators' motivation to search for masqueraders, and made masqueraders more difficult to detect. We further demonstrated that masquerading organisms have evolved complex microhabitat selection strategies that allow them to best exploit the density-dependent properties of masquerade. Our results strongly suggest the existence of opportunity costs associated with masquerade. Careful evaluation of such costs will be vital to the development of a fuller understanding of both the distribution of masquerade across taxa and ecosystems, and the evolution of the life history strategies of masquerading prey.

  16. Cholestatic liver disease masquerading as Wilson disease.

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    Sood, Vikrant; Rawat, Dinesh; Khanna, Rajeev; Alam, Seema

    2015-03-01

    Wilson disease and cholestatic liver diseases may present as a diagnostic dilemma if standard guidelines incorporating markers of copper overload are followed. We hereby present a series of four cases of sclerosing cholangitis masquerading as Wilson disease. True Wilson disease cases had significantly lower ceruloplasmin (6 vs. 16 mg/dL) and higher 24-hour urinary copper (322.3 vs. 74.5 μg/day) as compared to mimickers. Initial low serum ceruloplasmin levels normalized in mimickers on follow up, and this may used as a diagnostic indicator. Standard Wilson disease diagnostic criteria thus need further modification especially in developing countries to help avoid mismanagement.

  17. Masquerade Detection Using Support Vector Machine

    Institute of Scientific and Technical Information of China (English)

    YANG Min; WANG Li-na; ZHANG Huan-guo; CHEN Wei

    2005-01-01

    A new method using support vector data description (SVDD) to distinguish legitimate users from masqueraders based on UNIX user command sequences is proposed. Sliding windows are used to get low detection delay.Experiments demonstrate that the detection effect using en riched sequences is better than that of using truncated sequences. As a SVDD profile is composed of a small amount of support vectors, our SVDD-based method can achieve computation and storage advantage when the detection performance is similar to existing method.

  18. Primary cutaneous plasmacytosis: Masquerading as hidradenitis suppurativa

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    Tarang Goyal

    2016-01-01

    Full Text Available Isolated cutaneous plasmacytosis (CP is a rare entity with few cases reported in world literature. CP masquerading as hidradenitis suppurativa like presentation is a unique case with some features differentiating it clinically from it which were further confirmed by histopathology and immunostaining. Our case showed hyperplasia of mature plasma cells and polyclonal hypergammaglobulinemia, immunostaining for CD138 positivity and kappa: lambda ratio more than 3:1. Extensive clinical and laboratory investigations failed to reveal any underlying pathology, presence of any underlying disease accompanying the hypergammaglobulinemia and/or plasma cell proliferation.

  19. Governance and associated social roles of masquerades among the ...

    African Journals Online (AJOL)

    The second objective is to account for how globalization has impacted on such ... The researcher used oral interview delivered in Igbo language to gather ... the researcher personally observing aspects of masquerade activities of Igbo people.

  20. Orbital metastases from neuroendocrine carcinoma, masquerading as graves orbitopathy.

    Science.gov (United States)

    Sira, Mano; Clauss, Ralf P; Maclean, Chris; Rose, Geoffrey E

    2010-04-01

    We describe a patient with metastases from neuroendocrine carcinoma masquerading as Graves ophthalmopathy. This rare tumour possibly has a propensity for orbital spread, and we postulate a mechanism evoking the 'seed and soil' hypothesis.

  1. Scabies masquerading as bullous pemphigoid: scabies surrepticius

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    Cohen PR

    2017-08-01

    Full Text Available Philip R Cohen Department of Dermatology, University of California San Diego, La Jolla, CA, USA Abstract: Scabies, a parasitic infestation caused by the mite Sarcoptes scabiei, is diagnosed by observing either the mite, its ova, or its excrement. The mite tracts, known as burrows and a characteristic presentation of the pruritic condition, are typically found on the web spaces between the fingers. Other cutaneous lesions include excoriated papules, pustules, and vesicles. However, atypical clinical variants of scabies, such as bullous, crusted, hidden, incognito, nodular, and scalp forms of the parasitic infestation, mimic the morphologic features of other non-parasitic dermatoses. A 76-year-old man presented with pruritic blisters and urticarial plaques that demonstrated not only pathology changes, but direct immunofluorescence also showed findings of bullous pemphigoid. His condition improved, but did not resolve, with topical corticosteroid cream for the management of the primary autoimmune blistering disorder. When other family members subsequently developed scabies, the correct diagnosis for his condition, bullous scabies, was established by demonstrating mites, ova, and scybala on a mineral oil preparation from a skin scraping of a newly appearing burrow. Bullous scabies can masquerade not only clinically, but also both pathologically and immunologically as bullous pemphigoid. Scabies serrupticius is introduced as a unifying term to designate all of the non-classic presentations of S. scabiei mite infestation. Keywords: bullous, crusted, egg, hidden, incognito, masquerade, mimic, mite, nodular, Norwegian, pemphigoid, Sarcoptes scabiei, scabies, scalp, scybala, surrepticius

  2. Phototoxicity activity of Psoralea drupacea L. using Atremia salina bioassay system

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    Mohammad Ramezani

    2011-07-01

    Conclusion: The result showed that P. drupacea methanolic extract and chloroform fraction have phototoxicity in A. salina bioassay system and their toxic effect is related to phototoxic constituents such as psoralen.

  3. [Phototoxicity of Bergamot oil. Comparison between humans and guinea pigs].

    Science.gov (United States)

    Girard, J; Unkovic, J; Delahayes, J; Lafille, C

    1979-01-01

    Phototoxicity of bergamot oil in solar simulating radiation (SSR greater than or equal to 290 nm) and in long ultraviolet radiation (LUV greater than or equal to 320 nm) has been compared by studying photoaugmentation of erythema in the guinea pig after 24 h and pigmentary photoaugmentation in man on the 8th day. The results show that a close relationship exists between guinea pig and human responses, with both radiations used, and that man seems to be slightly more sensitive to phototoxic effects of bergamot oil than the guinea pig. This difference of sensitivity necessarily implies the participation of UVA (320--400 nm) in the phototoxic reaction of bergamot oil with solar radiation. This UVA participation is particularly obvious in the guinea pig; in man, the results are less clear and a certain synergy of UVB rays (290--320 nm) may be involved in the phototoxic UVA-induced reaction of bergamot oil. Despite these slight differences, the erythematous reaction in the guinea pig appears to be a remarkable experimental model to show out potential phototoxic reactions of products containing psoralens in man.

  4. Fagopyrins and Protofagopyrins: Detection, Analysis, and Potential Phototoxicity in Buckwheat.

    Science.gov (United States)

    Benković, Eva Tavčar; Kreft, Samo

    2015-06-24

    Buckwheat contains many healthy nutrients, and its consumption is therefore increasing. Buckwheat also contains fluorescent phototoxic fagopyrins. A systematic review of fagopyrins and the phototoxicity of buckwheat found that reliable quantitative data on fagopyrin toxicity are not yet available. Generally, buckwheat seeds, flour, and teas are safe in normal amounts. Diets extensively composed of buckwheat sprouts, herbs, and particularly flowers or of fagopyrin-rich buckwheat extracts may cause fagopyrism. A reference standard is needed, as it would enable the accurate evaluation of fagopyrin content in buckwheat products and would allow proper testing of their as yet unknown physical, chemical, and biological characteristics.

  5. Skin phototoxicity of cosmetic formulations containing photounstable and photostable UV-filters and vitamin A palmitate.

    Science.gov (United States)

    Gaspar, Lorena R; Tharmann, Julian; Maia Campos, Patricia M B G; Liebsch, Manfred

    2013-02-01

    The aim of this study was to evaluate the in vitro skin phototoxicity of cosmetic formulations containing photounstable and photostable UV-filters and vitamin A palmitate, assessed by two in vitro techniques: 3T3 Neutral Red Uptake Phototoxicity Test and Human 3-D Skin Model In Vitro Phototoxicity Test. For this, four different formulations containing vitamin A palmitate and different UV-filters combinations, two of them considered photostable and two of them considered photounstable, were prepared. Solutions of each UV-filter and vitamin under study and solutions of four different combinations under study were also prepared. The phototoxicity was assessed in vitro by the 3T3 NRU phototoxicity test (3T3-NRU-PT) and subsequently in a phototoxicity test on reconstructed human skin model (H3D-PT). Avobenzone presented a pronounced phototoxicity and vitamin A presented a tendency to a weak phototoxic potential. A synergistic effect of vitamin A palmitate on the phototoxicity of combinations containing avobenzone was observed. H3D-PT results did not confirm the positive 3T3-NRU-PT results. However, despite the four formulations studied did not present any acute phototoxicity potential, the combination 2 containing octyl methoxycinnamate (OMC), avobenzone (AVB) and 4-methylbenzilidene camphor (MBC) presented an indication of phototoxicity that should be better investigated in terms of the frequency of photoallergic or chronic phototoxicity in humans, once these tests are scientifically validated only to detect phototoxic potential with the aim of preventing phototoxic reactions in the general population, and positive results cannot predict the exact incidence of phototoxic reactions in humans.

  6. Aortoiliac occlusive disease masquerading as cerebrovascular accident

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    Nandeesh B

    2007-01-01

    Full Text Available Acute aortoiliac occlusion is an unusual but potentially catastrophic condition causing acute limb ischemia and associated with early and high rates of mortality and morbidity. It is caused by either embolic occlusion of the infra renal aorta at the bifurcation or beyond or thrombosis of the abdominal aorta and its large terminal branches. Neurological symptoms are rare manifestation of acute aortoiliac occlusion and when neurological symptoms predominate, patients are mistakenly considered to have cerebrovascular event. We present a 60-year-old man with atherosclerotic thrombotic occlusion of the left common iliac artery causing acute painful monoplegia. We mistook the acute monoplegia due to acute limb ischemia for cerebrovascular accident. Pathologic examination revealed a firm thrombus occluding the origin of left common iliac artery and extending along the length of the vessel. Acute aortic iliac occlusion can masquerade as a cerebrovascular stroke and a thorough clinical evaluation and imaging studies allow early diagnosis and instituting life-saving treatment timely.

  7. Phototoxicity of individual polycyclic aromatic hydrocarbons and petroleum to marine invertebrate larvae and juveniles

    Energy Technology Data Exchange (ETDEWEB)

    Pelletier, M.C.; Burgess, R.M.; Ho, K.T.; Kuhn, A.; McKinney, R.A.; Ryba, S.A. [Environmental Protection Agency, Narragansett, RI (United States)

    1997-10-01

    Phototoxicity resulting from photoactivated polycyclic aromatic hydrocarbons (PAHs) has been reported in the literature for a variety of freshwater organisms. The magnitude of increase in PAH toxicity often exceeds a factor of 100. In the marine environment phototoxicity to marine organisms has not been reported for individual or complex mixtures of PAHs. In this study, larvae and juveniles of the bivalve, Mulinia lateralis, and juveniles of the mysid shrimp, Mysidopsis bahia, were exposed to individual known phototoxic PAHs (anthracene, fluoranthene, pyrene), as well as the water-accommodated fractions of several petroleum products (Fuel Oil {number_sign}2, Arabian Light Crude, Prudhoe Bay Crude, Fuel Oil {number_sign}6) containing PAHs. Phototoxicity of individual PAHs was 12 to >50,000 times that of conventional toxicity. Three of the petroleum products demonstrated phototoxicity while the lightest product, Fuel Oil {number_sign}2, was not phototoxic at the concentrations tested. The phototoxicity of petroleum products appears to be dependent on the composition and concentrations of phototoxic PAHs present: lighter oils have fewer multiple aromatic ring, phototoxic compounds while heavier oils have higher levels of these types of molecules. This study shows that phototoxicity can occur in marine waters to marine species. Further, the occurrence of oil in marine waters presents the additional risk of phototoxicity not routinely assessed for during oil spills.

  8. Phototoxic reaction to a combined oral contraceptive (levonorgestrel/ethinylestradiol).

    Science.gov (United States)

    Richarz, N A; Aguilera, J; Castillo, G; Fuente, M J; Ferrándiz, C; Carrascosa, J M

    2017-09-13

    We present the case of a phototoxic skin reaction due to the regular intake of a combined oral contraceptive (levonorgestrel/ethinylestradiol). Upon spectrophotometer testing, we demonstrated high absorption in the UV-B region of the solar spectrum of the combined product (Ovoplex®), especially for the estrogen compound (ethinylestradiol).

  9. Protein Corona Prevents TiO2 Phototoxicity.

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    Maja Garvas

    Full Text Available TiO2 nanoparticles have generally low toxicity in the in vitro systems although some toxicity is expected to originate in the TiO2-associated photo-generated radical production, which can however be modulated by the radical trapping ability of the serum proteins. To explore the role of serum proteins in the phototoxicity of the TiO2 nanoparticles we measure viability of the exposed cells depending on the nanoparticle and serum protein concentrations.Fluorescence and spin trapping EPR spectroscopy reveal that the ratio between the nanoparticle and protein concentrations determines the amount of the nanoparticles' surface which is not covered by the serum proteins and is proportional to the amount of photo-induced radicals. Phototoxicity thus becomes substantial only at the protein concentration being too low to completely coat the nanotubes' surface.These results imply that TiO2 nanoparticles should be applied with ligands such as proteins when phototoxic effects are not desired - for example in cosmetics industry. On the other hand, the nanoparticles should be used in serum free medium or any other ligand free medium, when phototoxic effects are desired - as for efficient photodynamic cancer therapy.

  10. ENSEMBLE DESIGN OF MASQUERADER DETECTION SYSTEMS FOR INFORMATION SECURITY

    Directory of Open Access Journals (Sweden)

    T. Subbulakshmi

    2011-01-01

    Full Text Available Masqueraders are a category of intruders who impersonate other people on a computer system and use this entry point to use the information stored in the systems or throw other attacks into the network. This paper focuses on Ensemble Design of a Masquerader Detection System using Decision trees and Support Vector Machines for classification with two kernel functions linear and linear BSpline. The key idea is to find out specific patterns of command sequence that tells about user behaviour on a system, and use them to build classifiers that can perfectly recognize anomalous and normal behaviour. Real time truncated command line data set collected from a debian Linux server is used for performance comparison of the developed classifiers with the standard truncated command line data set of Schonlau[4]. The results show that Ensemble Design of Masquerader Detection Systems is much faster than individual Decision trees or Support Vector Machines.

  11. Masquerade Syndrome of Multicentre Primary Central Nervous System Lymphoma

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    Silvana Guerriero

    2011-01-01

    Full Text Available Purpose. In Italy we say that the most unlucky things can happen to physicians when they get sick, despite the attention of colleagues. To confirm this rumor, we report the sad story of a surgeon with bilateral vitreitis and glaucoma unresponsive to traditional therapies. Methods/Design. Case report. Results. After one year of steroidal and immunosuppressive therapy, a vitrectomy, and a trabeculectomy for unresponsive bilateral vitreitis and glaucoma, MRI showed a multicentre primary central nervous system lymphoma, which was the underlying cause of the masquerade syndrome. Conclusions. All ophthalmologists and clinicians must be aware of masquerade syndromes, in order to avoid delays in diagnosis.

  12. Unicentric Castleman’s Disease Masquerading Pancreatic Neoplasm

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    Saurabh Jain

    2012-01-01

    Full Text Available Castleman’s disease is a rare nonclonal proliferative disorder of the lymph nodes with an unknown etiology. Common locations of Castleman’s disease are mediastinum, neck, axilla, and abdomen. Castleman’s disease of a peripancreatic location masquerading as pancreatic neoplasm is an even rarer entity. On search of published data, we came across about 17 cases published on peripancreatic Castleman’s disease until now. Here we are reporting a case of retropancreatic Castleman's disease masquerading as retroperitoneal neoplasm in a 46-year-old male patient.

  13. Review of titanium dioxide nanoparticle phototoxicity: Developing a phototoxicity ratio to correct the endpoint values of toxicity tests.

    Science.gov (United States)

    Jovanović, Boris

    2015-05-01

    Titanium dioxide nanoparticles are photoactive and produce reactive oxygen species under natural sunlight. Reactive oxygen species can be detrimental to many organisms, causing oxidative damage, cell injury, and death. Most studies investigating TiO2 nanoparticle toxicity did not consider photoactivation and performed tests either in dark conditions or under artificial lighting that did not simulate natural irradiation. The present study summarizes the literature and derives a phototoxicity ratio between the results of nano-titanium dioxide (nano-TiO2 ) experiments conducted in the absence of sunlight and those conducted under solar or simulated solar radiation (SSR) for aquatic species. Therefore, the phototoxicity ratio can be used to correct endpoints of the toxicity tests with nano-TiO2 that were performed in absence of sunlight. Such corrections also may be important for regulators and risk assessors when reviewing previously published data. A significant difference was observed between the phototoxicity ratios of 2 distinct groups: aquatic species belonging to order Cladocera, and all other aquatic species. Order Cladocera appeared very sensitive and prone to nano-TiO2 phototoxicity. On average nano-TiO2 was 20 times more toxic to non-Cladocera and 1867 times more toxic to Cladocera (median values 3.3 and 24.7, respectively) after illumination. Both median value and 75% quartile of the phototoxicity ratio are chosen as the most practical values for the correction of endpoints of nano-TiO2 toxicity tests that were performed in dark conditions, or in the absence of sunlight.

  14. The 3T3 neutral red uptake phototoxicity test: Practical experience and implications for phototoxicity testing - The report of an ECVAM-EFPIA workshop

    NARCIS (Netherlands)

    Ceridono, M.; Tellner, P.; Bauer, D.; Barroso, J.; Alépée, N.; Corvi, R.; Smedt, A. de; Fellows, M.D.; Gibbs, N.K.; Heisler, E.; Jacobs, A.; Jirova, D.; Jones, D.; Kandárová,H.; Kasper, P.; Akunda, J.K.; Krul, C.; Learn, D.; Liebsch, M.; Lynch, A.M.; Muster, W.; Nakamura, K.; Nash, J.F.; Pfannenbecker, U.; Phillips, G.; Robles, C.; Rogiers, V.; Water, F. van de; Liminga, U.W.; Vohr, H.W.; Wattrelos, O.; Woods, J.; Zuang, V.; Kreysa, J.; Wilcox, P.

    2012-01-01

    This is the report from the “ECVAM–EFPIA workshop on 3T3 NRU Phototoxicity Test: Practical Experience and Implications for Phototoxicity Testing”, jointly organized by ECVAM and EFPIA and held on the 25–27 October 2010 in Somma Lombardo, Italy. The European Centre for the Validation of Alternative M

  15. Inflammatory myofibroblastic tumor masquerading as perforated appendicitis

    Directory of Open Access Journals (Sweden)

    Ioanna Mazotas

    2015-11-01

    Full Text Available Inflammatory myofibroblastic tumor (IMT is a rare and histologically benign tumor that most commonly presents in pediatric patients. Abdominal IMTs often present with non-specific symptoms, and therefore they can masquerade as other more common abdominal conditions. This report describes two cases of IMT presenting as perforated appendicitis. Both cases are of young children who presented with over 48 hours of abdominal pain and who had peritonitis on examination. Pre-operative ultrasounds for both patients revealed complex free fluid. Laparoscopic evaluation demonstrated hemoperitoneum, and further exploration revealed mesenteric avulsion with abnormally thickened mesentery. Pathology confirmed IMT arising from the small bowel mesentery in both cases. Both children underwent limited bowel resection and were discharged in stable condition on a course of non-steroidal anti-inflammatory drugs (NSAIDs. Given the association of avulsed bowel to trauma, non-accidental trauma was suspected in both cases and demonstrated in one. Both patients showed complete resolution of tumor on follow-up MRI. The diagnosis of IMT must always be considered when an intra-abdominal mass is encountered as its treatment differs greatly from other neoplasms.

  16. Intraocular Silicone Oil Masquerading as Terson Syndrome

    Directory of Open Access Journals (Sweden)

    Navid Elmi Sadr

    2016-01-01

    Full Text Available Introduction. Terson syndrome is described as intraocular hemorrhage in association with any type of intracranial hemorrhage and is associated with higher mortality rate and vision loss. Intraocular hemorrhage in Terson syndrome may be diagnosed using computed tomography but there are false positive results. Silicone oil which is widely used for internal tamponade of complicated retinal detachments has high attenuation on computed tomography and hyperintensity on T1-weighted magnetic resonance imaging that can mimic intraocular hemorrhage. This report shows that silicone oil is another origin of false positive results in interpreting CT findings for detecting Terson syndrome. Case Report. A 71-year-old diabetic woman presented with loss of consciousness. Brain computed tomography revealed right cerebellar hemorrhage and ventricular hemorrhage and hyperdensity in vitreous cavity of the left eye that was initially interpreted as vitreous hemorrhage. Terson syndrome was the initial diagnosis but ophthalmoscopic examination and brain MRI showed that the left eye had silicone oil tamponade. Conclusion. Without knowing the history of previous vitreoretinal surgery, CT scan findings of intraocular silicone oil may be interpreted as vitreous hemorrhage. In patients with concomitant intracranial hemorrhage, it can masquerade as Terson syndrome.

  17. Displacing lateral meniscus masquerading as patella dislocation.

    Science.gov (United States)

    Arendt, Elizabeth A; Fontboté, Cristián A; Rohr, Sara R

    2014-10-01

    To alert the treating clinician to an uncommon knee meniscal condition that often masquerades as a more common patella condition. Retrospective chart review of a series of cases was undertaken. A series of 12 knees in 11 patients were referred to an orthopaedic surgeon with a diagnosis of recurrent lateral patella dislocation. Three knees had undergone patella realignment surgery with continuance of symptoms. Eight patients had prior magnetic resonance images read as no meniscal pathology and no acute patella/patella retinacular injury. All patients presented for a consult with a similar history. Under anaesthesia, all knees had a stable patella as judged by physical examination. At the time of surgery, six patients had a frank tear in the lateral meniscus, all of which were readily displaceable. Six knees showed a displaceable lateral meniscus with attenuation but not a visible frank tear. Ten menisci were treated with repair, and two knees underwent partial lateral meniscectomies. Patient follow-up of minimally 18 months revealed no further episodes of "knee-cap dislocation" or symptoms of catching and locking. The clinician treating a patient with a history of a knee locking in flexion should have a high index of suspicion for a lateral meniscus tear or an unstable hypermobile lateral meniscus, despite patient report of perceived patella movement. History of symptoms occurring in knee flexion and attention to patella physical examination should be key factors in this diagnostic conundrum. Retrospective chart review, Level IV.

  18. Molecular pathway of near-infrared laser phototoxicity involves ATF-4 orchestrated ER stress.

    Science.gov (United States)

    Khan, Imran; Tang, Elieza; Arany, Praveen

    2015-06-01

    High power lasers are used extensively in medicine while lower power applications are popular for optical imaging, optogenetics, skin rejuvenation and a therapeutic modality termed photobiomodulation (PBM). This study addresses the therapeutic dose limits, biological safety and molecular pathway of near-infrared (NIR) laser phototoxicity. Increased erythema and tissue damage were noted in mice skin and cytotoxicity in cell cultures at phototoxic laser doses involving generation of reactive oxygen species (ROS) coupled with a rise in surface temperature (>45 °C). NIR laser phototoxicity results from Activating Transcription Factor-4 (ATF-4) mediated endoplasmic reticulum stress and autophagy. Neutralizations of heat or ROS and overexpressing ATF-4 were noted to rescue NIR laser phototoxicity. Further, NIR laser mediated phototoxicity was noted to be non-genotoxic and non-mutagenic. This study outlines the mechanism of NIR laser phototoxicity and the utility of monitoring surface temperature and ATF4 expression as potential biomarkers to develop safe and effective clinical applications.

  19. Phototoxic effects of 8-methoxypsoralen on rabbit corneal endothelium

    Energy Technology Data Exchange (ETDEWEB)

    Menon, I.A.; Basu, P.K.; Hasany, S.M.; Persad, S.D. (Univ. of Toronto, Ontario (Canada))

    1989-01-01

    The phototoxic effects of 8-methoxypsoralen (8-MOP) were investigated using the rabbit corneal endothelium in organ culture. The corneas were divided into four groups: (a) irradiated with a mercury vapor lamp (emitting UVA and visible radiation) in the presence of 8-MOP (experimental), (b) irradiated without 8-MOP (control A), (c) incubated with 8-MOP (control B) and (d) incubated without 8-MOP (control C). Specular and light microscopic examination showed that the experimental corneas had greater cellular damage compared to the control corneas. The effects of 8-MOP were restricted to certain localized areas of the cornea. However there was no significant difference in the amounts of 51Cr released from the labelled experimental and control corneas. These results show phototoxic damage of the corneal endothelial cells.

  20. Cervical perineural cyst masquerading as a cervical spinal tumor.

    Science.gov (United States)

    Joshi, Vijay P; Zanwar, Atul; Karande, Anuradha; Agrawal, Amit

    2014-04-01

    Tarlov (perineural) cysts of the nerve roots are common and usually incidental findings during magnetic resonance imaging of the lumbosacral spine. There are only a few case reports where cervical symptomatic perineural cysts have been described in the literature. We report such a case where a high cervical perineural cyst was masquerading as a cervical spinal tumor.

  1. Endometrioma in a virgin abdomen masquerading as an intramuscular lipoma

    OpenAIRE

    2015-01-01

    Endometriosis is the presence of endometrial tissue outside the uterine cavity. It has been previously reported in the abdominal wall secondary to gynaecological surgery. We present the case of a 32-year woman with endometrioma of the abdominal wall masquerading as an intramuscular lipoma with no previous surgical history.

  2. Endometrioma in a virgin abdomen masquerading as an intramuscular lipoma.

    Science.gov (United States)

    Al Shakarchi, J; Bohra, A

    2015-03-18

    Endometriosis is the presence of endometrial tissue outside the uterine cavity. It has been previously reported in the abdominal wall secondary to gynaecological surgery. We present the case of a 32-year woman with endometrioma of the abdominal wall masquerading as an intramuscular lipoma with no previous surgical history.

  3. Cervical Perineural Cyst Masquerading as a Cervical Spinal Tumor

    Science.gov (United States)

    Joshi, Vijay P; Zanwar, Atul; Karande, Anuradha

    2014-01-01

    Tarlov (perineural) cysts of the nerve roots are common and usually incidental findings during magnetic resonance imaging of the lumbosacral spine. There are only a few case reports where cervical symptomatic perineural cysts have been described in the literature. We report such a case where a high cervical perineural cyst was masquerading as a cervical spinal tumor. PMID:24761204

  4. Phototoxic and contact toxic reactions of the exocarp of sweet oranges: a common cause of cheilitis?

    Science.gov (United States)

    Volden, G; Krokan, H; Kavli, G; Midelfart, K

    1983-05-01

    Irritant skin reactions were produced within 1 h after application of the exocarp of sweet oranges or alcoholic extracts therefrom. Such reactions faded within 48 h. The exocarp, or extracts thereof, induced phototoxic reactions which were strongest at 72 h after exposure. The phototoxic reactions were only induced in natural blondes and only with some oranges. The in vivo phototoxic reactions were confirmed in vitro, causing a slight but clear photo-inhibition of Candida albicans. Only some oranges inhibited growth.

  5. Accidental bullous phototoxic reactions to bergamot aromatherapy oil.

    Science.gov (United States)

    Kaddu, S; Kerl, H; Wolf, P

    2001-09-01

    Oil of bergamot is an extract from the rind of bergamot orange (Citrus aurantium ssp bergamia) that has a pleasant, refreshing scent; until a few years ago it had been widely used as an ingredient in cosmetics but was restricted or banned in most countries because of certain adverse effects. More recently, oil of bergamot preparations have been gaining renewed popularity in aromatherapy. Oil of bergamot possesses photosensitive and melanogenic properties because of the presence of furocoumarins, primarily bergapten (5-methoxypsoralen [5-MOP]). However, 5-MOP is also potentially phototoxic and photomutagenic. Despite its increasing application, there are only a few recent reports of phototoxic reactions to bergamot aromatherapy oil. We describe two patients with localized and disseminated bullous phototoxic skin reactions developing within 48 to 72 hours after exposure to bergamot aromatherapy oil and subsequent ultraviolet exposure. One patient (case 2) had no history of direct contact with aromatherapy oil but developed bullous skin lesions after exposure to aerosolized (evaporated) aromatherapy oil in a sauna and subsequent UVA radiation in a tanning salon. This report highlights the potential health hazard related to the increasing use of psoralen-containing aromatherapy oils.

  6. Phototoxicity of petroleum products to marine invertebrate larvae and niles

    Energy Technology Data Exchange (ETDEWEB)

    Pelletier, M.C.; Burgess, R.; Ho, K.; Kuhn, A; McKinney, R.; Ryba, S. [Environmental Protection Agency, Narragansett, RI (United States)

    1995-12-31

    Ultraviolet light can activate certain polycyclic aromatic hydrocarbons (PAHs), inducing the production of free radicals. In biological organisms these free radicals destroy tissues, causing up to a 4,000 fold increase in toxicity. This dramatic response is a potential marker for PAH contamination in environmental samples. Ultraviolet enhancement of toxicity has ecological relevance as well. An oil spill can release large amounts of PAHs into the marine environment. Oil spill assessments to date have not included observations of any phototoxic effect on pelagic larvae or juveniles of benthic or epibenthic invertebrates. In this study, larvae and juveniles of the bivalve, Mulinia lateralis and juveniles of the mysid shrimp, Mysidopsis bahia were exposed to individual PAHs, as well as the water accommodated fractions of several petroleum products to verify the ability of this method to detect PAHs in environmental samples, and to determine if phototoxicity is a concern during and after an oil spill. Significant phototoxicity was seen in both single chemical and petroleum product exposures. Swartz`s EPAH model was not applicable to the authors` results. They hoped to show causality but were not fully successful due to the need to further develop the model with their species and expand the number of PAH analyzed.

  7. Role of flavonoids in controlling the phototoxicity of Hypericum perforatum extracts.

    Science.gov (United States)

    Wilhelm, K P; Biel, S; Siegers, C P

    2001-07-01

    Hypericum perforatum extracts are used mainly as oral antidepressants. Depending on source the extracts contain various amounts of phenylpropanes, flavonol derivates, biflavones, proathocyanidines, xanthones, phloroglucinoles, some amino acids, naphtodianthrones (hypericines) and essential oil constituents. The therapeutic use of Hypericum perforatum extracts however is limited by their phototoxic potential. It was the aim of the present study to investigate the phototoxic potential of 3 Hypericum perforatum extracts from different sources as well as some of its main constituents. In order to systematically study the phototoxic potential we established a modified neutral red assay utilizing an immortalized human keratinocyte cell line (HaCaT cells) as substrate and UVA irradiation. This modified neutral red assay was found to be a simple and reliable method for detecting phototoxic effects of reference agents and plant extracts. The validity of this method was demonstrated with known phototoxic compounds like chloropromazine and psoralenes like 5-MOP. Hypericum perforatum extracts demonstrated cytotoxicity and photocytotoxicity in a dose and UVA-dose dependent manner. Hypericine itself also evoked severe phototoxic effects and was thus identified as the main phototoxic constituent. Among the tested flavonoids quercitrin was found to be cytotoxic, while rutin unexpectedly demonstrated phototoxicity whereas quercitrin was effective to control the phototoxic activity of Hypericum perforatum extracts.

  8. Reliable Screening of Dye Phototoxicity by Using a Caenorhabditis elegans Fast Bioassay.

    Science.gov (United States)

    Bianchi, Javier Ignacio; Stockert, Juan Carlos; Buzzi, Lucila Ines; Buzz, Lucila Ines; Blázquez-Castro, Alfonso; Simonetta, Sergio Hernán

    2015-01-01

    Phototoxicity consists in the capability of certain innocuous molecules to become toxic when subjected to suitable illumination. In order to discover new photoactive drugs or characterize phototoxic pollutants, it would be advantageous to use simple biological tests of phototoxicy. In this work, we present a pilot screening of 37 dyes to test for phototoxic effects in the roundworm Caenorhabditis elegans. Populations of this nematode were treated with different dyes, and subsequently exposed to 30 min of white light. Behavioral outcomes were quantified by recording the global motility using an infrared tracking device (WMicrotracker). Of the tested compounds, 17 dyes were classified as photoactive, being phloxine B, primuline, eosin Y, acridine orange and rose Bengal the most phototoxic. To assess photoactivity after uptake, compounds were retested after washing them out of the medium before light irradiation. Dye uptake into the worms was also analyzed by staining or fluorescence. All the positive drugs were incorporated by animals and produced phototoxic effects after washing. We also tested the stress response being triggered by the treatments through reporter strains. Endoplasmic reticulum stress response (hsp-4::GFP strain) was activated by 22% of phototoxic dyes, and mitochondrial stress response (hsp-6::GFP strain) was induced by 16% of phototoxic dyes. These results point to a phototoxic perturbation of the protein functionality and an oxidative stress similar to that reported in cell cultures. Our work shows for the first time the feasibility of C. elegans for running phototoxic screenings and underscores its application on photoactive drugs and environmental pollutants assessment.

  9. Case 215: voriconazole-induced periostitis.

    Science.gov (United States)

    Tailor, Tina D; Richardson, Michael L

    2015-03-01

    History A 74-year-old woman presented with multifocal bone pain, including pain in multiple ribs, bilateral shoulders, and bilateral hips. The pain began several months before presentation and was quite severe, ultimately necessitating control with narcotics. At examination, strength in both lower extremities was slightly reduced, sensation and reflexes were intact, and range of motion was full, though painful. There were no notable constitutional symptoms of fever or weight loss. Laboratory work-up was remarkable for elevated alkaline phosphatase level (277 U/L [4.6 mkat/L]). The patient had undergone left lung transplantation 8 years prior for pulmonary fibrosis. A thorough pulmonary work-up for the cause of fibrosis, which included gathering an exposure, occupational, allergy, and previous infectious history, and a rheumatoid work-up were negative. The patient's posttransplantation course was complicated by bronchiolitis obliterans from chronic rejection and by recent pulmonary embolism, for which she was undergoing anticoagulation therapy at the time of presentation. Additionally, the patient experienced repeated pulmonary infections with Aspergillus, leading to multiple hospitalizations and long-term antifungal prophylaxis with voriconazole. A bone scan from an outside hospital was reviewed, and further imaging was performed.

  10. Combination of retinyl palmitate and UV-filters: phototoxic risk assessment based on photostability and in vitro and in vivo phototoxicity assays.

    Science.gov (United States)

    Benevenuto, Carolina Gomes; Guerra, Lucas Offenbecker; Gaspar, Lorena Rigo

    2015-02-20

    This study aimed to assess the phototoxic potential of combined UV-filters and retinyl palmitate (RP) in the presence or not of bemotrizinol (BMTZ), employing photostability and in vitro and in vivo phototoxicity assays. The formulations tested contained octocrylene (OCT), octyl methoxycinnamate (OMC), benzophenone-3 (BZP-3) and RP (photostable) or octocrylene (OCT), octyl methoxycinnamate (OMC), avobenzone (AVO) and RP (less photostable). Both formulations were supplemented with bemotrizinol. Photostability was evaluated by exposing, or not, formulations spread on a glass plate to UVA/UVB irradiation. The resulting products were quantified by HPLC analysis. In vitro phototoxicity of UV-filters and combinations were evaluated using 3T3 viable monolayer fibroblast cultures submitted, or not, to irradiation according to OECD TG 432. In vivo photoallergy and photoxicity were assessed by clinical studies (photopatch test). Photostability assays showed that UV-filter bemotrizinol was a better photostabilizer for RP/benzophenone-3 than for RP/avobenzone. The in vitro phototoxicity of the combination RP/avobenzone was reduced by bemotrizinol. Clinical studies did not indicate phototoxic or photoallergenic potentials in all formulations tested. It is concluded that the 3T3 NRU phototoxicity test may be considered a supplementary assay in formulation developments, since it can detect chemically unstable and potentially phototoxic combinations. However, extrapolation of in vitro positive results to human photopatch tests may be performed only to a limited extent. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Phototoxicity Evaluation of Pharmaceutical Substances with a Reactive Oxygen Species Assay Using Ultraviolet A.

    Science.gov (United States)

    Lee, Yong Sun; Yi, Jung-Sun; Lim, Hye Rim; Kim, Tae Sung; Ahn, Il Young; Ko, Kyungyuk; Kim, JooHwan; Park, Hye-Kyung; Sohn, Soo Jung; Lee, Jong Kwon

    2017-01-01

    With ultraviolet and visible light exposure, some pharmaceutical substances applied systemically or topically may cause phototoxic skin irritation. The major factor in phototoxicity is the generation of reactive oxygen species (ROS) such as singlet oxygen and superoxide anion that cause oxidative damage to DNA, lipids and proteins. Thus, measuring the generation of ROS can predict the phototoxic potential of a given substance indirectly. For this reason, a standard ROS assay (ROS assay) was developed and validated and provides an alternative method for phototoxicity evaluation. However, negative substances are over-predicted by the assay. Except for ultraviolet A (UVA), other UV ranges are not a major factor in causing phototoxicity and may lead to incorrect labeling of some non-phototoxic substances as being phototoxic in the ROS assay when using a solar simulator. A UVA stimulator is also widely used to evaluate phototoxicity in various test substances. Consequently, we identified the applicability of a UVA simulator to the ROS assay for photoreactivity. In this study, we tested 60 pharmaceutical substances including 50 phototoxins and 10 non-phototoxins to predict their phototoxic potential via the ROS assay with a UVA simulator. Following the ROS protocol, all test substances were dissolved in dimethyl sulfoxide or sodium phosphate buffer. The final concentration of the test solutions in the reaction mixture was 20 to 200 μM. The exposure was with 2.0~2.2 mW/cm(2) irradiance and optimization for a relevant dose of UVA was performed. The generation of ROS was compared before and after UVA exposure and was measured by a microplate spectrophotometer. Sensitivity and specificity values were 85.7% and 100.0% respectively, and the accuracy was 88.1%. From this analysis, the ROS assay with a UVA simulator is suitable for testing the photoreactivity and estimating the phototoxic potential of various test pharmaceutical substances.

  12. Mimicry and masquerade from the avian visual perspective

    Directory of Open Access Journals (Sweden)

    Mary Caswell STODDARD

    2012-08-01

    Full Text Available Several of the most celebrated examples of visual mimicry, like mimetic eggs laid by avian brood parasites and pala­table insects mimicking distasteful ones, involve signals directed at the eyes of birds. Despite this, studies of mimicry from the avian visual perspective have been rare, particularly with regard to defensive mimicry and masquerade. Defensive visual mimicry, which includes Batesian and Müllerian mimicry, occurs when organisms share a visual signal that functions to deter predators. Masquerade occurs when an organism mimics an inedible or uninteresting object, such as a leaf, stick, or pebble. In this paper, I present five case studies covering diverse examples of defensive mimicry and masquerade as seen by birds. The best-known cases of defensive visual mimicry typically come from insect prey, but birds themselves can exhibit defensive visual mimicry in an attempt to escape mobbing or dissuade avian predators. Using examples of defensive visual mimicry by both insects and birds, I show how quantitative models of avian color, luminance, and pattern vision can be used to enhance our understanding of mimicry in many systems and produce new hypotheses about the evolution and diversity of signals. Overall, I investigate examples of Batesian mimicry (1 and 2, Müllerian mimicry (3 and 4, and masquerade (5 as follows: 1 Polymorphic mimicry in African mocker swallowtail butterflies; 2 Cuckoos mimicking sparrowhawks; 3 Mimicry rings in Neotropical butterflies; 4 Plumage mimicry in toxic pitohuis; and 5 Dead leaf-mimicking butterflies and mantids [Current Zoology 58 (4: 630–648, 2012].

  13. Huntington’s disease masquerading as spinocerebellar ataxia

    OpenAIRE

    Rodríguez-Quiroga, Sergio Alejandro; Gonzalez-Morón, Dolores; Garretto, Nelida; Kauffman, Marcelo Andres

    2013-01-01

    Huntington’s disease (HD) is a neurodegenerative disorder of the central nervous system characterised by the presence of choreic abnormal movements, behavioural or psychiatric disturbances and dementia. Noteworthy, despite atypical motor symptoms other than chorea have been reported as initial presentation in some patients, a very few number of HD patients, presenting at onset mostly cerebellar dysfunction masquerading dominant spinocerebellar ataxias (SCA), were occasionally reported. We rep...

  14. Metastatic Prostate Cancer to the Urethra Masquerading as Urothelial Carcinoma

    OpenAIRE

    Zardawi, Ibrahim; Chong, Peter

    2016-01-01

    Tumors of the urethra, whether primary or metastatic, are very rare. The true nature of urethral neoplasm is not always obvious clinically nor in routine histological sections. Immunostains should be performed on such lesions because of management implications. We present a case of multiple metastases to the urethra from a prostatic carcinoma, masquerading as multiple urothelial carcinomas. Pathologists and urologists should be aware of the possibility of metastasis from the prostate.

  15. Metastatic Prostate Cancer to the Urethra Masquerading as Urothelial Carcinoma.

    Science.gov (United States)

    Zardawi, Ibrahim; Chong, Peter

    2016-07-01

    Tumors of the urethra, whether primary or metastatic, are very rare. The true nature of urethral neoplasm is not always obvious clinically nor in routine histological sections. Immunostains should be performed on such lesions because of management implications. We present a case of multiple metastases to the urethra from a prostatic carcinoma, masquerading as multiple urothelial carcinomas. Pathologists and urologists should be aware of the possibility of metastasis from the prostate.

  16. Metastatic Prostate Cancer to the Urethra Masquerading as Urothelial Carcinoma

    Directory of Open Access Journals (Sweden)

    Ibrahim Zardawi

    2016-07-01

    Full Text Available Tumors of the urethra, whether primary or metastatic, are very rare. The true nature of urethral neoplasm is not always obvious clinically nor in routine histological sections. Immunostains should be performed on such lesions because of management implications. We present a case of multiple metastases to the urethra from a prostatic carcinoma, masquerading as multiple urothelial carcinomas. Pathologists and urologists should be aware of the possibility of metastasis from the prostate.

  17. Mimicry and masquerade from the avian visual perspective

    Institute of Scientific and Technical Information of China (English)

    Mary Caswell STODDARD

    2012-01-01

    Several of the most celebrated examples of visual mimicry,like mimetic eggs laid by avian brood parasites and palatable insects mimicking distasteful ones,involve signals directed at the eyes of birds.Despite this,studies of mimicry from the avian visual perspective have been rare,particularly with regard to defensive mimicry and masquerade.Defensive visual mimicry,which includes Batesian and Müllerian mimicry,occurs when organisms share a visual signal that functions to deter predators.Masquerade occurs when an organism mimics an inedible or uninteresting object,such as a leaf,stick,or pebble.In this paper,I present five case studies covering diverse examples of defensive mimicry and masquerade as seen by birds.The best-known cases of defensive visual mimicry typically come from insect prey,but birds themselves can exhibit defensive visual mimicry in an attempt to escape mobbing or dissuade avian predators.Using examples of defensive visual mimicry by both insects and birds,I show how quantitative models of avian color,luminance,and pattern vision can be used to enhance our understanding of mimicry in many systems and produce new hypotheses about the evolution and diversity of signals.Overall,I investigate examples of Batesian mimicry (1 and 2),Müllerian mimicry (3 and 4),and masquerade (5) as follows:1) Polymorphic mimicry in African mocker swallowtail butterflies; 2) Cuckoos mimicking sparrowhawks; 3) Mimicry rings in Neotropical butterflies; 4) Plumage mimicry in toxic pitohuis; and 5) Dead leaf-mimicking butterflies and mantids.

  18. A bioassay using Artemia salina for detecting phototoxicity of plant coumarins.

    Science.gov (United States)

    Ojala, T; Vuorela, P; Kiviranta, J; Vuorela, H; Hiltunen, R

    1999-12-01

    Artemia salina (brine shrimp) has been successfully used for toxicity testing, and a screening test for phototoxicity has been developed based on this method. The ability of the method to test the phototoxic potential of seven known compounds was investigated. Athamantin (an angular furanocoumarin) and umbelliferone (a simple coumarin) showed no phototoxicity, while linear furanocoumarins exhibited phototoxic activity in the following order: psoralen > bergapten > peucedanin > xanthotoxin. The applicability of this method was also tested in screening the phototoxicity of plant material. Six plants from Apiaceae [Aegopodium podagraria L., Anethum graveolens L., Angelica archangelica L., Levisticum officinalis Koch, Petroselinum crispum (P. Mill) A. W. Hill., and Peucedanum palustre (L.) Moench] and one from Rutaceae (Ruta graveolens L.) were selected, all of them known to contain furanocoumarins. Extracts from leaves collected at different times during the growth period were used in the screening. Our results were in accordance with the furanocoumarin content of these plants and with the results of other phototoxicity tests. The Artemia salina method proved to be rapid, simple and inexpensive, and is therefore ideal in the initial biological screening of large numbers of samples for simultaneous detection of both toxicity and phototoxicity.

  19. Phototoxicity of bergamot oil assessed by in vitro techniques in combination with human patch tests.

    Science.gov (United States)

    Kejlová, K; Jírová, D; Bendová, H; Kandárová, H; Weidenhoffer, Z; Kolárová, H; Liebsch, M

    2007-10-01

    The aim of this study was to clarify the differences in the phototoxicity of bergamot oil obtained from four different suppliers. Spectral and chemical analyses were performed to identify presence of photoactive compounds in the test samples. The phototoxicity was assessed in vitro by the 3T3 NRU phototoxicity test (PT) and subsequently in a phototoxicity test on reconstructed human skin model (H3D PT). Confirmatory photopatch tests in a group of volunteers were performed using the first non-phototoxic concentration determined in the H3D PT. The spectral and chemical analyses revealed, that two samples of bergamot oil exhibited a potential for photoactivation. These oils were subsequently classified as phototoxic in the 3T3 NRU PT, however, only on the basis of borderline results and depending on the solvent used. H3D PT revealed clear classifications, correlating well with the findings of spectral and chemical analysis. The test was, however, not yet capable of precise prediction of safe, non-phototoxic concentrations. Additional endpoints, e.g. interleukin determination might be employed to increase the sensitivity of the test. Although the study showed the usefulness of the tiered testing strategy, currently, the extrapolation of in vitro results to human situation may be performed only to a limited extent.

  20. Reliable Screening of Dye Phototoxicity by Using a Caenorhabditis elegans Fast Bioassay.

    Directory of Open Access Journals (Sweden)

    Javier Ignacio Bianchi

    Full Text Available Phototoxicity consists in the capability of certain innocuous molecules to become toxic when subjected to suitable illumination. In order to discover new photoactive drugs or characterize phototoxic pollutants, it would be advantageous to use simple biological tests of phototoxicy. In this work, we present a pilot screening of 37 dyes to test for phototoxic effects in the roundworm Caenorhabditis elegans. Populations of this nematode were treated with different dyes, and subsequently exposed to 30 min of white light. Behavioral outcomes were quantified by recording the global motility using an infrared tracking device (WMicrotracker. Of the tested compounds, 17 dyes were classified as photoactive, being phloxine B, primuline, eosin Y, acridine orange and rose Bengal the most phototoxic. To assess photoactivity after uptake, compounds were retested after washing them out of the medium before light irradiation. Dye uptake into the worms was also analyzed by staining or fluorescence. All the positive drugs were incorporated by animals and produced phototoxic effects after washing. We also tested the stress response being triggered by the treatments through reporter strains. Endoplasmic reticulum stress response (hsp-4::GFP strain was activated by 22% of phototoxic dyes, and mitochondrial stress response (hsp-6::GFP strain was induced by 16% of phototoxic dyes. These results point to a phototoxic perturbation of the protein functionality and an oxidative stress similar to that reported in cell cultures. Our work shows for the first time the feasibility of C. elegans for running phototoxic screenings and underscores its application on photoactive drugs and environmental pollutants assessment.

  1. Phototoxic maculopathy induced by quartz infrared heat lamp

    Science.gov (United States)

    Zheng, Xinhua; Xie, Ping; Hu, Zizhong; Zhang, Weiwei; Liang, Kang; Wang, Xiuying; Liu, Qinghuai

    2017-01-01

    Abstract Rationale: A large proportion of the output of quartz infrared heat lamps is emitted as infrared radiation (IR). Retinal damage induced by IR-A and visible light on arc welders has been reported. However, case reports of retinal damage caused by quartz infrared heat lamps are rare. To the best of our knowledge, this is the first reported case of phototoxic maculopathy induced by quartz infrared heat lamps. Patient concerns: We report a female with a 1-month history of progressive blurred vision and dysmorphopsia in her right eye after improper staring at the tubes of a quartz infrared heater. Her best corrected visual acuity of the right eye was 20/32. Optical coherence tomography revealed a defect from the ellipsoid zone to retinal pigment epithelium (RPE)/Bruch's complex layer with a diameter of 360mmat its widest. P1 amplitudes in the two central concentric rings were reduced as assessed by multifocal electroretinography. Diagnoses: The patient was diagnosed with phototoxic maculopathy. Interventions: The patient was advised to cease all exposure to the infrared heater and was treated with peribulbar injections of methylprednisolone, oral Pancreatic Kininogenase, and oral Mecobalamin. Outcomes: Ten months later, her BCVA improved to 20/20. All examination results returned to normal except for a small residual defect in the interdigitation zone and RPE/Bruch's complex layer in her optical coherence tomography. Lessons: Light emitted by quartz infrared heat lamps may cause damage to the retina through photothermal and photochemical means. The public is insufficiently aware of the hazard potential of infrared heat lamps and other IR-A sources on human retina. PMID:28099337

  2. The in vivo rat skin photomicronucleus assay: Phototoxicity and photogenotoxicity evaluation of six fluoroquinolones

    NARCIS (Netherlands)

    Reus, A.A.; Usta, M.; Kenny, J.D.; Clements, P.J.; Pruimboom-Brees, I.; Aylott, M.; Lynch, A.M.; Krul, C.A.M.

    2012-01-01

    An in vivo photomicronucleus test (MNT) using rat skin, the target organ for photoirritancy and carcinogenicity, was recently described. The assay was evaluated using fluoroquinolone (FQ) antibiotics with varying degrees of phototoxic potency (i.e. sparflocacin [SPFX], lomefloxacin [LOFX],

  3. Trichilemmal Cyst of the Eyelid: Masquerading as Recurrent Chalazion

    Science.gov (United States)

    Meena, Manju; Mittal, Ruchi; Saha, Debarati

    2012-01-01

    A 52-years-old female presented with a history of a painless, progressive swelling in the left lower eyelid of one-year duration. The lesion was excised twice as a chalazion and recurred. Excisional biopsy of the mass was performed and histopathological findings were consistent with those of trichilemmal cyst. We report a rare case of trichilemmal cyst of the eyelid which was masquerading as chalazion for which the patient had undergone multiple surgeries. Wide excision was done and diagnosis was confirmed on histopathology. There was no recurrence seen till 2 months of postoperative period. Trichilemmal cyst, although rare, should be considered as differential diagnosis of recurrent chalazion. PMID:22606489

  4. Trichilemmal Cyst of the Eyelid: Masquerading as Recurrent Chalazion

    Directory of Open Access Journals (Sweden)

    Manju Meena

    2012-01-01

    Full Text Available A 52-years-old female presented with a history of a painless, progressive swelling in the left lower eyelid of one-year duration. The lesion was excised twice as a chalazion and recurred. Excisional biopsy of the mass was performed and histopathological findings were consistent with those of trichilemmal cyst. We report a rare case of trichilemmal cyst of the eyelid which was masquerading as chalazion for which the patient had undergone multiple surgeries. Wide excision was done and diagnosis was confirmed on histopathology. There was no recurrence seen till 2 months of postoperative period. Trichilemmal cyst, although rare, should be considered as differential diagnosis of recurrent chalazion.

  5. Strongyloidiasis of duodenum clinically masquerading as gastric malignancy

    Directory of Open Access Journals (Sweden)

    V Srinivasa Murthy

    2013-01-01

    Full Text Available A 58-year-old male patient presented with pain abdomen since 1 month and bilious vomiting since 1 week. After admission to our hospital, in view of his age and clinical presentation, upper gastrointestinal endoscopy was done and biopsy sent for histopathological examination. A diagnosis of Strongyloidiasis of duodenum was made. Herein, we report such an unusual case, where the diagnosis was first made by duodenal biopsy, rather than simple stool examination. Since the case clinically masqueraded as gastric malignancy, the importance of routine simple stool examination and role of pathologist in identifying the parasite is hereby highlighted.

  6. In Vitro Cytotoxicity and Phototoxicity Assessment of Acylglutamate Surfactants Using a Human Keratinocyte Cell Line

    OpenAIRE

    Abhay Kyadarkunte; Milind Patole; Varsha Pokharkar

    2014-01-01

    In the current study, human keratinocyte cell line was used as in vitro cell culture model to elucidate the effects of the fatty acid chain length of acylglutamate (amino acid-based surfactant) namely, sodium cocoyl glutamate, sodium lauroyl glutamate, and sodium myristoyl glutamate on their cytotoxicity and the ultraviolet B induced phototoxicity. The endpoint used to assess toxicity was a tetrazolium-based assay whereas, the phototoxic potential of acylglutamate surfactants was predicted u...

  7. Effects of material morphology on the phototoxicity of nano-TiO2 to bacteria.

    Science.gov (United States)

    Tong, Tiezheng; Shereef, Anas; Wu, Jinsong; Binh, Chu Thi Thanh; Kelly, John J; Gaillard, Jean-François; Gray, Kimberly A

    2013-01-01

    Nanostructured titania (nano-TiO2) is produced in diverse shapes, but it remains largely unknown how tuning the morphology of nano-TiO2 may alter its toxicity. Herein, we show that material morphology plays a critical role in regulating the phototoxicity of nano-TiO2 to bacteria. Low-dimensional nano-TiO2, including nanotubes, nanorods, and nanosheets, were synthesized hydrothermally, and their effects on the bacterial viability of Escherichia coli and Aeromonas hydrophila were compared to spherical nanostructures (anatase nanospheres and P25). Results reveal that TiO2 nanotubes and nanosheets are less phototoxic than their rod- and sphere-shape counterparts under simulated solar irradiation. None of the tested nano-TiO2 shows toxicity in the dark. In contrast to their diminished phototoxicity, however, TiO2 nanotubes and nanosheets exhibit comparable or even higher photoactivity than other nanostructures. Observations by scanning transmission electron microscopy suggest that material morphology influences nano-TiO2 phototoxicity by governing how nano-TiO2 particles align at the bacterial cell surface. Overall, when comparing materials with different morphologies and dimensionality, nano-TiO2 phototoxicity is not a simple function of photocatalytic reactivity or ROS production. Instead, we propose that the evaluation of nano-TiO2 phototoxicity encompasses a three-pronged approach, involving the intrinsic photoactivity, aggregation of nano-TiO2, and the nano-TiO2/bacteria surface interactions.

  8. Mangiferin and naringenin affect the photostability and phototoxicity of sunscreens containing avobenzone.

    Science.gov (United States)

    Kawakami, Camila Martins; Gaspar, Lorena Rigo

    2015-10-01

    Efficient UV-absorbing molecules are designed to protect against UV-light exposure. However, the development of photostable sunscreens is important to preserve the photoprotective efficacy and to prevent the formation of reactive oxygen species (ROS) and photodegradation products, which can promote phototoxic or photoallergic contact dermatitis. The aim of this study was to evaluate the effects of mangiferin and naringenin on the photostability and phototoxicity of sunscreens containing avobenzone. Cosmetic sunscreen formulations containing octocrylene (OCT), octyl methoxycinnamate (OMC) and avobenzone (AVO) were prepared and supplemented or not with mangiferin, naringenin, or with both compounds in combination. For photostability studies, samples of the formulations were spread onto glass plates, exposed to UVA radiation and then analyzed by high performance liquid chromatography (HPLC) to determine UV filters and the antioxidants recovery. The phototoxicity of the UV filters and antioxidants was evaluated using 3T3 fibroblast cultures that were subjected (or not) to irradiation according to OECD TG 432. The photostability studies demonstrated that AVO and naringenin showed the highest photodegradation when present in formulation FN (containing octocrylene, avobenzone, octyl methoxycinnamate and naringenin). The addition of mangiferin to this combination (FMN) resulted in an improved photostability of both substances compared to FN. The in vitro phototoxicity test showed that only avobenzone was considered phototoxic. The combination containing AVO/naringenin exhibited phototoxic potential; however, this was reduced by the addition of mangiferin (combination CMN). The results of this study are promising because it was demonstrated that mangiferin could increase the photostability and reduce the phototoxic potential of the combination of naringenin and AVO. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Delayed phlegmon with gallstone fragments masquerading as soft tissue sarcoma

    Science.gov (United States)

    Goodman, Laura F.; Bateni, Cyrus P.; Bishop, John W.; Canter, Robert J.

    2016-01-01

    Complications from lost gallstones after cholecystectomy are rare but varied from simple perihepatic abscess to empyema and expectoration of gallstones. Gallstone complications have been reported in nearly every organ system, although reports of malignant masquerade of retained gallstones are few. We present the case of an 87-year-old woman with a flank soft tissue tumor 4 years after laparoscopic cholecystectomy. The initial clinical, radiographic and biopsy findings were consistent with soft tissue sarcoma (STS), but careful review of her case in multidisciplinary conference raised the suspicion for retained gallstones rather than STS. The patient was treated with incisional biopsy/drainage of the mass, and gallstones were retrieved. The patient recovered completely without an extensive resectional procedure, emphasizing the importance of multidisciplinary sarcoma care to optimize outcomes for potential sarcoma patients. PMID:27333918

  10. Masquerade syndrome:Retinoblastoma presenting as phacolytic glaucoma

    Institute of Scientific and Technical Information of China (English)

    Li-Jing Peng; Syed Shoeb Ahmad; Nor Haizura Bt Abd Rani; May May Choo; Shuaibah Abdul Ghani

    2016-01-01

    We aim to report an uncommon presentation of retinoblastoma and its management. A 4-year-old boy presented with left eye pain for 1 week with eye redness after being hit by a ball. On examination, the visual acuity in his right eye was 6/6 and left eye was no perception to light. The conjunctiva in his left eye was injected and cornea was edematous. There was pseudohypopyon inferiorly. Lens was opaque and there was no fundus view. Intraocular pressure was 50 mmHg. Patient was initially treated as phacolytic glaucoma with severe inflammation. B scan showed intralesional calcification with retinal detachment. CT orbit showed left intraocular mass with calcification and optic nerve involvement. Thus, our final diagnosis was left eye retinoblastoma. Patient was performed a enucleation with chemotherapy in left eye. One year after the treatment, there was no local and distant invasion of the tumor. Anterior inflammation is a rare form of masquerade syndrome associated with retinoblastoma.

  11. Generating a Corpus of Mobile Forensic Images for Masquerading user Experimentation.

    Science.gov (United States)

    Guido, Mark; Brooks, Marc; Grover, Justin; Katz, Eric; Ondricek, Jared; Rogers, Marcus; Sharpe, Lauren

    2016-11-01

    The Periodic Mobile Forensics (PMF) system investigates user behavior on mobile devices. It applies forensic techniques to an enterprise mobile infrastructure, utilizing an on-device agent named TractorBeam. The agent collects changed storage locations for later acquisition, reconstruction, and analysis. TractorBeam provides its data to an enterprise infrastructure that consists of a cloud-based queuing service, relational database, and analytical framework for running forensic processes. During a 3-month experiment with Purdue University, TractorBeam was utilized in a simulated operational setting across 34 users to evaluate techniques to identify masquerading users (i.e., users other than the intended device user). The research team surmises that all masqueraders are undesirable to an enterprise, even when a masquerader lacks malicious intent. The PMF system reconstructed 821 forensic images, extracted one million audit events, and accurately detected masqueraders. Evaluation revealed that developed methods reduced storage requirements 50-fold. This paper describes the PMF architecture, performance of TractorBeam throughout the protocol, and results of the masquerading user analysis. © 2016 American Academy of Forensic Sciences.

  12. Impact of natural organic matter on particle behavior and phototoxicity of titanium dioxide nanoparticles

    Science.gov (United States)

    Due to their inherent phototoxicity and inevitable environmental release, titanium dioxide nanoparticles (nano-TiO2) are increasingly studied in the field of aquatic toxicology. One of the particular interests is the interactions between nano-TiO2 and natural organic matter (NOM)...

  13. The in vivo rat skin photomicronucleus assay: Phototoxicity and photogenotoxicity evaluation of six fluoroquinolones

    NARCIS (Netherlands)

    Reus, A.A.; Usta, M.; Kenny, J.D.; Clements, P.J.; Pruimboom-Brees, I.; Aylott, M.; Lynch, A.M.; Krul, C.A.M.

    2012-01-01

    An in vivo photomicronucleus test (MNT) using rat skin, the target organ for photoirritancy and carcinogenicity, was recently described. The assay was evaluated using fluoroquinolone (FQ) antibiotics with varying degrees of phototoxic potency (i.e. sparflocacin [SPFX], lomefloxacin [LOFX], ciproflox

  14. In Vitro Phototoxicity and Hazard Identification of Nano-scale Titanium Dioxide

    Science.gov (United States)

    Nano-titanium dioxide (nano-Ti02) catalyzes many reactions under UV radiation and is hypothesized to cause phototoxicity. A human-derived line of retinal pigment epithelial cells (ARPE-19) was treated with six different samples of nano-Ti02 and exposed to UVA radiation. The Ti02 ...

  15. [Toxic mustard plaster dematitis and phototoxic dematitis after application of bergamot oil].

    Science.gov (United States)

    Weisenseel, P; Woitalla, S

    2005-12-15

    Two cases that illustrate the risks attendant on the therapeutic use of natural medications by laypersons are reported. In the first case, the application of a mustard plaster triggered toxic dermatitis. In the second case, a session in a solarium after the external application of bergamot oil resulted in a phototoxic reaction.

  16. Recurrent angio-fibroma of breast masquerading as phyllodes tumor.

    Science.gov (United States)

    Chaurasia, Jai K; Alam, Feroz; Shadan, Mariam; Naim, Mohammed

    2015-01-01

    A young Indian female presented with a recurring tumor in the right breast masquerading as phyllodes tumor. Patient had history of five times excision and recurrences of the tumor, diagnosed as fibrous phyllodes of the breast. Presently, a well-circumscribed tumor of about 10 cm size, comprising of benign fibrous-angiomatous tissue with evidence of foci of pyogenic vasculitis was observed. Immuno-histochemical markers for the myo-epithelial and epithelial elements excluded the possibility of fibrous phyllodes, inflammatory myofibroblastic tumor, desmoid fibromatosis, and metaplastic carcinoma. The present findings were diagnostic of an inflammatory angio-fibroma of the right breast, not reported in the earlier literature. The observations indicated that the female breast may be susceptible to spontaneous productive and common-antibiotic-resistant focal septic vascular inflammation giving rise to angio-fibromatous proliferation producing a well-defined tumor mass in the breast, distinguishable from the other breast lesions by the connective tissue stains and immuno-histochemical markers.

  17. Cross-reactivity and masqueraders in seafood reactions.

    Science.gov (United States)

    Banks, Taylor A; Gada, Satyen M

    2013-01-01

    Confounding variables play a significant role in many adverse seafood reactions and a clear understanding of these factors is important in properly characterizing reactions associated with potential masqueraders and mimics. Although the medical literature is replete with reviews of seafood hypersensitivity and reports of cross-reactive and newly characterized allergens, there has not been a recent effort to provide an updated overview of the several processes that may lead clinicians to draw incorrect conclusions in evaluating reported reactions to seafood. Ranging from seafood intoxications to other nonallergic or complex seafood reactions, these events can easily be misconstrued as representing a seafood IgE-mediated allergy. Among these are the more familiar topics of cross-reactivity and scombroid intoxication, and those with a still evolving understanding such as ciguatera fish poisoning and Anisakis reactions. This article seeks to provide an accessible but comprehensive summary of the relevant information surrounding these confounders in assessing adverse reactions to seafood. Such knowledge may be instrumental in unraveling complex or otherwise unclear presentations and aid clinicians in accurately evaluating and managing patients with reported seafood reactions.

  18. Wilson′s disease masquerading as nonalcoholic steatohepatitis

    Directory of Open Access Journals (Sweden)

    Sabina Mahmood

    2009-01-01

    Full Text Available Background : Wilson′s disease is one of the most common hereditary causes of unclear hepatopathy. Patient & Method: A 34-year old male patient with a history of hyperlipidemia was admitted with symptoms of abdominal pain and slight hematuria. Abnormal liver function tests, ultrasound reports and liver biopsy were suggestive of nonalcoholic steatohepatitis (NASH. The patient received preliminary treatment for NASH. However, on subsequent follow-up, NASH remained unresolved and liver histology showed fibrosis progression from fibrosis stage 1 to stage 3. Results: Biochemical tests revealed that the levels of serum ceruloplasmin were decreased (7mg/dl while the urinary excretion of copper was found to be increased (174.2 μg/day. Wilson′s disease was confirmed by diagnostic mutation analysis involving Direct Sequencing. Heterogeneity in the patient′s ATP7B gene confirmed Wilson′s disease. Administration of D-penicillamine resulted in a decrease in fat deposition in the liver and no further progression in fibrosis after 10 months. Conclusion: Adult patient presenting NASH as first symptoms need to be examined for Wilson′s disease and other metabolic conditions affecting the liver, prior to initiation of treatment. ( Mahmood S, Inada N, Izumi A, Kawanaka M, Kobashi H, Yamada G. Wilson′s disease masquerading as nonalcoholic steatohepatitis.

  19. Appendiceal Diverticulitis Clinically Masquerading as an Appendiceal Carcinoma

    Directory of Open Access Journals (Sweden)

    Tadashi Terada

    2014-01-01

    Full Text Available Appendiceal diverticulosis is a rare condition. Herein reported is a case of appendiceal diverticulosis and diverticulitis clinically masquerading as appendiceal carcinoma. A 62-year-old woman presented with abdominal pain. US and CT showed a tumor measuring 5 × 4 × 4 cm in vermiform appendix. Colon endoscopy showed mucosal elevation and irregularity in the orifice of vermiform appendix. A biopsy of the appendiceal mucosa showed no significant changes. Clinical diagnosis was appendiceal carcinoma and wide excision of terminal ileum, appendix, cecum, and ascending colon was performed. Grossly, the appendix showed a tumor measuring 5 × 3 × 4 cm. The appendiceal lumen was opened, and the appendiceal mucosa was elevated and irregular. The periappendiceal tissue showed thickening. Microscopically, the lesion was multiple appendiceal diverticula. The diverticula were penetrating the muscle layer. The mucosa showed erosions in places. Much fibrosis, abscess formations, and lymphocytic infiltration were seen in the subserosa. Abscesses were also seen in the diverticular lumens. Some diverticula penetrated into the subserosa. The pathologic diagnosis was appendiceal diverticulitis. When they encounter an appendiceal mass, clinicians should consider appendiceal diverticulitis as a differential diagnosis.

  20. Identifying and Quantifying Recurrent Novae Masquerading as Classical Novae

    CERN Document Server

    Pagnotta, Ashley

    2014-01-01

    Recurrent novae (RNe) are cataclysmic variables with two or more nova eruptions within a century. Classical novae (CNe) are similar systems with only one such eruption. Many of the so-called 'CNe' are actually RNe for which only one eruption has been discovered. Since RNe are candidate Type Ia supernova progenitors, it is important to know whether there are enough in our galaxy to provide the supernova rate, and therefore to know how many RNe are masquerading as CNe. To quantify this, we collected all available information on the light curves and spectra of a Galactic, time-limited sample of 237 CNe and the 10 known RNe, as well as exhaustive discovery efficiency records. We recognize RNe as having (a) outburst amplitude smaller than 14.5 - 4.5 * log(t_3), (b) orbital period >0.6 days, (c) infrared colors of J-H > 0.7 mag and H-K > 0.1 mag, (d) FWHM of H-alpha > 2000 km/s, (e) high excitation lines, such as Fe X or He II near peak, (f) eruption light curves with a plateau, and (g) white dwarf mass greater tha...

  1. Nodular syphilitic scleritis masquerading as an ocular tumor.

    Science.gov (United States)

    Shaikh, Sufiyan I; Biswas, Jyotirmay; Rishi, Pukhraj

    2015-01-01

    Scleritis may be the initial or only presenting feature of systemic, autoimmune, or infectious disorders. Corticosteroids are the mainstay of treatment for immune-mediated scleritis. However, steroids could prove detrimental when used to treat infectious scleritis. Hence, infectious causes of scleritis should be ruled out. A 47-year-old male from central India presented with swelling, pain, and redness in the left eye since 2 months. The patient was diagnosed elsewhere as having an extraocular extension of intraocular tumor and advised radiation brachytherapy for the same. Clinical examination revealed nodular scleritis in the left eye. The patient did not have any systemic illness or complaints suggestive of connective tissue disease. Laboratory investigations ruled out the same. However, Venereal Disease Research Laboratory (VDRL) test was positive. Rapid plasma reagin (RPR) test and Treponema pallidum hemagglutination assay (TPHA) were also positive, confirming the diagnosis of syphilis. Ultrabiomicroscopy (UBM) and ultrasound scan of the eye ruled out intraocular tumor. Treatment was initiated with benzathine penicillin 2.4 million units per week for 3 weeks to which the patient responded remarkably well. Although rare, syphilis can present as nodular scleritis masquerading as ocular tumor. Syphilis must be considered in the list of etiological diagnoses in patients presenting with nodular scleritis, and testing for this disease should be a part of routine investigation in patients with scleritis.

  2. Mucocele After Orbital Fracture Repair Masquerading as Optic Neuritis.

    Science.gov (United States)

    Park, Jongyeop; Kim, Jinhyun; Choi, Jinsu; Kim, Hochang

    2016-06-01

    The authors report a patient of mucocele formation after orbital wall fracture repair masquerading as optic neuritis.A 38-year-old man with a history of medial orbital wall fracture repair with an alloplastic implant 10 years previously, presented with left visual disturbance and mild ocular pain with movement of the left eye of 3-day duration, and a relative afferent papillary defect in his left eye. He reported having cold symptoms 2 weeks before presentation. His symptoms were typical of retrobulbar optic neuritis. Under suspicion of optic neuritis, computed tomography and magnetic resonance imaging were performed and revealed a large cyst in the sphenoid sinus and ethmoid sinus, just behind the alloplastic implant, that was compressing the medial rectus muscle and optic nerve of the left eye. The patient underwent endoscopic marsupialization of the cyst. Subsequent histologic examinations revealed a cyst lined with ciliated pseudostratified columnar epithelium. The patient had an uncomplicated postoperative course and the visual disturbance resolved. For patients who present solely with optic neuropathy after orbital fracture repair, it is important to be vigilant of potentially rare cause, mucocele formation.

  3. Crypsis via leg clustering: twig masquerading in a spider.

    Science.gov (United States)

    Zhang, Shichang; Mao, Kuei-Kai; Lin, Po-Ting; Ho, Chiu-Ju; Hung, Wei; Piorkowski, Dakota; Liao, Chen-Pan; Tso, I-Min

    2015-03-01

    The role of background matching in camouflage has been extensively studied. However, contour modification has received far less attention, especially in twig-mimicking species. Here, we studied this deceptive strategy by revealing a special masquerade tactic, in which the animals protract and cluster their legs linearly in the same axis with their bodies when resting, using the spider Ariamnes cylindrogaster as a model. We used cardboard papers to construct dummies resembling spiders in appearance and colour. To differentiate the most important factors in the concealment effect, we manipulated body size (long or short abdomen) and resting postures (leg clustered or spread) of the dummies and recorded the responses of predators to different dummy types in the field. The results showed that dummies with clustered legs received significantly less attention from predators, regardless of the body length. Thus, we conclude that A. cylindrogaster relies on the resting posture rather than body size for predator avoidance. This study provides, to the best of our knowledge, empirical evidence for the first time that twig-mimicking species can achieve effective camouflage by contour modification.

  4. Arteries masquerading as varicose veins: A trap for phlebologists.

    Science.gov (United States)

    Jones, L; Parsi, K

    2015-12-01

    Ultrasound guided sclerotherapy may be complicated by intra-arterial injections resulting in significant tissue necrosis. Here, we present a 69-year-old man with a history of right small saphenous vein "stripping", presenting for the treatment of symptomatic lower limb varicose veins. Duplex ultrasound of the right lower limb outlined the pathway of venous incompetence. Despite the history of "stripping", the small saphenous vein was present but the sapheno-popliteal junction was ligated at the level of the knee crease. No other unusual findings were reported at the time. During ultrasound guided sclerotherapy, subcutaneous vessels of the right posterior calf were noted to be pulsatile on B-mode ultrasound. Treatment was interrupted. Subsequent angiography and sonography showed absence of the right distal popliteal artery. A cluster of subcutaneous vessels of the right medial and posterior calf were found to be arterial collaterals masquerading as varicose veins. Injection sclerotherapy of these vessels would have resulted in significant tissue loss. This case highlights the importance of vigilance at the time of treatment and the invaluable role of ultrasound in guiding endovenous interventions.

  5. e. In zini, and from eved 011. 07. oks, OLOJA MASQUERADE ...

    African Journals Online (AJOL)

    Precious

    The Igala believe that one's life from birth to death passes through a cycle and a state of ... cannot behold the knowledge of the arts and science used in putting ... The African concept of masquerade is not the same as the western definition of ...

  6. AngioVac extraction of intra-atrial hepatoma masquerading as PICC-associated thrombus

    Science.gov (United States)

    Abboud, Samir; Raparia, Kirtee; Ubago, Julianne M.; Resnick, Scott

    2016-01-01

    Thrombus associated with peripherally inserted central catheterization is not uncommon. Treatment is typically conservative; however, more aggressive therapies can be considered in patients with tenuous medical condition. The authors present a patient with metastatic hepatocellular carcinoma masquerading as peripherally inserted central catheter-associated intra-atrial thrombus, subsequently removed via vacuum-assisted mechanical thrombectomy. PMID:26509915

  7. The 3T3 neutral red uptake phototoxicity test: practical experience and implications for phototoxicity testing--the report of an ECVAM-EFPIA workshop.

    Science.gov (United States)

    Ceridono, Mara; Tellner, Pär; Bauer, Daniel; Barroso, João; Alépée, Nathalie; Corvi, Raffaella; De Smedt, Ann; Fellows, Mick D; Gibbs, Neil K; Heisler, Eckhard; Jacobs, Abigail; Jirova, Dagmar; Jones, David; Kandárová, Helena; Kasper, Peter; Akunda, Jacqueline Kinyamu; Krul, Cyrille; Learn, Douglas; Liebsch, Manfred; Lynch, Anthony M; Muster, Wolfgang; Nakamura, Kazuichi; Nash, J Frank; Pfannenbecker, Uwe; Phillips, Gareth; Robles, Catherine; Rogiers, Vera; Van De Water, Femke; Liminga, Ulla Wändel; Vohr, Hans-Werner; Wattrelos, Olivier; Woods, Julie; Zuang, Valérie; Kreysa, Joachim; Wilcox, Phil

    2012-08-01

    This is the report from the "ECVAM-EFPIA workshop on 3T3 NRU Phototoxicity Test: Practical Experience and Implications for Phototoxicity Testing", jointly organized by ECVAM and EFPIA and held on the 25-27 October 2010 in Somma Lombardo, Italy. The European Centre for the Validation of Alternative Methods (ECVAM) was established in 1991 within the European Commission Joint Research, based on a Communication from the European Commission (1991). The main objective of ECVAM is to promote the scientific and regulatory acceptance of alternative methods which are of importance to the biosciences and which reduce, refine and replace the use of laboratory animals. The European Federation of Pharmaceuticals Industries and Association (EFPIA) represent the pharmaceutical industry operating in Europe. Through its direct membership of 31 national associations and 40 leading pharmaceutical companies, EFPIA is the voice on the EU scene of 2200 companies committed to researching, developing and bringing to patients new medicines that improve health and the quality of life around the world. The workshop, co-chaired by Joachim Kreysa (ECVAM) and Phil Wilcox (GSK, EFPIA) involved thirty-five experts from academia, regulatory authorities and industry, invited to contribute with their experiences in the field of phototoxicology. The main objectives of the workshop were: -to present 'in use' experience of the pharmaceutical industry with the 3T3 Neutral Red Uptake Phototoxicity Test (3T3 NRU-PT), -to discuss why it differs from the results in the original validation exercise, -to discuss technical issues and consider ways to improve the usability of the 3T3 NRU-PT for (non-topical) pharmaceuticals, e.g., by modifying the threshold of chemical light absorption to trigger photo-toxicological testing, and by modifying technical aspects of the assay, or adjusting the criteria used to classify a positive response. During the workshop, the assay methodology was reviewed by comparing the OECD

  8. Influence of the environment and phototoxicity of the live cell imaging system at IMP microbeam facility

    Science.gov (United States)

    Liu, Wenjing; Du, Guanghua; Guo, Jinlong; Wu, Ruqun; Wei, Junzhe; Chen, Hao; Li, Yaning; Zhao, Jing; Li, Xiaoyue

    2017-08-01

    To investigate the spatiotemporal dynamics of DNA damage and repair after the ion irradiation, an online live cell imaging system has been established based on the microbeam facility at Institute of Modern Physics (IMP). The system could provide a sterile and physiological environment by making use of heating plate and live cell imaging solution. The phototoxicity was investigated through the evaluation of DNA repair protein XRCC1 foci formed in HT1080-RFP cells during the imaging exposure. The intensity of the foci induced by phototoxicity was much lower compared with that of the foci induced by heavy ion hits. The results showed that although spontaneous foci were formed due to RFP exposure during live cell imaging, they had little impact on the analysis of the recruitment kinetics of XRCC1 in the foci induced by the ion irradiation.

  9. Modulation of Melanogenesis and Antioxidant Status of Melanocytes in Response to Phototoxic Action of Doxycycline.

    Science.gov (United States)

    Rok, Jakub; Buszman, Ewa; Beberok, Artur; Delijewski, Marcin; Otręba, Michał; Wrześniok, Dorota

    2015-11-01

    Doxycycline is a commonly used tetracycline antibiotic showing the broad spectrum of antibacterial action. However, the use of this antibiotic is often connected with the risk of phototoxic reactions that lead to various skin disorders. One of the factors influencing the photosensitivity reactions is the melanin content in melanocytes. In this study, the impact of doxycycline and UVA irradiation on cell viability, melanogenesis and antioxidant defense system in cultured normal human epidermal melanocytes (HEMn-DP) was examined. The exposure of cells to doxycycline and UVA radiation resulted in concentration-dependent loss in melanocytes viability and induced melanin biosynthesis. Significant changes were stated in cellular antioxidant enzymes activity: SOD, CAT and GPx, which indicates alterations of antioxidant defense system. The results obtained in vitro may explain the mechanisms of phototoxic reactions that occur in normal human epidermal melanocytes in vivo after exposure of skin to doxycycline and UVA radiation.

  10. In Vitro Cytotoxicity and Phototoxicity Assessment of Acylglutamate Surfactants Using a Human Keratinocyte Cell Line

    Directory of Open Access Journals (Sweden)

    Abhay Kyadarkunte

    2014-07-01

    Full Text Available In the current study, human keratinocyte cell line was used as in vitro cell culture model to elucidate the effects of the fatty acid chain length of acylglutamate (amino acid-based surfactant namely, sodium cocoyl glutamate, sodium lauroyl glutamate, and sodium myristoyl glutamate on their cytotoxicity and the ultraviolet B induced phototoxicity. The endpoint used to assess toxicity was a tetrazolium-based assay whereas, the phototoxic potential of acylglutamate surfactants was predicted using two models namely, the Photo-Irritation Factor and Mean Photo Effect. The results of this study showed that the fatty acid chain length of acylglutamate greatly influences toxic effects on human keratinocyte cells. In addition, all the acylglutamate surfactants tested on human keratinocyte cells demonstrated significantly less cytotoxicity (when irradiated and non-irradiated with ultraviolet B light; p < 0.05 and no phototoxic potential was observed in any of the acylglutamate surfactants, when compared with the positive control chlorpromazine. In conclusion, the in vitro studies confirm the suitability of sodium lauroyl glutamate destined for the synthesis and stabilization of lipid nanoparticles.

  11. Phototoxic effects of lysosome-associated genetically encoded photosensitizer KillerRed

    Science.gov (United States)

    Serebrovskaya, Ekaterina O.; Ryumina, Alina P.; Boulina, Maria E.; Shirmanova, Marina V.; Zagaynova, Elena V.; Bogdanova, Ekaterina A.; Lukyanov, Sergey A.; Lukyanov, Konstantin A.

    2014-07-01

    KillerRed is a unique phototoxic red fluorescent protein that can be used to induce local oxidative stress by green-orange light illumination. Here we studied phototoxicity of KillerRed targeted to cytoplasmic surface of lysosomes via fusion with Rab7, a small GTPase that is known to be attached to membranes of late endosomes and lysosomes. It was found that lysosome-associated KillerRed ensures efficient light-induced cell death similar to previously reported mitochondria- and plasma membrane-localized KillerRed. Inhibitory analysis demonstrated that lysosomal cathepsins play an important role in the manifestation of KillerRed-Rab7 phototoxicity. Time-lapse monitoring of cell morphology, membrane integrity, and nuclei shape allowed us to conclude that KillerRed-Rab7-mediated cell death occurs via necrosis at high light intensity or via apoptosis at lower light intensity. Potentially, KillerRed-Rab7 can be used as an optogenetic tool to direct target cell populations to either apoptosis or necrosis.

  12. Statins and voriconazole induce programmed cell death in Acanthamoeba castellanii.

    Science.gov (United States)

    Martín-Navarro, Carmen M; López-Arencibia, Atteneri; Sifaoui, Ines; Reyes-Batlle, María; Valladares, Basilio; Martínez-Carretero, Enrique; Piñero, José E; Maciver, Sutherland K; Lorenzo-Morales, Jacob

    2015-05-01

    Members of the genus Acanthamoeba are facultative pathogens of humans, causing a sight-threatening keratitis and a life-threatening encephalitis. In order to treat those infections properly, it is necessary to target the treatment not only to the trophozoite but also to the cyst. Furthermore, it may be advantageous to avoid parasite killing by necrosis, which may induce local inflammation. We must also avoid toxicity of host tissue. Many drugs which target eukaryotes are known to induce programmed cell death (PCD), but this process is poorly characterized in Acanthamoeba. Here, we study the processes of programmed cell death in Acanthamoeba, induced by several drugs, such as statins and voriconazole. We tested atorvastatin, fluvastatin, simvastatin, and voriconazole at the 50% inhibitory concentrations (IC50s) and IC90s that we have previously established. In order to evaluate this phenomenon, we investigated the DNA fragmentation, one of the main characteristics of PCD, with quantitative and qualitative techniques. Also, the changes related to phosphatidylserine exposure on the external cell membrane and cell permeability were studied. Finally, because caspases are key to PCD pathways, caspase activity was evaluated in Acanthamoeba. All the drugs assayed in this study induced PCD in Acanthamoeba. To the best of our knowledge, this is the first study where PCD induced by drugs is described quantitatively and qualitatively in Acanthamoeba.

  13. Voriconazole-induced periostitis in two post-transplant patients

    OpenAIRE

    Bucknor, Matthew D.; Gross, Andrew J; LINK, THOMAS M.

    2013-01-01

    While drug-related periostitis has been known of for many years, the specific association of diffuse periostitis with voriconazole (most frequently in transplant patients) has only been recently explicitly addressed in the literature. Recognition of the radiologic and clinical manifestations of voriconazole-related periostitis is important for helping to narrow an otherwise broad differential diagnosis. We present two cases that illustrate different radiologic presentations of this painful ca...

  14. Voriconazole-induced periostitis in two post-transplant patients.

    Science.gov (United States)

    Bucknor, Matthew D; Gross, Andrew J; Link, Thomas M

    2013-08-01

    While drug-related periostitis has been known of for many years, the specific association of diffuse periostitis with voriconazole (most frequently in transplant patients) has only been recently explicitly addressed in the literature. Recognition of the radiologic and clinical manifestations of voriconazole-related periostitis is important for helping to narrow an otherwise broad differential diagnosis. We present two cases that illustrate different radiologic presentations of this painful cause of diffuse periostitis. Case 1 features a 60 year-old woman with a history of orthotopic heart transplant who was hospitalized for "full body pain" with progressively worsening bone tenderness involving the humeri, knees, femurs, hips, and hands. Case 2 describes a 48 year-old man with a history of acute lymphoblastic leukemia status post stem cell transplant who presented with diffuse arthralgias involving bilateral ankles, knees, wrists, and elbows.

  15. Pulmonary Embolism Masquerading as High Altitude Pulmonary Edema at High Altitude.

    Science.gov (United States)

    Pandey, Prativa; Lohani, Benu; Murphy, Holly

    2016-12-01

    Pandey, Prativa, Benu Lohani, and Holly Murphy. Pulmonary embolism masquerading as high altitude pulmonary edema at high altitude. High Alt Med Biol. 17:353-358, 2016.-Pulmonary embolism (PE) at high altitude is a rare entity that can masquerade as or occur in conjunction with high altitude pulmonary edema (HAPE) and can complicate the diagnosis and management. When HAPE cases do not improve rapidly with descent, other diagnoses, including PE, ought to be considered. From 2013 to 2015, we identified eight cases of PE among 303 patients with initial diagnosis of HAPE. Upon further evaluation, five had deep vein thrombosis (DVT). One woman had a contraceptive ring and seven patients had no known thrombotic risks. PE can coexist with or mimic HAPE and should be considered in patients presenting with shortness of breath from high altitude regardless of thrombotic risk.

  16. Allergic contact dermatitis to Plectranthus amboinicus masquerading as chronic leg ulcer.

    Science.gov (United States)

    Chang, Shyue-Luen; Chang, Ya-Ching; Yang, Chin-Hsun; Hong, Hong-Shang

    2005-12-01

    This report discusses a case of a 69-year-old woman who developed chronic non-healing leg ulcers after long-term topical use of Plectranthus amboinicus. The ulcer was proven to be allergic contact dermatitis to P. amboinicus by a patch test. The ulcer healed after discontinuation of P. amboinicus. To the best of our knowledge, this is the first reported case of allergic contact dermatitis to P. amboinicus masquerading as chronic leg ulcer.

  17. Synergic phototoxic effect of visible light or Gallium-Arsenide laser in the presence of different photo-sensitizers on Porphyromonas gingivalis and Fusobacterium nucleatum

    Directory of Open Access Journals (Sweden)

    Habibollah Ghanbari

    2015-01-01

    Conclusion: Within the limitations of this study, the synergic phototoxic effect of visible light in combination with each of the photosensitizers on P. gingivalis and F. nucleatum. However, the synergic phototoxic effect of laser exposure and hydrogen peroxide and curcumin as photosensitizers on F. nucleatum was not shown.

  18. Phototoxicity to sulphonamide-derived oral antidiabetics and diuretics: comparative in-vitro and in-vivo investigations

    Science.gov (United States)

    Selvaag, Edgar; Anholt, Helle; Moan, Johan; Thune, Per

    1997-12-01

    Seven oral antidiabetics (chlorpropamide, glibenclamide, glipizide, gliquidone, glymidine, tolazamide, and tolbutamide), and 14 diuretics (bemetizide, bendroflumethiazide, benzylhydrochlorothiazide, bumetanide, butizide, chlortalidone, furosemide, hydrochlorothiazide, hydroflumethiazide, indapamide, piretanide, polythiazide, trichlormethiazide, and xipamide) were investigated for potential phototoxicity in vitro using a cell culture model and in vivo in hairless mice. After exposure to broad band UVA, the majority of the substances tested in vitro yielded phototoxic action leading to loss of culture forming ability. In vivo, all tested substances induced edema or ulceration, and lead to a significant increase in skin fold thickness of the mouse skin. In all a number of substances not described to induce clinical photosensitivity nor phototoxicity in vitro or in vivo were detected in our testing. In determining potential photosensitizers, it seems important to utilize different test methods, as not all substances will exhibit action in a given assay.

  19. Phototoxicity and chronic toxicity of methyl paraben and 1,2-hexanediol in Daphnia magna.

    Science.gov (United States)

    Lee, Jiyun; Park, Nayeon; Kho, Younglim; Lee, Kiyoung; Ji, Kyunghee

    2017-01-01

    Parabens are used as antimicrobial preservatives in consumer products. Exposure to methylparaben (MP) has been associated with adverse health outcomes, therefore, an alternative compound, 1,2-hexanediol (1,2-H), has been applied for cosmetics. In the present study, the phototoxicity of MP and 1,2-H, as well as the toxic effect caused by chronic exposure, were investigated using Daphnia magna. The 48 h acute toxicity tests with D. magna were conducted under indoor or ultraviolet (UV) light irradiation conditions, i.e., exposure to 4 h/d sunlight. Changes in the transcription of genes related to oxidative stress were determined in D. magna juveniles, to investigate the underlying mechanism of phototoxicity. The 21 d chronic toxicity tests of MP and 1,2-H were performed under indoor light irradiation. Exposure to MP under environmental level of UV light was more detrimental to D. magna. Transcripts of catalase and glutathione-S-transferase genes in D. magna was significantly increased by co-exposure to MP and UV light. After 21 d of chronic exposure to MP and 1,2-H, the reproduction no-observed effect concentrations for D. magna were 1 and >10 mg/L, respectively. The present study showed that exposure to UV could magnify the toxicity of MP on daphnids. Although acute and chronic toxicities of 1,2-H were generally lower than those of MP, its effects on other aquatic organisms should not be ignored. Further studies are needed to identify other mechanisms of MP phototoxicity.

  20. Potent phototoxicity of marine bunker oil to translucent herring embryos after prolonged weathering.

    Directory of Open Access Journals (Sweden)

    John P Incardona

    Full Text Available Pacific herring embryos (Clupea pallasi spawned three months following the Cosco Busan bunker oil spill in San Francisco Bay showed high rates of late embryonic mortality in the intertidal zone at oiled sites. Dead embryos developed to the hatching stage (e.g. fully pigmented eyes before suffering extensive tissue deterioration. In contrast, embryos incubated subtidally at oiled sites showed evidence of sublethal oil exposure (petroleum-induced cardiac toxicity with very low rates of mortality. These field findings suggested an enhancement of oil toxicity through an interaction between oil and another environmental stressor in the intertidal zone, such as higher levels of sunlight-derived ultraviolet (UV radiation. We tested this hypothesis by exposing herring embryos to both trace levels of weathered Cosco Busan bunker oil and sunlight, with and without protection from UV radiation. Cosco Busan oil and UV co-exposure were both necessary and sufficient to induce an acutely lethal necrotic syndrome in hatching stage embryos that closely mimicked the condition of dead embryos sampled from oiled sites. Tissue levels of known phototoxic polycyclic aromatic compounds were too low to explain the observed degree of phototoxicity, indicating the presence of other unidentified or unmeasured phototoxic compounds derived from bunker oil. These findings provide a parsimonious explanation for the unexpectedly high losses of intertidal herring spawn following the Cosco Busan spill. The chemical composition and associated toxicity of bunker oils should be more thoroughly evaluated to better understand and anticipate the ecological impacts of vessel-derived spills associated with an expanding global transportation network.

  1. Phototoxicity and antipsoriatic effect of a topical methoxypsoralen solution in relation to the application time

    DEFF Research Database (Denmark)

    Meffert, H; Andersen, Klaus Ejner; Sönnichsen, N

    1984-01-01

    The phototoxicity and antipsoriatic activity of a topically applied 0.075% methoxypsoralen alcohol-glycerol solution was investigated in relation to the interval between drug application and irradiation. On healthy skin, maximum UVA sensitivity for erythema development appeared 40 to 60 min after...... the application of the methoxypsoralen solution, but in psoriatic plaques the antipsoriatic UVA sensitization reached its maximum after 10 to 20 min. This difference between induction of antipsoriatic effect and erythema sensitivity may be explained by rapid penetration of methoxypsoralen in psoriatic lesions...

  2. Phototoxicity of TiO{sub 2} nanoparticles to a freshwater benthic amphipod: Are benthic systems at risk?

    Energy Technology Data Exchange (ETDEWEB)

    Li, Shibin, E-mail: li.shibin@epa.gov [U.S. Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Mid-Continent Ecology Division, Duluth, MN (United States); Wallis, Lindsay K.; Ma, Hongbo [U.S. Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Mid-Continent Ecology Division, Duluth, MN (United States); Diamond, Stephen A. [Nanosafe Inc., Blacksburg, VA (United States)

    2014-01-01

    This study investigated phototoxicity of TiO{sub 2} nanoparticles (nano-TiO{sub 2}) to a freshwater benthic amphipod (Hyalella azteca) using 48-h and 96-h bioassays. Thorough monitoring of particle interactions with exposure media (Lake Superior water, LSW) and the surface of organisms was performed using dynamic light scattering, UV/Vis spectroscopy, and Scanning Electron Microscopy. Large agglomeration and sedimentation (> 77%) in LSW was observed after 0.5 h. A simulated solar radiation (SSR)-favored surface attachment of nanoparticles was observed, indicating enhanced phototoxicity with the increased attachment. A 96-h median lethal concentration (LC50) of 29.9 mg/L in H. azteca was calculated, with a daily 4-h UV exposure of 2.2 W/m{sup 2}. Phototoxicity of nano-TiO{sub 2} under SSR had a 21-fold increase as compared to that under ambient laboratory light. This phototoxicity was also dependent on UV dose, with calculated LC50s around 22.9 (95% CI, 20.5–23.3) Wh/m{sup 2} when exposed to 20 mg/L nano-TiO{sub 2}. Also, H. azteca exhibited negative phototaxis in the presence of shelters, indicating that other factors might play a role in environmental systems. Finally, the environmental implications of nano-TiO{sub 2} to benthic organisms were illustrated, emphasizing the importance of various environmental factors in the ultimate phototoxicity. This increased phototoxicity and its complex interactions with various environmental factors suggest further investigations are needed for future risk assessment of photoactive nanomaterials to benthic organisms. - Graphical abstract: Display Omitted - Highlights: •Large aggregation of TiO{sub 2} nanoparticles in Lake Superior water was observed. •Phototoxicity was dependent on the dose of both solar radiation and nanoparticle. •A solar radiation favored surface attachment of nanoparticles was observed. •Hyalella azteca exhibited negative phototaxis in the presence of shelters. •Factors influencing

  3. Phototoxicity of nano titanium dioxides in HaCaT keratinocytes—Generation of reactive oxygen species and cell damage

    Energy Technology Data Exchange (ETDEWEB)

    Yin, Jun-Jie [Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD 20740 (United States); Liu, Jun [CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology, Beijing 100190 (China); Ehrenshaft, Marilyn [Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC 27709 (United States); Roberts, Joan E. [Fordham University, 113 West 60th Street, New York, NY 10023 (United States); Fu, Peter P. [National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR 72079 (United States); Mason, Ronald P. [Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC 27709 (United States); Zhao, Baozhong, E-mail: zhaobz@nanoctr.cn [CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology, Beijing 100190 (China)

    2012-08-15

    Nano-sized titanium dioxide (TiO{sub 2}) is among the top five widely used nanomaterials for various applications. In this study, we determine the phototoxicity of TiO{sub 2} nanoparticles (nano-TiO{sub 2}) with different molecular sizes and crystal forms (anatase and rutile) in human skin keratinocytes under UVA irradiation. Our results show that all nano-TiO{sub 2} particles caused phototoxicity, as determined by the MTS assay and by cell membrane damage measured by the lactate dehydrogenase (LDH) assay, both of which were UVA dose- and nano-TiO{sub 2} dose-dependent. The smaller the particle size of the nano-TiO{sub 2} the higher the cell damage. The rutile form of nano-TiO{sub 2} showed less phototoxicity than anatase nano-TiO{sub 2}. The level of photocytotoxicity and cell membrane damage is mainly dependent on the level of reactive oxygen species (ROS) production. Using polyunsaturated lipids in plasma membranes and human serum albumin as model targets, and employing electron spin resonance (ESR) oximetry and immuno-spin trapping as unique probing methods, we demonstrated that UVA irradiation of nano-TiO{sub 2} can induce significant cell damage, mediated by lipid and protein peroxidation. These overall results suggest that nano-TiO{sub 2} is phototoxic to human skin keratinocytes, and that this phototoxicity is mediated by ROS generated during UVA irradiation. Highlights: ► We evaluate the phototoxicity of nano-TiO{sub 2} with different sizes and crystal forms. ► The smaller the particle size of the nano-TiO{sub 2} the higher the cell damage. ► The rutile form of nano-TiO{sub 2} showed less phototoxicity than anatase nano-TiO{sub 2}. ► ESR oximetry and immuno-spin trapping techniques confirm UVA-induced cell damage. ► Phototoxicity is mediated by ROS generated during UVA irradiation of nano-TiO{sub 2}.

  4. Comparative phototoxicity of nanoparticulate and bulk ZnO to a free-living nematode Caenorhabditis elegans: The importance of illumination mode and primary particle size

    Energy Technology Data Exchange (ETDEWEB)

    Ma, H., E-mail: mah77@uga.edu [Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA 30602 (United States); Kabengi, N.J.; Bertsch, P.M.; Unrine, J.M. [Department of Plant and Soil Sciences, University of Kentucky, Lexington, KY 40546 (United States); Glenn, T.C.; Williams, P.L. [Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA 30602 (United States)

    2011-06-15

    The present study evaluated phototoxicity of nanoparticulate ZnO and bulk-ZnO under natural sunlight (NSL) versus ambient artificial laboratory light (AALL) illumination to a free-living nematode Caenorhabditis elegans. Phototoxicity of nano-ZnO and bulk-ZnO was largely dependent on illumination method as 2-h exposure under NSL caused significantly greater mortality in C. elegans than under AALL. This phototoxicity was closely related to photocatalytic reactive oxygen species (ROS) generation by the ZnO particles as indicated by concomitant methylene blue photodegradation. Both materials caused mortality in C. elegans under AALL during 24-h exposure although neither degraded methylene blue, suggesting mechanisms of toxicity other than photocatalytic ROS generation were involved. Particle dissolution of ZnO did not appear to play an important role in the toxicity observed in this study. Nano-ZnO showed greater phototoxicity than bulk-ZnO despite their similar size of aggregates, suggesting primary particle size is more important than aggregate size in determining phototoxicity. - Highlights: > Phototoxicity of nano- or bulk-ZnO was enhanced by natural sunlight illumination. > This phototoxicity was well-correlated to photocatalytic ROS generation. > Toxicity of ZnO particles not related to photocatalytic ROS generation was also observed. > Nano-ZnO showed greater phototoxicity than bulk-ZnO due to its greater total surface area per unit mass. > Primary particle size appeared to be more important than aggregate size in determining phototoxicity. - Phototoxicity of nanoparticulate and bulk ZnO was greatly enhanced by natural sunlight illumination compared to artificial laboratory light illumination.

  5. Vancomycin-functionalised Ag-TiO{sub 2} phototoxicity for bacteria

    Energy Technology Data Exchange (ETDEWEB)

    Wan Yi [Chinese Academy of Sciences, Key Lab of Corrosion Science, Shandong Province, Institute of Oceanology, 7 Nanhai Road, Qingdao 266071 (China); Zhang Dun, E-mail: zhangdun@ms.qdio.ac.cn [Chinese Academy of Sciences, Key Lab of Corrosion Science, Shandong Province, Institute of Oceanology, 7 Nanhai Road, Qingdao 266071 (China); Wang Yi; Qi Peng; Wu Jiajia; Hou Baorong [Chinese Academy of Sciences, Key Lab of Corrosion Science, Shandong Province, Institute of Oceanology, 7 Nanhai Road, Qingdao 266071 (China)

    2011-02-15

    Research highlights: {yields} A multivalent interaction between Van-Ag-TiO{sub 2} and SRB. {yields} Van-Ag-TiO{sub 2} allow for selective photokilling of pathogen. {yields} Van-Ag-TiO{sub 2} show certain bactericidal property in dark. - Abstract: This study reports on the synthesis of vancomycin (Van)-functionalised Ag-TiO{sub 2} nanoparticles and their enhanced bactericidal activities. Van-Ag-TiO{sub 2} nanoparticles were prepared by nanoparticle deposition and chemical cross-linking reactions. The catalysts showed high efficiency for the degradation of methylene blue under ultraviolet (UV) illumination. The photocatalytic inactivation of the sulphate-reducing bacteria, Desulfotomaculum, was also studied under UV light irradiation and in the dark using aqueous mixtures of Ag, Ag-SiO{sub 2}, Ag-TiO{sub 2}, and Van-Ag-TiO{sub 2}. The Van-Ag-TiO{sub 2} nanoparticles showed a capacity to target Van-sensitive bacteria. They also effectively prevented bacterial cell growth through the functionalised nanoparticles under UV irradiation for 1 h. To investigate the specificity of the catalyst phototoxicity, a Van-resistant bacteria, Vibrio anguillarum, was used as the negative control. The results indicated that Van-Ag-TiO{sub 2} nanoparticles had a higher selective phototoxicity for Van-sensitive bacteria. Therefore, the antibiotic molecule-functionalised core-shell nanoparticles allow for selective photokilling of pathogenic bacteria.

  6. Photosensitizer Adhered to Cell Culture Microplates Induces Phototoxicity in Carcinoma Cells

    Directory of Open Access Journals (Sweden)

    Verena Ziegler

    2013-01-01

    Full Text Available In vitro experiments in plastic receptacles are the basis of characterization of new photosensitizers (PSs for the photodynamic therapy. We recently reported that lipophilic PSs adhere to cell culture microplates in a kinetic-like manner (Engelhardt et al., 2011. In the current study, we examined the interaction and phototoxic effects of the microplate-adhered PS in cancer cells. Therefore, we preloaded microplates with hypericin, Foscan, PVP-hypericin, or aluminum (III phthalocyanine tetrasulfonate chloride (AlPCS4 for 24 hours and measured the PS distribution after addition of A431 human carcinoma cells: following another 24 hours up to 68% of hypericin were detected in the cell fraction. The hydrophilic PVP-hypericin and AlPCS4 also diffused into the cells, but the quantities of PS adherence were considerably lower. Microplate-adhered Foscan appeared not to be redistributed. In contrast to the hydrophilic PSs, the cellular phototoxicity of microplate-adhered lipophilic PS was high, independent of whether the PS (i was pre-loaded onto microplates or (ii added simultaneously with the cells or (iii one day after cell seeding. Based on these results, we suggest testing lipophilic PS dyes for their adherence to microplates. Furthermore, the ability of plastic materials to (reversibly store PSs might represent a new approach for the PS delivery or the development of antimicrobial coatings.

  7. Phototoxic and modulatory effects of natural products from the skin of Rhinella jimi (Stevaux, 2002

    Directory of Open Access Journals (Sweden)

    Samuel V. Brito

    2012-02-01

    Full Text Available The skin of amphibians possesses a large diversity of biologically active compounds that are associated with the natural defenses of these animals against pathogens. Five different extracts and fractions were obtained from the skin of Rhinella jimi: methanol extract (ME, methanol fractions (MF, chloroform extract of methanol extract (CF, aqueous alkaloid fraction (AAF and aqueous non-alkaloid fraction (ANAF. All fractions were evaluated with respect to their antibiotic modifying activity in standard bacterial strains and multiresistant clinical isolates. Antagonism was detected with kanamycin and gentamicin when combined with substances obtained from the skin of R. jimi. Phototoxic activity was observed in the methanol and chlorophorm fractions, as well as the aqueous non-alkaloid fraction. The antagonistic action was apparently associated with the protection afforded by the bacterial populations that inhabit the skin of this amphibian, preventing colonization by pathogenic fungi. The phototoxic activity demonstrated by natural products from the skin of R. jimi showed an interruption of the bacterial growth after UV exposure. This could indicate an antibacterial effect activated by the UV light, opening a path for carrying the attack by pathogenic fungi, causing the disease related with the amphibian decline.

  8. Vancomycin-functionalised Ag@TiO2 phototoxicity for bacteria.

    Science.gov (United States)

    Wan, Yi; Zhang, Dun; Wang, Yi; Qi, Peng; Wu, Jiajia; Hou, Baorong

    2011-02-15

    This study reports on the synthesis of vancomycin (Van)-functionalised Ag@TiO(2) nanoparticles and their enhanced bactericidal activities. Van-Ag@TiO(2) nanoparticles were prepared by nanoparticle deposition and chemical cross-linking reactions. The catalysts showed high efficiency for the degradation of methylene blue under ultraviolet (UV) illumination. The photocatalytic inactivation of the sulphate-reducing bacteria, Desulfotomaculum, was also studied under UV light irradiation and in the dark using aqueous mixtures of Ag, Ag@SiO(2), Ag@TiO(2), and Van-Ag@TiO(2). The Van-Ag@TiO(2) nanoparticles showed a capacity to target Van-sensitive bacteria. They also effectively prevented bacterial cell growth through the functionalised nanoparticles under UV irradiation for 1h. To investigate the specificity of the catalyst phototoxicity, a Van-resistant bacteria, Vibrio anguillarum, was used as the negative control. The results indicated that Van-Ag@TiO(2) nanoparticles had a higher selective phototoxicity for Van-sensitive bacteria. Therefore, the antibiotic molecule-functionalised core-shell nanoparticles allow for selective photokilling of pathogenic bacteria.

  9. Action spectrum for bergamot-oil phototoxicity measured by sunburn cell counting.

    Science.gov (United States)

    Yasui, Y; Hirone, T

    1994-05-01

    The present study investigated the phototoxic effect of bergamot oil and its photosensitive component, bergapten, on sunburn cell (SBC) production in guinea pig skin. The back skin was pretreated with bergamot oil or bergapten and exposed to monochromatic light under various conditions. After irradiation, skin specimens were excised, and histological sections were prepared. The number of sunburn cells in the interfollicular epidermis was counted. The SBC formation by bergamot oil or bergapten plus UVB radiation was the same as that without pretreatment with any photosensitizer. In contrast, a significant number of SBCs were induced by bergamot oil or bergapten plus UVA radiation, but no SBCs were found after the treatment with UVA alone. The result indicates that bergamot oil or bergapten was photosensitized by UVA irradiation. The SBCs were linearly increased in a UV-dose dependent manner. On the basis of the regression lines, an action spectrum and spectral peak for the photosensitizers plus UVA were obtained. The action spectrum for bergamot oil- and bergapten-induced SBC formation was in the ranges of 325-365 nm and 325-350 nm, and their spectral peaks were at 335-345 nm and 335-350 nm, respectively. The data are in good accordance with those estimated from skin erythema reactions. Therefore, counting SBCs is a very useful parameter for quantitative evaluation of phototoxicity.

  10. In vitro phototoxicity of a new phthalocyanine-immunoconjugate for use in photodynamic therapy

    Science.gov (United States)

    Martin, Michael; Kaul, Sepp; Drechsler, Ute; Geyer, M.; Kurek, R.; Hanack, Michael; Seeger, Stefan; Wallwiener, D.; Wolfrum, Juergen M.

    1996-12-01

    Non specific localization of photosensitizers after application in vivo limits progress in PDT. Relatively selective distribution of photosensitizers in malignant tissues is crucial for a successful treatment. The target specificity of photosensitizers may be improved by linking photosensitizers with monoclonal antibodies. In this approach, a high specific monoclonal antibody, BM-2 which is directed against epitopes of the mucine glycoprotein TAG-12 was used. This antibody shows reactivity with 96% of all primary breast carcinomas. BM-2 was conjugated with a second generation phthalocyanine photosensitizer which is only weakly phototoxic to human T-47D tumor cells without conjugation in vitro. With respect to future clinical application, illumination times from 25 to 100 minutes and a powerful diode laser with an emission of 690 nm was chosen, which provides deeper tissue penetration in vivo. We observed phototoxicity towards T-47D human breast carcinoma cells at concentrations ranging from 0.25 to 6 micromol/L and light doses from 6 to 24 J/cm2. The immunoconjugates discriminated mucine-positive and mucine-negative tumor cells and showed high photocytotoxic selectivity towards mucine-positive T-47D cells in vitro. The conjugate showed no dark toxicity. In vivo experiments will follow.

  11. Excitation Light Dose Engineering to Reduce Photo-bleaching and Photo-toxicity.

    Science.gov (United States)

    Boudreau, Colton; Wee, Tse-Luen Erika; Duh, Yan-Rung Silvia; Couto, Melissa P; Ardakani, Kimya H; Brown, Claire M

    2016-01-01

    It is important to determine the most effective method of delivering light onto a specimen for minimal light induced damage. Assays are presented to measure photo-bleaching of fluorophores and photo-toxicity to living cells under different illumination conditions. Turning the light off during part of the experimental time reduced photo-bleaching in a manner proportional to the time of light exposure. The rate of photo-bleaching of EGFP was reduced by 9-fold with light pulsing on the micro-second scale. Similarly, in living cells, rapid line scanning resulted in reduced cell stress as measured by mitochondrial potential, rapid cell protrusion and reduced cell retraction. This was achieved on a commercial confocal laser scanning microscope, without any compromise in image quality, by using rapid laser scan settings and line averaging. Therefore this technique can be implemented broadly without any software or hardware upgrades. Researchers can use the rapid line scanning option to immediately improve image quality on fixed samples, reduce photo-bleaching for large high resolution 3D datasets and improve cell health in live cell experiments. The assays developed here can be applied to other microscopy platforms to measure and optimize light delivery for minimal sample damage and photo-toxicity.

  12. Comparison of in vitro and in vivo phototoxicity tests with S-(-)-10,11-dihydroxyfarnesic acid methyl ester produced by Beauveria bassiana KACC46831.

    Science.gov (United States)

    Kim, Min-A; Son, Hyeong-U; Yoon, Cheol-Sik; Nam, Sung-Hee; Choi, Young-Cheol; Lee, Sang-Han

    2014-09-01

    Beauveria bassiana is a fungi that is well-known for demonstrating a resistance to environmental change. To confirm whether S-(-)-10,11-dihydroxyfarnesic acid methyl ester (DHFAME) produced by Beauveria bassiana KACC46831 causes phototoxicity when used for cosmetic purposes due to its anti-tyrosinase activity, we conducted in vitro and in vivo phototoxicity tests. There were no significant changes or damage observed in the compound-treated group with regards to skin phototoxicity, while 8-methoxypsoralen, which served as a positive control, induced toxic effects. The in vitro 3T3 neutral red uptake assay, an alternative assessment, was used for further confirmation of the phototoxicity. The results showed that DHFAME did not exhibit phototoxicity at the designated concentrations, with or without UV irradiation in the 3T3 cells. These results indicated that the methyl ester produced by Beauveria bassiana KACC46831 does not induce phototoxicity in the skin. Therefore, the results of the present study indicate that DHFAME shows potential for use as a cosmetic ingredient that does not cause skin phototoxicity.

  13. Species sensitivity and dependence on exposure conditions impacting the phototoxicity of TiO2 nanoparticles to benthic organisms

    Science.gov (United States)

    Toxicity of TiO2 nanoparticles (nano-TiO2) to aquatic organisms can be greatly increased upon the exposure to ultraviolet radiation (UV). This phenomenon has received some attention for pelagic species, however, investigations of nano-TiO2 phototoxicity in benthic organisms are s...

  14. Phototoxicity of TiO2 nanoparticles to a freshwater benthic amphipod: are benthic systems at risk?

    Science.gov (United States)

    This study investigated phototoxicity of TiO2 nanoparticles (nano-TiO2) to a freshwater benthic amphipod (Hyalella azteca) using 48-h and 96-h bioassays. Thorough monitoring of particle interactions with exposure media (Lake Superior water, LSW) and the surface of organisms was p...

  15. Modeling TiO2 nanoparticle phototoxicity: The importance of chemical concentration, ultraviolet radiation intensity, and time

    Science.gov (United States)

    Toxicity of TiO2 nanoparticles (nano-TiO2) to aquatic organisms can be greatly increased upon the exposure to ultraviolet radiation (UV). This phenomenon has received some attention for pelagic species, however, investigations of nano-TiO2 phototoxicity in benthic organisms are s...

  16. Phototoxic properties of perfumes containing bergamot oil on human skin: photoprotective effect of UVA and UVB sunscreens.

    Science.gov (United States)

    Dubertret, L; Serraf-Tircazes, D; Jeanmougin, M; Morlière, P; Averbeck, D; Young, A R

    1990-11-01

    As part of an international cooperative study of the photophysical, photomutagenic and photocarcinogenic properties of bergamot oil and the effect of UVA and UVB sunscreens, the phototoxic properties of model perfumes containing 5, 15 and 50 ppm 5-methoxypsoralen (5-MOP) in bergamot oil with and without a sunscreen have been investigated on human skin. It has been confirmed that the photosensitivity of human skin is maximal 2 h after perfume application. Interestingly the addition of a UVA sunscreen is more efficient for decreasing the phototoxic properties of bergamot oil than is a UVB sunscreen. The addition of sunscreens in a model perfume containing 50 ppm 5-MOP in bergamot oil can reduce the phototoxic properties of this perfume to a toxicity equivalent to that produced by the application of a model perfume containing 15 ppm 5-MOP without sunscreens. However, despite their promising protective effect in vitro, UVB and UVA sunscreens at low concentration (0.5%-1%) in perfumes cannot suppress the phototoxicity of bergamot oil on human skin.

  17. Phototoxicity of TiO2 Nanoparticles to Two Aquatic Species: Daphnia magna and Zebrafish (Danio rerio) Embryo

    Science.gov (United States)

    Ecotoxicological studies on TiO2 nanoparticles (nano-TiO2) are expanding rapidly due to their widespread use in both industrial and consumer products. However, few studies have focused on their potential phototoxicity related to the photocatalytic property of the material. In thi...

  18. Phototoxicity of TiO2 Nanoparticles to Two Aquatic Species: Daphnia magna and Zebrafish (Danio rerio) Embryo

    Science.gov (United States)

    Ecotoxicological studies on TiO2 nanoparticles (nano-TiO2) are expanding rapidly due to their widespread use in both industrial and consumer products. However, few studies have focused on their potential phototoxicity related to the photocatalytic property of the material. In thi...

  19. Photocatalytic reactive oxygen species production and phototoxicity of titanium dioxide nanoparticles are dependent on the solar ultraviolet radiation spectrum.

    Science.gov (United States)

    Ma, Hongbo; Brennan, Amanda; Diamond, Stephen A

    2012-09-01

    Generation of reactive oxygen species (ROS) by titanium dioxide nanoparticles (nano-TiO(2)) and its consequent phototoxicity to Daphnia magna were measured under different solar ultraviolet (UV) spectra by applying a series of optical filters in a solar simulator. Removing UV-B (280-320 nm) from solar radiation had no significant impact on photocatalytic ROS production of nano-TiO(2), whereas removal of UV-A (320-400 nm) decreased ROS production remarkably. Removal of wavelengths below 400 nm resulted in negligible ROS production. A linear correlation between ROS production and D. magna immobilization suggests that photocatalytic ROS production may be a predictor of phototoxicity for nano-TiO(2). Intracellular ROS production within D. magna was consistent with the immobilization of the organism under different solar UV spectra, indicating that oxidative stress was involved in phototoxicity. The dependence of nano-TiO(2) phototoxicity on environmentally realistic variations in solar radiation suggests that risk assessment of these nanomaterials requires careful evaluation of exposure conditions in the environment.

  20. Cardiac sarcoid: a chameleon masquerading as hypertrophic cardiomyopathy and dilated cardiomyopathy in the same patient.

    Science.gov (United States)

    Agarwal, Anushree; Sulemanjee, Nasir Z; Cheema, Omar; Downey, Francis X; Tajik, A Jamil

    2014-05-01

    Sarcoidosis is a multisystem, granulomatous disease of unknown etiology often seen in young adults, with cardiac involvement in more than one-quarter of sarcoid patients. The clinical presentation of cardiac sarcoid depends upon the location and extent of myocardium involved. Although cardiac sarcoid may produce asymmetrical septal hypertrophy, it is most commonly considered in the differential diagnosis of dilated cardiomyopathy. The hypertrophic stage of cardiac sarcoid is rarely seen. We describe a case of cardiac sarcoid in a young patient wherein a distinctive appearance of the cardiac sarcoid spectrum from "hypertrophic" stage to thinned/scarred stage, masquerading as hypertrophic cardiomyopathy followed by dilated cardiomyopathy, is demonstrated.

  1. Mycetoma clinically masquerading as squamous cell carcinoma: case report and literature review.

    Science.gov (United States)

    Momin, Saira B; Richardson, Blakely S; Bryan, Michael G; Del Rosso, James Q; Mobini, Narciss

    2009-02-01

    Mycetoma is a chronic and progressive subcutaneous granulomatous infection characterized by painless swelling and tumefaction, draining sinus tracts, and purulent discharge. The term eumycetoma is used to describe an infection caused by fungi, while an actinomycetoma is used to describe an infection caused by filamentous bacteria. An accurate identification of the pathogen plays a vital role in the treatment plan as well as a positive outcome for the patient. In this report, we present an elderly white female with an initial presentation of mycetoma masquerading as a squamous cell carcinoma. We also review microbiology, diagnostic modalities, and treatment for mycetoma.

  2. Hepatosplenic Gamma/DeltaT-Cell Lymphoma Masquerading as Alcoholic Hepatitis and Methadone Withdrawal

    Directory of Open Access Journals (Sweden)

    H.A. Lopez Morra

    2007-09-01

    Full Text Available Hepatosplenic gamma/delta T-cell lymphoma is a rare neoplasm of mature gamma/delta T-cells with sinusoidal infiltration of spleen, liver, and bone marrow. Patients are predominantly adolescent and young adult males and usually present with marked hepatosplenomegaly. Pancytopenia is another common finding. Despite an initial response to treatment, patients have a median survival of one to two years. In this report, we document a case of alcoholic hepatitis and methadone withdrawal masquerading unsuspected, hepatosplenic gamma/delta T-cell lymphoma with unusual CD20 positivity.

  3. Womanliness as Masquerade: Tracing Luce Irigaray’s Theory in Angela Carter’s Nights at the Circus

    Directory of Open Access Journals (Sweden)

    Yiğit Sümbül

    2015-12-01

    Full Text Available Womanliness as Masquerade: Tracing Luce Irigaray’s Theory in Angela Carter’s Nights at the Circus Abstract Published in 1977 with a great deal of controversy within European feminist circles, Luce Irigaray’s This Sex Which Is Not One presents the author’s commentary on the modern phallocentric culture, commodification of women and their counteraction disguised within the very patriarchal structures. Irigaray, for instance, views womanliness and female submissiveness as a strategy that women have always made use of in order to develop a much more unfettered self behind such masks. Women masquerade as objects to be consumed to achieve a freer voice from the patriarchal discourse and to establish themselves as the ultimate subjects of a never-ending cultural exchange. Irigaray’s views on female strategies such as masquerade and performativity are applicable to a feminist reading of Angela Carter’s famous postmodern novel, Nights at the Circus (1984, which critiques the patriarchal ideology with its suggestion of a New Woman. Fevvers, the protagonist of the novel, imprisons the male voice in the novel behind the invisible cage of her own world of performances and uses her womanliness to suppress the male willpower to the degree of self-submission. In this respect, this study argues that Carter’s generation of Fevvers as the New Woman is reminiscent of what Irigaray theorizes in her above article with respect to questions like womanliness, masquerade and performativity.

  4. Assessment of phototoxicity, skin irritation, and sensitization potential of polystyrene and TiO2 nanoparticles

    Science.gov (United States)

    Park, Yoon-Hee; Jeong, Sang Hoon; Yi, Sang Min; Hyeok Choi, Byeong; Kim, Yu-Ri; Kim, In-Kyoung; Kim, Meyoung-Kon; Son, Sang Wook

    2011-07-01

    The human skin equivalent model (HSEM) is well known as an attractive alternative model for evaluation of dermal toxicity. However, only limited data are available on the usefulness of an HSEM for nanotoxicity testing. This study was designed to investigate cutaneous toxicity of polystyrene and TiO2 nanoparticles using cultured keratinocytes, an HSEM, and an animal model. In addition, we also evaluated the skin sensitization potential of nanoparticles using a local lymph node assay with incorporation of BrdU. Findings from the present study indicate that polystyrene and TiO2 nanoparticles do not induce phototoxicity, acute cutaneous irritation, or skin sensitization. Results from evaluation of the HSEMs correspond well with those from animal models. Our findings suggest that the HSEM might be a useful alternative model for evaluation of dermal nanotoxicity.

  5. The phototoxicity of polycyclic aromatic hydrocarbons: a theoretical study of excited states and correlation to experiment.

    Science.gov (United States)

    Betowski, Leon D; Enlow, Mark; Riddick, Lee

    2002-06-01

    Investigators using models to determine the phototoxic effects of sunlight on polycyclic aromatic hydrocarbons (PAHs) have invoked the excited states of the molecule as important in elucidating the mechanism of these reactions. Energies of actual excited states were calculated for ten PAHs by several ab initio methods. The main method used for these calculations was the Configuration Interaction approach, modeling excited states as combinations of single substitutions out of the Hartree-Fock ground state. These calculations correlate well with both experimentally measured singlet and triplet state energies and also previous HOMO-LUMO gap energies that approximate the singlet state energies. The excited state calculations then correlate well with general models of photo-induced toxicity based for the PAHs.

  6. Lessons to be learned: a case study approach--acute appendicitis masquerading as macroamylasaemia.

    Science.gov (United States)

    Ganesh, Muniappan; Salam, Imroz

    2008-05-01

    Macroamylasaemia is a condition in which serum amylase is elevated in the presence of a low to normal urinary amylase and normal renal function. It is rare but can masquerade as other clinical disorders. Discussed here is a case report of a patient who presented initially with abdominal pain (later recognized as being due to gangrenous appendicitis) and in whom there was a very high serum amylase level, leading to an erroneous initial diagnosis and management as acute pancreatitis. The CT scan of the abdomen was normal without any evidence of pancreatitis. Subsequently, the renal amylase:creatinine clearance ratio (C(am)/C(cr)) was found to be low, being characteristic and diagnostic of macroamylasaemia; the latter was, in turn, the cause for the elevated serum amylase level. The underlying macroamylasaemia had thus masqueraded as pancreatitis. The patient underwent appendicectomy and hence made an excellent recovery. It is vitally important to recognize this condition in order to avoid both an incorrect diagnosis and inappropriate treatment/management.

  7. Two cases of uveitis masquerade syndrome caused by bilateral intraocular large B-cell lymphoma

    Directory of Open Access Journals (Sweden)

    Jovanović Svetlana

    2013-01-01

    Full Text Available Introduction. Sometimes it is not easy to clinically recognize subtle differences between intraocular lymphoma and noninfectious uveitis. The most common lymphoma subtype involving the eye is B-cell lymphoma. Case report. We presented two patients aged 59 and 58 years with infiltration of the subretinal space with a large B-cell non-Hodgkin intraocular lymphoma. The patients originally had clinically masked syndrome in the form of intermediate uveitis. As it was a corticosteroid-resistant uveitis, we focused on the possible diagnosis of neoplastic causes of this syndrome. During hospitalization, the neurological symptoms emerged and multiple subretinal changes accompanied by yellowish white patches of retinal pigment epithelium with signs of vitritis, which made us suspect the intraocular lymphoma. Endocranial magnetic resonance imaging established tumorous infiltration in the region of the left hemisphere of the cerebellum. The histopathological finding confirmed the diagnosis of large B-cell non-Hodgkin lymphoma of risk moderate degree, immunoblast - centroblast cytological type. The other patient had clinical chronic uveitis accompanied by yellowish shaped white echographic changes of the retina and localized changes in the level of the subretina. The diagnosis of lymphoma was made by brain biopsy. Conclusion. Uveitis masquerade syndrome should be considered in all patients over 40 years with idiopathic steroid-resistant uveitis. Treatment begun on time can affect the course and improve the prognosis of uveitis masquerade syndrome (UMS and systemic disease.

  8. Optical coherence tomography and autofluorescence findings in chronic phototoxic maculopathy secondary to snow-reflected solar radiation

    Directory of Open Access Journals (Sweden)

    Dhananjay Shukla

    2015-01-01

    Full Text Available A professional mountain trekker presented with gradual, moderate visual decline in one eye. The subnormal vision could not be explained by the examination of anterior and posterior segment of either eye, which was unremarkable. Optical coherence tomography and autofluorescence imaging revealed subtle defects in the outer retina, which correlated with the extent of visual disturbance. A novel presentation of retinal phototoxicity due to indirect solar radiation reflected from snow in inadequately protected eyes of a chronically exposed subject is reported.

  9. Granulocytic sarcoma masquerading as Ewing′s sarcoma: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Haresh Kunhi

    2008-01-01

    Full Text Available An eleven-year-old boy presented with a swelling in his left elbow. Radiologically the features were that of an Ewing′s sarcoma involving the ulna. Histopathology showed small round cell tumor strongly positive for Monoclonal Imperial Cancer research fund 2 (MIC2 antigen. Similar cells in the bone marrow were involved with MIC2 positivity. The patient developed skin lesions, which on biopsy were found to be chloromas. The initial biopsies were reevaluated with special stains revealing granulocytic sarcomas in acute myeloid leukemia masquerading as Ewing′s due to its MIC2 positivity. The possibility of myeloid neoplasms should be considered routinely with known MIC2 positive round cell tumors.

  10. Fashion pictures and women pictures in French women magazine. Normatives parades or strategic masquerade?

    Directory of Open Access Journals (Sweden)

    Justine MARILLONNET

    2014-12-01

    Full Text Available This article proposes to study the fashion pictures within a representative sample of French women magazines. Based on the method of “sémiologie des indices”, used to analyze a corpus of woman’s body and fashion staged, this paper addresses the issue of new functions granted to the stereotyping process. Starting to the assumption of a contract between audience and media, this analysis shows that the gender stereotype may be prescribed, up to a caricature of the womanhood, to the female readers identified as co-producers of the media discourse. Demonstrating both the co-existence of a plurality of gender representations in its pictures and their variability, this work proposes the concept of strategic masquerade to apprehend the possible new functions for the process of gender stereotyping in media.

  11. The Analysis of IP Masquerading Technology%IP伪装技术分析

    Institute of Scientific and Technical Information of China (English)

    王京智; 洪观甫

    2012-01-01

    本文介绍了当前网监管理工作中经常遇到的诈骗、色情、六合彩等违规网站经常使用的IP伪装技术,并结合实例讲解了此类网站的工作原理以及提出防范措施,为从事该项技术工作的工程师提供参考。%This paper introduces the IP masquerading technology, which are extensively encountered in current network monitoring, such as fraud, pornography and lottery ticket illegal websites. Connecting with the real example to explain the working principle of such websites, proposing precautionary measures, and providing a reference for the engineers who involved in the technical works.

  12. FNAC of Bacillus- Calmette- Guerin lymphadenitis masquerading as Langerhans cell histiocytosis.

    Directory of Open Access Journals (Sweden)

    Gupta Nalini

    2004-12-01

    Full Text Available Abstract Bacillus Calmette Guerin (BCG lymphadenitis is a well known entity. Disseminated BCG infection usually presents as generalized lymphadenopathy, skin rash and hepatosplenomegaly and at times, can pose a diagnostic challenge to clinicians. There are only a few published studies on the cytological findings of BCG lymphadenitis. In this letter we report the fine needle aspiration cytology (FNAC of BCG lymphadenitis clinically masquerading as Langerhans cell histiocytosis (LCH. FNA smears showed sheets of foamy macrophages and many polymorphs in a dirty necrotic background with many macrophages as well as polymorphs showing negatively stained rod like structures within their cytoplasm. Zeihl Neelson stain revealed that these cells were heavily loaded with acid fast bacilli (AFB. In the index case, AFB were also seen within the cytoplasm of polymorphs, which has not been documented earlier in the literature.

  13. A Case of Hyperemesis Gravidarum due to Gastric Cancer Masquerading as Preeclampsia

    Directory of Open Access Journals (Sweden)

    Daniel R. Hersh

    2011-12-01

    Full Text Available Nausea and vomiting are symptoms frequently seen in normal pregnancy. We report a patient with gastric carcinoma who presented with severe hyperemesis gravidarum that led to extreme volume depletion, hypertension, proteinuria, and acute renal failure. A 35-year-old woman (para 2-1-0-1 with a prenatal course significant for persistent nausea, vomiting, and poor weight gain presented at 36 weeks' gestation with elevated blood pressure (157/114 mm Hg, proteinuria (4+, hypochloremic metabolic alkalosis, and severe intravascular volume contraction. A presumptive diagnosis of severe preeclampsia was made, the patient was given intravenous MgSO4, and cesarean delivery was accomplished uneventfully. When significant emesis persisted in the postoperative period, esophagogastroduodenoscopy revealed an antral/prepyloric mass with a biopsy-proven poorly differentiated adenocarcinoma. To our knowledge, this is the first report of a case of hyperemesis gravidarum with gastric cancer masquerading as preeclampsia.

  14. A masquerade is not watched from one spot: reassessing the study of African religions

    Directory of Open Access Journals (Sweden)

    Umar Habila Dadem Danfulani

    1999-01-01

    Full Text Available The search for an adequate methodological approach to the study of African Religions in their multiformity has been a fervent one. In this paper, approaches to the study of African Religions today are proposed. These are polymethodic and multidimentional approaches, the contextual study of African Religions, the historical approaches (demonstrated in the art of masquerading, the need to balance synchronic and diachronic approaches, the use of art and iconography in the study and female studies. The fifth focuses on studying African Religions as insider. The author also examines the problems of the "insider" and the politics of doing research in history of religions in a Nigerian university.The conclusion strongly recommends a multidisciplinary approach for studying African Religions.

  15. Brugada syndrome masquerading as acute myocardial infarction in a patient presenting with ventricular fibrillation

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Idiopathic ventricular fibrillation (VF) has been reported to account for 3%-9% of all sudden arrhythmic deaths.1 In 1991, Pedro and Josep Brugada first described a subgroup of patients with idiopathic VF who presented with a right bundle branch block (RBBB) pattern and marked ST-segment elevation in the right precordial leads V1-V3 during sinus rhythm in the absence of any structural heart disease.2 This is now known as the Brugada syndrome. In Hong Kong the first two cases of Brugada syndrome were reported in April 1999 in local medical literature. Since then more patients from different local hospitals were identified to suffer from the syndrome. We report here a male patient suffering from Brugada syndrome which masqueraded as an acute anteroseptal myocardial infarction 10 years ago.

  16. Primary Cutaneous Lymphoma-Associated Pseudoepitheliomatous Hyperplasia Masquerading as Squamous Cell Carcinoma in a Young Adult.

    Science.gov (United States)

    Ansari, Mahsa; Azmoodeh Ardalan, Farid; Najafi, Masoumeh; Goodarzi, Azadeh; Ghanadan, Alireza

    2015-12-01

    Primary cutaneous anaplastic large cell lymphoma is a T-cell malignancy with atypical CD30 positive lymphocytes. Pseudoepitheliomatous hyperplasia is an uncommon finding in primary cutaneous anaplastic large cell lymphoma, and may mimic squamous cell carcinoma as pseudomalignancy. Careful attention of a pathologist to correct diagnosis of pseudoepitheliomatous hyperplasia and its underlying causes will help physicians to avoid inappropriate management. Here, we present a 22-year-old man referred to our hospital with a solitary nodule persistent on his forearm which was diagnosed as squamous cell carcinoma in the first biopsy. The lesion recurred after two months and histopathologic and immunohistochemistry examination revealed anaplastic large cell lymphoma with florid pseudoepitheliomatous hyperplasia which masquerading as well-differentiated squamous cell carcinoma. Diagnosis of pseudoepitheliomatous hyperplasia must guide the pathologist to search for underlying causes, such as primary cutaneous lymphoma. Pseudoepitheliomatous hyperplasia may mimic squamous cell carcinoma and this can result in inappropriate diagnosis and management.

  17. Severe bleeding after antithrombotic therapy in urosepsis masquerading as myocardial infarction.

    Science.gov (United States)

    Cheng, Kuo-Wei; Shih, Hsin-Chin; How, Chorng-Kuang; Lin, Yang-Ying; Hung-Tsang Yen, David; Huang, Mu-Shun

    2011-01-01

    Cardiac dysfunction is common in patients with severe sepsis and septic shock. We present a 71-year-old woman with Escherichia coli urosepsis and sepsis-induced myocardial injury masquerading as non-ST elevated myocardial ischemia. Spontaneous psoas hematoma requiring blood transfusion and intracranial hemorrhage developed after antiplatelet and anticoagulant therapies, even in therapeutic doses. The patient was managed conservatively and recovered well with minor residual hemiparesis. Bleeding complications are a common risk of antithrombotic therapy. It is therefore crucial to weigh the impact of efficacy against safety. Old age, female gender, renal insufficiency and sepsis character increased the risk of bleeding in this patient. A misinterpretation of elevated cardiac troponin I may give rise to a diagnostic dilemma and cause unnecessary morbidity.

  18. Sporadic bilateral synchronous multicentric papillary renal cell carcinoma masquerading as bilateral multifocal pyelonephritis.

    Science.gov (United States)

    Karthikeyan, V S; Dorairajan, L N; Kumar, S; Vijayakumar, A R; Ramesh, A; Ganesh Rajesh, N; Halanaik, D; Gupta, S

    2014-07-01

    Pyelonephritis is defined as an inflammation of the kidney and renal pelvis. The diagnosis is usually clinical. Acute multifocal bacterial nephritis is a rare form of pyelonephritis that is more severe and sepsis is more common. We report a patient who presented with fever and right-sided abdominal pain associated with right flank tenderness, suggesting right acute pyelonephritis. Bilateral multifocal pyelonephritis was diagnosed on ultrasonography, radionuclide renal scintigraphy and computed tomography. However, owing to non-resolution of symptoms, a biopsy was performed, which showed bilateral papillary renal cell carcinoma (PRCC). PRCC is known to exhibit multicentricity. To our knowledge, a case of bilateral multicentric PRCC masquerading as bilateral multifocal pyelonephritis has not been reported in the English literature. This case highlights the need to be vigilant while treating patients with focal lesions of the kidney as an inflammatory condition lest a malignancy should be missed.

  19. Chloroaluminium phthalocyanine polymeric nanoparticles as photosensitisers: photophysical and physicochemical characterisation, release and phototoxicity in vitro.

    Science.gov (United States)

    de Paula, Carina Silva; Tedesco, Antonio Cláudio; Primo, Fernando Lucas; Vilela, José Mário Carneiro; Andrade, Margareth Spangler; Mosqueira, Vanessa Carla Furtado

    2013-06-14

    Nanoparticles of poly(d,l-lactide-co-glycolide), poly(d,l-lactide) and polyethylene glycol-block-poly(d,l-lactide) were developed to encapsulate chloroaluminium phthalocyanine (AlClPc), a new hydrophobic photosensitiser used in photodynamic therapy (PDT). The mean nanoparticle size varied from 115 to 274 nm, and the encapsulation efficiency ranged from 57% to 96% due to drug precipitation induced by different types of polymer. All nanoparticle formulations presented negative zeta potential values (-37 mV to -59 mV), explaining their colloidal stability. The characteristic photophysical parameters were analysed: the absorption spectrum profile, fluorescence quantum yield and transient absorbance decay, with similar values for free and nanoparticles of AlClPc. The time-resolved spectroscopy measurements for AlClPc triplet excited state lifetimes indicate that encapsulation in nanocapsules increases triplet lifetime, which is advantageous for PDT efficiency. A sustained release profile over 168 h was obtained using external sink method. An in vitro phototoxic effect higher than 80% was observed in human fibroblasts at low laser light doses (3 J/cm(2)) with 10 μM of AlClPc. The AlClPc loaded within polymeric nanocapsules presented suitable physical stability, improved photophysical properties, sustained released profile and suitable activity in vitro to be considered a promising formulation for PDT.

  20. Clinical and histopathological study of the phototoxic dermatitis in Zebu calves in grazing of Brachiaria decumbens

    Directory of Open Access Journals (Sweden)

    José Cardona-Álvarez

    2016-05-01

    Full Text Available Objective. The objective was to study the clinical and histopathological aspects of Phototoxic Dermatitis Secondary (PDS, secondary to ingestion of Brachiaria decumbens in Zebu calves (Bos indicus department of Cordoba, Colombia. Materials and methods. Twelve calves Zebu, male, 12 to 18 months, PDS diagnosed with clinical, histopathologically studied and laboratory exams. Results.Clinically, signs of photophobia, dehydration, progressive emaciation, icteric mucous membranes and skin lesions as res-breaking with leathery skin appearance, skin peeling and scabbing over large areas were evident. The lesions were located bilaterally in different areas of the skin in ears, perineal region, epigastric and costal. Serological tests gave the high catalytic activity of the liver enzymes AST and GGT indicating liver injury consistent with cholestasis. Histopathologically was observed in hematoxylin eosin, chronic necrotic dermatitis, in trichrome Gomori poor dermal proliferation disorganized fibroblasts, low presence of diffuse connective tissue and collagen fibers disorganized and picrosirius red / polarization areas reddish birefringence was observed was observed and greenyellow, indicating moderate presence of mature collagen type I (bright red in polarization and Type III (bright yellowish-green polarization. Conclusions. The definitive diagnosis of the disease was based on clinical features, laboratory findings and histopathological findings, being conclusive as diagnostic methods of the PDS. In the literature there are no reports of studies PDS in Zebu calves department of Córdoba and Colombia.

  1. Possible mechanism of psoralen phototoxicity not involving direct interaction with DNA

    Energy Technology Data Exchange (ETDEWEB)

    Laskin, J.D.; Lee, E.; Yurkow, E.J.; Laskin, D.L.; Gallo, M.A.

    1985-09-01

    Psoralens in combination with ultraviolet light (UVA; 320-400 nm) are used in the photochemical treatment of a variety of skin diseases including vitiligo, a skin depigmentational disorder, and psoriasis, a disease of accelerated epidermal cell proliferation. Although it is generally assumed that the major site of action of the psoralens is DNA, the authors have obtained evidence that another site may be the primary target for these compounds. They have identified specific, saturable, high-affinity binding sites for 8-methoxypsoralen on HeLa cells and have detected specific binding of 8-methoxypsoralen to four other human cell lines and five mouse cell lines. In HeLa cells, specific binding is reversible and independent of the ability of the compound to intercalate into DNA. In addition, binding sites become covalently modified by the psoralen after UVA exposure. Specific binding of 8-(methyoxy-/sup 3/H)methoxypsoralen constitutes 79% of the label bound to the cells. Scatchard analysis indicated two classes of psoralen binding sites. Based on these findings, the authors hypothesize that specific binding sites for psoralens on mammalian cells mediate, at least in part, psoralen-induced phototoxicity.

  2. Pitavastatin, a new HMG-CoA reductase inhibitor, induces phototoxicity in human keratinocytes NCTC-2544 through the formation of benzophenanthridine-like photoproducts.

    Science.gov (United States)

    Viola, Giampietro; Grobelny, Pawel; Linardi, Maria Antonella; Salvador, Alessia; Dall'Acqua, Stefano; Sobotta, Łukasz; Mielcarek, Jadwiga; Dall'Acqua, Francesco; Vedaldi, Daniela; Basso, Giuseppe

    2012-03-01

    This study reports the results of an investigation of the phototoxicity mechanism induced by pitavastatin and its photoproducts, namely 6-cyclopropyl-10-fluoro-7,8-dihydrobenzo[k]phenanthridine (PP3) and 6-cyclopropyl-10-fluorobenzo[k]phenanthridine (PP4). The phototoxicity was tested in human keratinocytes cell lines NCTC-2544, and the results proved that under the same conditions, all three compounds exhibited phototoxic effects in the model tested. The reduction in cell viability was found to be both concentration- and UVA dose-dependent. A point of note is that both the photoproducts produced a dramatic decrease in cell viability with GI(50) values one order of magnitude lower compared to the parent compound. In particular, the fully aromatic derivative (PP4) showed the highest antiproliferative activity. Flow cytometric analysis indicated that pitavastatin and the photoproduct PP4 principally induced necrosis, as revealed by the large appearance of propidium iodide-positive cells and also confirmed by the rapid drop in cellular ATP levels. Further studies committed to better understanding of photoinduced cell death mechanism(s) revealed that neither pitavastatin nor PP4 induced mitochondrial depolarization or lysosomal damage, but, interestingly, extensive cell lipid membrane peroxidation along with a significant oxidation of model proteins occurred, suggesting that pitavastatin and PP4 exert their phototoxic effect mainly in the cellular membranes. The present results suggest that the phototoxicity of pitavastatin may be mediated by the formation of benzophenanthridine-like photoproducts that appear to have high potential as photosensitizers.

  3. Photosensitizing properties of 6-methoxy-2-naphthylacetic acid, the major metabolite of the phototoxic non-steroidal anti-inflammatory and analgesic drug nabumetone.

    Science.gov (United States)

    Canudas, N; Zamora, D; Villamizar, J E; Fuentes, J; Castelli, C; Taddei, A

    2005-08-01

    The photobiological properties of 6-methoxy-2-naphthylacetic acid (6-MNAA) were studied using a variety of in vitro phototoxicity assays: photohemolysis, photoperoxidation of linoleic acid, photosensitized degradation of histidine and thymine and the Candida phototoxicity test. 6-MNAA was phototoxic in vitro. 6-MNAA reduced nitro blue tetrazolium (NBT) when irradiated with lambda > or = 300 nm in deoxygenated aqueous buffer solution (pH 7.4). NBT can be reduced by reaction with the excited state of 6-MNAA subject to interference with molecular oxygen. The photohemolysis rate was inhibited by the presence of 1,4-diazabicyclo[2.2.2]octane (DABCO), sodium azide (NaN3) and reduced glutathione (GSH). Photoperoxidation of linoleic acid and photosensitized degradation of histidine and thymine were significantly inhibited by sodium azide and reduced glutathione. 6-MNAA was phototoxic to C. albicans, C. lipolytica and C. tropicalis. A mechanism involving singlet oxygen, radicals, and electron transfer reactions is suggested for the observed phototoxicity.

  4. Photosensitized rose Bengal-induced phototoxicity on human melanoma cell line under natural sunlight exposure.

    Science.gov (United States)

    Srivastav, Ajeet K; Mujtaba, Syed Faiz; Dwivedi, Ashish; Amar, Saroj K; Goyal, Shruti; Verma, Ankit; Kushwaha, Hari N; Chaturvedi, Rajnish K; Ray, Ratan Singh

    2016-03-01

    Rose Bengal (RB) is an anionic water-soluble xanthene dye, which used for many years to assess eye cornea and conjunctiva damage. RB showed strong absorption maxima (λmax) under visible light followed by UV-B and UV-A. RB under sunlight exposure showed a time-dependent photodegradation. Our results show that photosensitized RB generates (1)O2 via Type-II photodynamic pathway and induced DNA damage under sunlight/UV-R exposure. 2'dGuO degradation, micronuclei formation, and single- and double-strand breakage were the outcome of photogenotoxicity caused by RB. Quenching studies with NaN3 advocate the involvement of (1)O2 in RB photogenotoxicity. RB induced linoleic acid photoperoxidation, which was parallel to (1)O2-mediated DNA damage. Oxidative stress in A375 cell line (human melanoma cell line) was detected through DCF-DA assay. Photosensitized RB decreased maximum cellular viability under sunlight followed by UV-B and UV-A exposures. Apoptosis was detected as a pattern of cell death through the increased of caspase-3 activity, decreased mitochondrial membrane potential, and PS translocation through inner to outer plasma membrane. Increased cytosolic levels of Bax also advocate the apoptotic cell death. We propose a p53-mediated apoptosis via increased expression of Bax gene and protein. Thus, the exact mechanism behind RB phototoxicity was the involvement of (1)O2, which induced oxidative stress-mediated DNA and membrane damage, finally apoptotic cell death under natural sunlight exposure. The study suggests that after the use of RB, sunlight exposure may avoid to prevent from its harmful effects. Copyright © 2015. Published by Elsevier B.V.

  5. Lysosomal and mitochondrial permeabilization mediates zinc(II) cationic phthalocyanine phototoxicity.

    Science.gov (United States)

    Marino, Julieta; García Vior, María C; Furmento, Verónica A; Blank, Viviana C; Awruch, Josefina; Roguin, Leonor P

    2013-11-01

    In order to find a novel photosensitizer to be used in photodynamic therapy for cancer treatment, we have previously showed that the cationic zinc(II) phthalocyanine named Pc13, the sulfur-linked dye 2,9(10),16(17),23(24)-tetrakis[(2-trimethylammonium) ethylsulfanyl]phthalocyaninatozinc(II) tetraiodide, exerts a selective phototoxic effect on human nasopharynx KB carcinoma cells and induces an apoptotic response characterized by an increase in the activity of caspase-3. Since the activation of an apoptotic pathway by chemotherapeutic agents contributes to the elimination of malignant cells, in this study we investigated the molecular mechanisms underlying the antitumor action of Pc13. We found that after light exposure, Pc13 induced the production of reactive oxygen species (ROS), which are mediating the resultant cytotoxic action on KB cells. ROS led to an early permeabilization of lysosomal membranes as demonstrated by the reduction of lysosome fluorescence with acridine orange and the release of lysosomal proteases to cytosol. Treatment with antioxidants inhibited ROS generation, preserved the integrity of lysosomal membrane and increased cell proliferation in a concentration-dependent manner. Lysosome disruption was followed by mitochondrial depolarization, cytosolic release of cytochrome C and caspases activation. Although no change in the total amount of Bax was observed, the translocation of Bax from cytosol to mitochondria, the cleavage of the pro-apoptotic protein Bid, together with the decrease of the anti-apoptotic proteins Bcl-XL and Bcl-2 indicated the involvement of Bcl-2 family proteins in the induction of the mitochondrial pathway. It was also demonstrated that cathepsin D, but not caspase-8, contributed to Bid cleavage. In conclusion, Pc13-induced cell photodamage is triggered by ROS generation and activation of the mitochondrial apoptotic pathway through the release of lysosomal proteases. In addition, our results also indicated that Pc13 induced

  6. Broad-spectrum sunscreens prevent the secretion of proinflammatory cytokines in human keratinocytes exposed to ultraviolet A and phototoxic lomefloxacin

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, P.; Cybulski, M. [Lasers and Electro-Optics Div., Consumer and Clinical Radiation Protection Bureau, Product Safety Program, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario (Canada)], E-mail: pascale_reinhardt@hc-sc.gc.ca; Miller, S.M.; Ferrarotto, C.; Wilkins, R. [Radiobiology Div., Consumer and Clinical Radiation Protection Bureau, Product Safety Program, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario (Canada); Deslauriers, Y. [Lasers and Electro-Optics Div., Consumer and Clinical Radiation Protection Bureau, Product Safety Program, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario (Canada)

    2006-02-15

    The combination of phototoxic drugs and ultraviolet (UV) radiation can trigger the release of proinflammatory cytokines. The present study measured the ability of sunscreens to prevent cytokine secretion in human keratinocytes following cotreatment of these cells with a known photoreactive drug and UVA. Keratinocytes were treated for 1 h with increasing concentrations of lomefloxacin (LOM) or norfloxacin (NOR), exposed to 15 J/cm{sup 2} UVA, and incubated for 24 h. NOR, owing to the absence of a fluorine atom in position 8, was non-phototoxic and used as a negative control. Cell viability and the release of 3 cytokines were assessed, namely interleukin-1{alpha} (IL-1{alpha}), interleukin-6 (IL-6), and tumour necrosis factor-{alpha} (TNF-{alpha}). The measurement of these cytokines may be a useful tool for detecting photoreactive compounds. To measure their ability to prevent cytokine secretion, various sunscreens were inserted between the UVA source and the cells. Treatment with NOR, NOR plus UVA, or LOM had no effect on the cells. LOM plus UVA, however, had an effect on cell viability and on cytokine secretion. IL-1{alpha} levels increased with LOM concentration. The release of TNF-{alpha} and IL-6 followed the same pattern at lower concentrations of LOM but peaked at 15 {mu}mol/L and decreased at higher concentrations. Sunscreens protected the cells from the effects of LOM plus UVA, as cell viability and levels of cytokines remained the same as in the control cells. In conclusion, the application of broad-spectrum sunscreen by individuals exposed to UVA radiation may prevent phototoxic reactions initiated by drugs such as LOM. (author)

  7. Castleman Disease of Hyaline Vascular Type in the Infrathyroidal Region: A Masquerader of Parathyroid Adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Kwon; Kwon, Sun Young [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2013-03-15

    Castleman disease of the infrathyroidal region is extremely rare. We report both CT and sonographic findings of a case of infrathyroidal paratracheal Castleman disease of hyaline vascular type, which masquerades parathyroid adenoma, in a 48-year-old woman. We further provide its histological findings at sonographically guided core-needle biopsy (US-CNB) and excisional biopsy. The lesion was ovoid with homogeneous intense enhancement on contrast-enhanced CT (CECT), and was homogeneous, markedly hypoechoic, and hypervascular on ultrasonography (US). Histological findings of the specimen obtained by US-CNB suggested lymphoproliferative lesion, and thus was inconclusive; those obtained by excisional biopsy were characteristics of Castleman disease of hyaline vascular type. Hyaline vascular type Castleman's disease should be included in the differential diagnosis of a mass of the infrathyroidal region with homogeneous intense enhancement on CECT, as well as with marked hypoechogenicity and hypervascularity on US. US-CNB may be of limited value in the histological diagnosis of this entity.

  8. Drain Tube-Induced Jejunal Penetration Masquerading as Bile Leak following Whipple’s Operation

    Directory of Open Access Journals (Sweden)

    Sang Ho Bae

    2011-05-01

    Full Text Available A 70-year-old man had undergone pancreaticoduodenectomy due to a distal common bile duct malignancy. After the operation, serous fluid discharge decreased from two drain tubes in the retroperitoneum. Over four weeks, the appearance of the serous fluid changed to a greenish bile color and the patient persistently drained over 300 ml/day. Viewed as bile leak at the choledochojejunostomy, treatment called for endoscopic diagnosis and therapy. Cap-fitted forward-viewing endoscopy demonstrated that the distal tip of a pancreatic drain catheter inserted at the pancreaticojejunostomy site had penetrated the opposite jejunum wall. One of the drain tubes primarily placed in the retroperitoneum had also penetrated the jejunum wall, with the distal tip positioned near the choledochojejunostomy site. No leak of contrast appeared beyond the jejunum or anastomosis site. Following repositioning of a penetrating catheter of the pancreaticojejunostomy, four days later, the patient underwent removal of two drain tubes without additional complications. In conclusion, the distal tip of the catheter, placed to drain pancreatic juice, penetrated the jejunum wall and may have caused localized perijejunal inflammation. The other drain tube, placed in the retroperitoneal space, might then have penetrated the inflamed wall of the jejunum, allowing persistent bile drainage via the drain tube. The results masqueraded as bile leakage following pancreaticoduodenectomy.

  9. Arthritis of the sternoclavicular joint masquerading as rupture of the cervical oesophagus: a case report

    Directory of Open Access Journals (Sweden)

    Katsoulis Iraklis E

    2009-01-01

    Full Text Available Abstract Introduction Sternoclavicular septic arthritis is a rare condition and accounts only for 1% of cases of septic arthritis in the general population. The most common risk factors are intravenous drug use, central-line infection, distant-site infection, immunosuppression, trauma and diabetes mellitus. This is a report of an unusual case where this type of arthritis was masquerading as rupture of the cervical oesophagus. Case presentation A 63-year-old man presented complaining of right neck pain and dysphagia following a bout of violent coughing. Physical examination revealed cellulitis extending from the right sternoclidomastoid region to the anterior upper chest. Computed tomography showed inflammatory changes behind the right sternoclavicular joint with mediastinitis and ipsilateral pleural effusion. These findings raised the suspicion of spontaneous rupture of the cervical oesophagus. Management involved jejunal feeding along with broad-spectrum antibiotics. The inflammation, however, relapsed after discontinuation of the antibiotics and this time, computed tomography pointed to a diagnosis of arthritis of the sternoclavicular joint. The patient responded completely to a 6-week course of oral penicillin, flucloxacillin and metronidazole. Conclusion Sternoclavicular arthritis is a rare condition that has been associated with a variety of predisposing factors. It may, however, occur in otherwise completely healthy individuals and should be included in the differential diagnosis of other inflammatory conditions of the neck and upper chest.

  10. High-mass twins & resolution of the reconfinement, masquerade and hyperon puzzles of compact star interiors

    Energy Technology Data Exchange (ETDEWEB)

    Blaschke, David [Bogoliubov Laboratory for Theoretical Physics, JINR Dubna, 141980 Dubna (Russian Federation); Instytut Fizyki Teoretycznej, Uniwersytet Wroclawski, 50-204 Wroclaw (Poland); Alvarez-Castillo, David E. [Bogoliubov Laboratory for Theoretical Physics, JINR Dubna, 141980 Dubna (Russian Federation); Instituto de Física, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México (Mexico)

    2016-01-22

    We aim at contributing to the resolution of three of the fundamental puzzles related to the still unsolved problem of the structure of the dense core of compact stars (CS): (i) the hyperon puzzle: how to reconcile pulsar masses of 2 M{sub ⊙} with the hyperon softening of the equation of state (EoS); (ii) the masquerade problem: modern EoS for cold, high density hadronic and quark matter are almost identical; and (iii) the reconfinement puzzle: what to do when after a deconfinement transition the hadronic EoS becomes favorable again? We show that taking into account the compositeness of baryons (by excluded volume and/or quark Pauli blocking) on the hadronic side and confining and stiffening effects on the quark matter side results in an early phase transition to quark matter with sufficient stiffening at high densities which removes all three present-day puzzles of CS interiors. Moreover, in this new class of EoS for hybrid CS falls the interesting case of a strong first order phase transition which results in the observable high mass twin star phenomenon, an astrophysical observation of a critical endpoint in the QCD phase diagram.

  11. High-mass twins & resolution of the reconfinement, masquerade and hyperon puzzles of compact star interiors

    CERN Document Server

    Blaschke, David

    2016-01-01

    We aim at contributing to the resolution of three of the fundamental puzzles related to the still unsolved problem of the structure of the dense core of compact stars (CS): (i) the hyperon puzzle: how to reconcile pulsar masses of $2\\,$M$_\\odot$ with the hyperon softening of the equation of state (EoS); (ii) the masquerade problem: modern EoS for cold, high density hadronic and quark matter are almost identical; and (iii) the reconfinement puzzle: what to do when after a deconfinement transition the hadronic EoS becomes favorable again? We show that taking into account the compositeness of baryons (by excluded volume and/or quark Pauli blocking) on the hadronic side and confining and stiffening effects on the quark matter side results in an early phase transition to quark matter with sufficient stiffening at high densities which removes all three present-day puzzles of CS interiors. Moreover, in this new class of EoS for hybrid CS falls the interesting case of a strong first order phase transition which resul...

  12. Is XTE J1739-285 a quark star masquerading as a neutron star

    CERN Document Server

    Xiaoping, Zheng; Li, Zhang

    2007-01-01

    The recent discovery of burst oscillation at 1122Hz in the X-ray transient XTE J1739-285 supports the suggestion that it contains a submillisecond pulsar\\cite{1}. We here find for the first time the enormous dissipation effect in the transition boundary layer between quark matter core and hadron matter envelope. Just combining the estimation with previous dissipation mechanism together, we show that XTE J1739-285 can be uniquely restricted to a quark star masquerading as a neutron star (hybrid star) that contains a pure quark matter or mixed quark-hadron matter core from synthesizing both gravitational wave radiation (r-mode) instability and Keplerian motion constraints at 1122Hz lever. Such constraints allow the radii in the range $9{\\rm km}\\leq R\\leq 12{\\rm km}$ and the masses in the range $1.2M_\\odot\\leq M\\leq 2.0M_\\odot$. The normal neutron stars, hyperon stars and strange stars within the mass-radius limits are excluded.

  13. A Case of Retained Graphite Anterior Chamber Foreign Body Masquerading as Stromal Keratitis

    Science.gov (United States)

    Han, Eun Ryung; Wee, Won Ryang; Lee, Jin Hak

    2011-01-01

    We report a case of a retained graphite anterior chamber foreign body that was masquerading as stromal keratitis. A 28-year-old male visited with complaints of visual disturbance and hyperemia in his right eye for four weeks. On initial examination, he presented with a stromal edema involving the inferior half of the cornea, epithelial microcysts, and moderate chamber inflammation. Suspecting herpetic stromal keratitis, he was treated with anti-viral and anti-inflammatory agents. One month after the initial visit, anterior chamber inflammation was improved and his visual acuity recovered to 20/20, but subtle corneal edema still remained. On tapering the medication, after three months, a foreign body was incidentally identified in the inferior chamber angle and was surgically removed resulting in complete resolution of corneal edema. The removed foreign body was a fragment of graphite and he subsequently disclosed a trauma with mechanical pencil 12 years earlier. This case showed that the presence of an anterior chamber foreign body should always be considered in the differential diagnosis of idiopathic localized corneal edema. PMID:21461226

  14. Leber's hereditary optic neuropathy masquerading as optic neuritis with spontaneous visual recovery.

    Science.gov (United States)

    Hsu, Tsui-Kang; Wang, An-Guor; Yen, May-Yung; Liu, Jorn-Hon

    2014-01-01

    We report a case of Leber's hereditary optic neuropathy (LHON) masquerading as optic neuritis with late visual recovery. A 28-year-old man had gradual visual loss in both eyes for two weeks. Visual acuity was 0.4 in the right eye and 0.7 in the left. Fundus examination revealed hyperaemic discs in each eye. Fluorescein angiography revealed dye leakage at both optic discs in the late phase. Static perimetry (Humphrey 30-2) revealed bilateral relative central scotomata. Magnetic resonance imaging of the optic nerves was normal and his lumbar puncture showed normal opening pressure. He received steroid pulse therapy for three days. Nevertheless, vision in his right eye deteriorated to 0.1 one month later and left vision worsened to 0.05 six months later. Fifteen months after onset, his vision began to improve. At 21 months, his vision recovered to 0.9 R and 1.0 L. Peripheral blood DNA sequencing revealed 14484 mutation of mitochondrial DNA (mtDNA). Visual recovery can occur in patients with Leber's hereditary optic neuropathy with mtDNA 14484 mutation. LHON could be misdiagnosed as optic neuritis in some cases. Molecular examination of mtDNA mutation can confirm the diagnosis of LHON in clinically controversial patients. We should keep in mind the diagnosis of LHON when optic neuritis shows poor response to pulse therapy.

  15. A RARE CASE OF EXTRAMEDULLARY PLASMACYTOMA MASQUERADING AS JUVENILE NASOPHARYNGEAL ANGIOFIBROMA

    Directory of Open Access Journals (Sweden)

    Harshita V. Sabhahit

    2016-09-01

    Full Text Available BACKGROUND Plasmacytomas are rare plasma cell tumours occurring consequent to monoclonal proliferation of plasma cells. They are divided into Solitary bone plasmacytoma, Extramedullary plasmacytoma (EMP and Multiple myeloma. EMPs are commonly housed in the head and neck region with a predilection to the mucosa associated lymphoid tissue in the aerodigestive tract. The nasal cavity, paranasal sinuses, and nasopharynx are the most common sites. OBJECTIVE We describe our experience with this tumour owing to its clinical rarity and a different way of presentation. METHODS After complete surgical excision of a nasal mass presenting in a young male with features masquerading that of Juvenile Nasopharyngeal Angiofibroma, a diagnosis of plasma cell tumour was made on histopathological analysis which was confirmed using immunohistochemistry. Serum electrophoresis, urine Bence Jones proteins, complete skeletal survey were done to rule out any progression into multiple myeloma. Radiation therapy was given with 45 Gy in 25 fractions at 1.8 Gy per day, 5 days a week. RESULTS Followup after 2 years showed no recurrence locally as well as in regional nodes. CONCLUSION Given to the rarity of the tumour, undefined manner of presentation and a predominant prevalence in the head and neck region, every otolaryngologist should keep EMP in mind while considering sinonasal masses. A multidisciplinary approach with a combination of surgery and radiotherapy is found to benefit the patient significantly. A long term watch out for progression to MM is mandatory to commence early treatment and thus prolonged disease-free survival from the same.

  16. Chronic Mercury Intoxication Masquerading as Systemic Disease: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Alexandre Malek

    2017-05-01

    Full Text Available Background: Mercury is a highly toxic environmental metal that exists in three different forms: elemental, inorganic and organic. Intoxication occurs in either occupational or non-occupational settings, mainly after the inhalation of vapour and fumes in work places, laboratories or homes. Chronic mercury toxicity ranges from mild and insignificant to severe and life-threatening. We describe the case of a young male patient who presented with multiple organ dysfunction after chronic mercury exposure. Case presentation: We report the case of 28-year-old male artisanal gold miner who was admitted to hospital for severe neurological impairment associated with inflammatory bowel disease-like symptoms and a skin rash after mercury exposure. Symptomatic treatment and corticosteroid administration assured rapid clinical improvement. Chronic mercury poisoning can masquerade as an autoimmune or systemic inflammatory disease. Conclusion: Physicians should be aware that low exposure to mercury, even from artisanal gold mining, may be harmful to health. Management can be simple without the need for aggressive or invasive therapeutic measures. Larger case series are required in order to establish a clear management plan.

  17. Cyclic mood disorder heralding adult-onset autosomal dominant leucodystrophy: a clinical masquerader.

    Science.gov (United States)

    Jain, Rajendra S; Prakash, Swayam; Raghavendra, B S; Nagpal, Kadam; Handa, Rahul

    2014-06-01

    Leucodystrophies are a heterogeneous group of progressive white matter diseases which may be inherited in dominant, recessive or X-linked fashion depending on the type. Adrenoleucodystrophy (ALD) and metachromatic leucodystrophy (MLD) are rather commoner forms of leucodystrophies whereas krabbes disease, alexander disease, cannavans disease etc. are of less common type. Adult-onset autosomal dominant leucodystrophy (ADLD) is a lately described rarer form of leucodystrophy with perhaps no case report from India. Various leucodystrophies may have different clinical presentations, ranging from subtle cognitive and psychiatric manifestations to gross motor disabilities, visual impairment and seizure. Psychiatric manifestations in the form of psychoses and frank schizophrenia are commonly described in MLD. Depression though uncommonly reported in MLD, cyclic mood disorders have been rarely described in any form of leucodystrophies. We are reporting an eye opener, a case of ADLD which masqueraded as a rapid cyclic mood disorder for initial four years, later to be followed by progressive neurological signs and symptoms. To the best of our knowledge, this is perhaps the first case report of ADLD presenting as rapid cyclic mood disorder in the world literature.

  18. Submucosal lipoma of the large intestine masquerading as a colonic malignancy.

    Science.gov (United States)

    Coyne, Pe; Teemul, T; Dent, B; Henderson, D; Crabbe, R; Garud, T

    2011-02-01

    Lipomas of the alimentary tract are rare tumours that can mimic malignant lesions. They are often small and asymptomatic although larger tumours can present with intusussception or as abdominal masses. We present a case of a transverse colon submucosal lipoma masquerading as a colonic adenocarcinoma leading to resection. A 74 year-old-man was referred urgently for assessment with altered bowel habits, and lower abdominal discomfort along with a positive Faecal-Occult-Blood sample. Colonoscopy demonstrated a large polypoidal lesion at the hepatic flexure with ulceration. Biopsies were inconclusive. A staging CT scan confirmed a 3.3 x 4.3 x 3.4cm Polyp with colonic wall thickening suspicious of malignancy. An extended right hemi-colectomy was performed. Histology showed a large submucosal lipoma with 12 reactive lymph nodes. Colonic lipoma often present as incidental findings detected on either imaging or endoscopically whilst investigating other symptoms. Their appearances can mimic colonic malignancy and surgical resection may be required.

  19. Comparison of TiO2 nanoparticle and graphene-TiO2 nanoparticle composite phototoxicity to Daphnia magna and Oryzias latipes

    Science.gov (United States)

    With a dramatic rise in complexity, needs of nanotoxicology research go beyond simple forms of nanomaterials. This study compared the phototoxicity of nano-TiO2and graphene-TiO2 nanocomposite (GNP). GNP was synthesized based on a hydrothermal method, which simultaneously performe...

  20. Comparison of TiO2 nanoparticle and graphene-TiO2 nanoparticle composite phototoxicity to Daphnia magna and Oryzias latipes

    Science.gov (United States)

    With a dramatic rise in complexity, needs of nanotoxicology research go beyond simple forms of nanomaterials. This study compared the phototoxicity of nano-TiO2and graphene-TiO2 nanocomposite (GNP). GNP was synthesized based on a hydrothermal method, which simultaneously performe...

  1. Comparative study of the phototoxicity of long-wavelength photosensitizers targeted by the MornigaG lectin.

    Science.gov (United States)

    Evangelio, Emi; Poiroux, Guillaume; Culerrier, Raphaël; Pratviel, Geneviève; Van Damme, Els J M; Peumans, Willy J; Barre, Annick; Rougé, Pierre; Benoist, Hervé; Pitié, Marguerite

    2011-07-20

    Morniga G is a plant lectin selective for high density of tumor-associated carbohydrate T and Tn antigens on the surface of cells. The interaction of the protein with Tn induces its cell penetration. This property was used for targeting photosensitizers (consisting of the porphyrins TrMPyP and TPPS, the Al(III)-phthalocyanin AlPcS(4), and the chlorin e6) against leukemic Jurkat T cells after covalent coupling to the protein. The control of MornigaG/photosensitizer loading allowed the comparison of the toxicity of the different photosensitizer conjugates. Conjugate including a single AlPcS(4) per protein appeared promising, since it is poorly toxic when irradiated under white light, while it shows a strong phototoxicity (LD(50) = 4 nM) when irradiated in the therapeutic window, it preferentially kills cancerous lymphocytes, and the sugar binding specificity of the lectin part of the molecule remains unaltered.

  2. Pancreatic Heterotopia: Masquerading as Malignancy - A 15-Year Single Institutional Surgicalpathology Review

    Directory of Open Access Journals (Sweden)

    Rani Kanthan

    2015-07-01

    Full Text Available Context Pancreatic heterotopia, the presence of pancreatic tissue anywhere outside of the anatomical pancreas, is rare and typically an incidental finding. This manuscript reports two index cases of unusual presentations of pancreatic heterotopia masquerading as malignant lesions. Case reports Case #1: Fifty-five year-old female with right upper quadrant pain was found to have a retroperitoneal tumor between the right kidney and liver. Case #2: Thirty-eight-year-old female with a 20-year history of right upper quadrant pain and pancreatitis was found to have an incidental jejunal mass. An intraoperative frozen section was ordered on these two patients for suspected malignancy. Frozen section analysis in both cases showed the presence of benign glandular tissue admixed with ducts in a typical lobular fashion consistent with benign pancreatic tissue, confirming pancreatic heterotopia. The two index cases were investigated and analyzed in detail with relevant review of the literature as available in PubMed and Medline. A 15-year retrospective computer-based histopathological surgical review was conducted in our laboratory and the results were analyzed in the context of evidence-based literature of pancreatic heterotopias. 153 pancreatic pathologies were identified of which the commonest lesion was adenocarcinoma (58.8% followed by pancreatic heterotopia (10.5%, pancreatic neuroendocrine tumors (7.2% and pancreatitis (7.2%. Conclusions Pancreatic heterotopia is rare and most often an incidental finding; however, occasionally patients may present with a mass suggestive of malignancy, leading to clinical diagnostic dilemmas. Awareness of this uncommon lesion is of particular importance at intraoperative frozen section analysis for lesions in atypical locations.

  3. Primary hepatocellular carcinoma in ectopic liver masquerading as left adrenal carcinoma: a rare occurrence

    Directory of Open Access Journals (Sweden)

    Shailendra Kumar

    2010-06-01

    Full Text Available We report a unique case of primary hepatocellular carcinoma in an ectopic liver rest in the left renal hilum masquerading as a left adrenal tumor. Adrenal tumors have been reported within adrenal rests inside the liver but hepatocellular carcinoma in ectopic liver rests in the adrenal area is an extremely rare entity. To the best of our knowledge, this is the first case report from the Indian subcontinent to describe this event in the English literature. Our patient, a sixty-year-old, non-diabetic, non-hypertensive male, presented with a history of left flank pain for the past six months. He was a chronic smoker and also consumed excessive amounts of alcohol. He had chronic obstructive pulmonary disease and was hepatitis B surface antigen positive. A contrast enhanced computer tomography scan of the abdomen showed an 8¥8¥8 cm, well-defined, heterogeneously enhancing mass with central necrosis, in the left suprarenal region. The provisional diagnosis of an adrenal tumor was made and open transperitoneal excision of the tumor along with two enlarged lymph nodes was done. Immunohistochemistry staining of the specimen revealed it to be a primary hepatocellular carcinoma. The patient died within six months of surgery owing to extensive metastases. We concluded that chronic hepatitis B infection and chronic and excessive alcohol consumption and/or chronic smoking may have been the predisposing factors for the occurrence of primary hepatocellular carcinoma in the liver rest in our patient. The prognosis appears to be poor despite surgical management.

  4. Evaluation of phototoxic and photogenotoxic risk associated with the use of photosensitizers in suntan preparations: application to tanning preparations containing bergamot oil.

    Science.gov (United States)

    Moysan, A; Morlière, P; Averbeck, D; Dubertret, L

    1993-01-01

    Bases for the elaboration of a standardized protocol are proposed for studying phototoxic effects of skin tanning preparations containing photosensitizing agents. The experimental procedure includes in vivo phototoxicity tests, evaluation of the photogenotoxic risk and determination of the photosensitizer concentration in plasma after topical application. This procedure was carried out with tanning preparations containing a well-known photosensitizer, 5-methoxypsoralen, as a component of bergamot oil. The whole study has been performed using topical application of the commercial suntan product, i.e. containing the sunscreens and all other components. Whereas the exposure to solar simulated radiation never triggered any phototoxic response, a photosensitizing effect was observed for skin type I volunteers exposed to high doses of ultraviolet A. The transepidermal penetration resulted in a 5-methoxypsoralen concentration of 1-4 ng/ml in the suction blister fluid. The photogenotoxicity of this suction blister fluid containing 5-methoxypsoralen and also other ingredients of the tanning preparation was assayed on yeast cells and was found to be rather low. 5-Methoxypsoralen was also detected in plasma after repeated applications but at low concentrations (about 1 ng/ml) which do not present a potential risk for systemic ocular effects.

  5. The masquerade game: marine mimicry adaptation between egg-cowries and octocorals

    Science.gov (United States)

    Fuentes-Pardo, Angela P.; Ní Almhain, Íde; Ardila-Espitia, Néstor E.; Cantera-Kintz, Jaime; Forero-Shelton, Manu

    2016-01-01

    system comprised background-matching mimicry, of the masquerade type, between egg-cowries (Simnia/Simnialena) and octocorals (Pacifigorgia/Eugorgia/Leptogorgia). We observed mimicry mismatches related to fitness trade-offs, such as reproductive aggregations vs. vulnerability against predators. Despite the general assumption that coevolution of mimicry involves speciation, egg-cowries with different hosts and colorations comprise the same lineages. Consequently, we infer that there would be significant tradeoffs between mimicry and the pursuit of reproductive aggregations in egg-cowries. The findings of this study not only contribute to the understanding of the evolution of mimicry in egg-cowries, a poorly studied group of marine gastropods, but also to the development of a new biologically meaningful board game that could be implemented as a learning tool. PMID:27547514

  6. The masquerade game: marine mimicry adaptation between egg-cowries and octocorals

    Directory of Open Access Journals (Sweden)

    Juan A. Sánchez

    2016-08-01

    -fertilize. Discussion. Our study system comprised background-matching mimicry, of the masquerade type, between egg-cowries (Simnia/Simnialena and octocorals (Pacifigorgia/Eugorgia/Leptogorgia. We observed mimicry mismatches related to fitness trade-offs, such as reproductive aggregations vs. vulnerability against predators. Despite the general assumption that coevolution of mimicry involves speciation, egg-cowries with different hosts and colorations comprise the same lineages. Consequently, we infer that there would be significant tradeoffs between mimicry and the pursuit of reproductive aggregations in egg-cowries. The findings of this study not only contribute to the understanding of the evolution of mimicry in egg-cowries, a poorly studied group of marine gastropods, but also to the development of a new biologically meaningful board game that could be implemented as a learning tool.

  7. The Masquerades of a Childhood Ciliary Body Medulloepithelioma: A Case of Chronic Uveitis, Cataract, and Secondary Glaucoma

    Directory of Open Access Journals (Sweden)

    Jocelyn Chua

    2012-01-01

    Full Text Available Ciliary body medulloepitheliomas in childhood often masquerade other intraocular conditions due to its insidious nature as well as its secondary effects on proximal intraocular tissues in the anterior chamber. We report a case where a ciliary body medulloepithelioma in a two-year-old boy presents with chronic uveitis, cataract, and an uncontrolled secondary glaucoma after an innocuous blunt ocular trauma. The diagnosis was only made after the occurrence of a ciliary body mass. We discuss the clinical features of ciliary body medulloepitheliomas, the implications of a delayed diagnosis and treatment as well as the concern of periorbital tumor seeding with the use of an aqueous shunt implant in this case.

  8. Idiopathic polypoidal choroidal vasculopathy masquerading as choroidal tumors: one year follow-up of a peripheral lesion

    Directory of Open Access Journals (Sweden)

    Rony Carlos Preti

    2015-06-01

    Full Text Available ABSTRACT This case report describes peripheral idiopathic polypoidal choroidal vasculopathy (IPCV with a collection of small aneurysmal dilations that masqueraded as choroidal tumors in an elderly patient. A 68-year-old African American woman was referred to us with a suspected diagnosis of asymptomatic vascular choroidal tumor and choroidal capillary hemangioma, affecting the temporal peripheral fundus. Upon examination, optical coherence tomography (OCT revealed two large hemorrhagic pigment epithelium detachments (PED, and indocyanine green angiography (ICG confirmed the diagnosis of IPCV. One year later, there was reduction in the hemorrhagic pigment epithelium detachments and the lesion took on a different appearance, resembling a choroidal osteoma. No treatment was necessary despite the presence of multiple polyps. IPCV is a rare condition that can resemble other choroidal diseases depending on the stage of presentation. OCT is the best tool to determine the characteristics of the lesions, and indocyanine green angiography should be used to confirm the diagnosis. Not all cases require treatment.

  9. Successful Intra-peritoneal Antibiotic Therapy for Primary Abdominal Nocardiosis in an Immunocompetent Young Female Masquerading as Carcinoma Ovary

    Directory of Open Access Journals (Sweden)

    Ravi N Patil

    2012-01-01

    Full Text Available Nocardiosis is a common opportunistic infection in the immunocompromised and in patients with chronic debilitating diseases,e.g continuous ambulatory peritoneal dialysis (CAPD patients. Primary abdominal nocardiosis is rare and is indeed a very rare infection in immunocompetent persons. Only two cases have been reported in immunocompetent patients so far and this may be third case to the best of our knowledge and first in India. About 11 cases have been reported in CAPD patients and AIDS patients.We report a case of Nocardiosis in an immunocompetent young female who presented with an abdomino-pelvic mass masquerading as carcinoma ovary.After initial resistance to various antibiotics, she responded to intraperitoneal and oral linezolid and oral ciprofloxacin.

  10. Nanostructured delivery system for zinc phthalocyanine: preparation, characterization, and phototoxicity study against human lung adenocarcinoma A549 cells

    Directory of Open Access Journals (Sweden)

    Mariana da Volta Soares

    2011-01-01

    Full Text Available Mariana da Volta Soares1, Mainara Rangel Oliveira1, Elisabete Pereira dos Santos1, Lycia de Brito Gitirana2, Gleyce Moreno Barbosa3, Carla Holandino Quaresma3, Eduardo Ricci-Júnior11Department of Medicines, Laboratório de Desenvolvimento Galênico (LADEG, Faculty of Pharmacy, 2Laboratory of Animal and Comparative Histology, Glycobiology Research Program, Institute of Biomedical Science, 3Department of Medicines, Laboratório Multidisciplinar de Ciências Farmacêuticas, Faculty of Pharmacy, Federal University of Rio de Janeiro (UFRJ, Rio de Janeiro, BrazilAbstract: In this study, zinc phthalocyanine (ZnPc was loaded onto poly-ε-caprolactone (PCL nanoparticles (NPs using a solvent emulsification–evaporation method. The process yield and encapsulation efficiency were 74.2% ± 1.2% and 67.1% ± 0.9%, respectively. The NPs had a mean diameter of 187.4 ± 2.1 nm, narrow distribution size with a polydispersity index of 0.096 ± 0.004, zeta potential of -4.85 ± 0.21 mV, and spherical shape. ZnPc has sustained release, following Higuchi’s kinetics. The photobiological activity of the ZnPc-loaded NPs was evaluated on human lung adenocarcinoma A549 cells. Cells were incubated with free ZnPc or ZnPc-loaded NPs for 4 h and then washed with phosphate-buffered saline. Culture medium was added to the wells containing the cells. Finally, the cells were exposed to red light (660 nm with a light dose of 100 J/cm2. The cellular viability was determined after 24 h of incubation. ZnPc-loaded NPs and free photosensitizer eliminated about 95.9% ± 1.8% and 28.7% ± 2.2% of A549 cells, respectively. The phototoxicity was time dependent up to 4 h and concentration dependent at 0–5 µg ZnPc. The cells viability decreased with the increase of the light dose in the range of 10–100 J/cm2. Intense lysis was observed in the cells incubated with the ZnPc-loaded NPs and irradiated with red light. ZnPc-loaded PCL NPs are the release systems that promise photodynamic

  11. Light sheet-based fluorescence microscopy (LSFM) reduces phototoxic effects and provides new means for the modern life sciences

    Science.gov (United States)

    Pampaloni, Francesco; Ansari, Nari; Girard, Philippe; Stelzer, Ernst H. K.

    2011-07-01

    Most optical technologies are applied to flat, basically two-dimensional cellular systems. However, physiological meaningful information relies on the morphology, the mechanical properties and the biochemistry of a cell's context. A cell requires the complex three-dimensional relationship to other cells. However, the observation of multi-cellular biological specimens remains a challenge. Specimens scatter and absorb light, thus, the delivery of the probing light and the collection of the signal light become inefficient; many endogenous biochemical compounds also absorb light and suffer degradation of some sort (photo-toxicity), which induces malfunction of a specimen. In conventional and confocal fluorescence microscopy, whenever a single plane, the entire specimen is illuminated. Recording stacks of images along the optical Z-axis thus illuminates the entire specimen once for each plane. Hence, cells are illuminated 10-20 and fish 100-300 times more often than they are observed. This can be avoided by changing the optical arrangement. The basic idea is to use light sheets, which are fed into the specimen from the side and overlap with the focal plane of a wide-field fluorescence microscope. In contrast to an epi-fluorescence arrangement, such an azimuthal fluorescence arrangement uses two independently operated lenses for illumination and detection. Optical sectioning and no photo-toxic damage or photo-bleaching outside a small volume close to the focal plane are intrinsic properties. Light sheet-based fluorescence microscopy (LSFM) takes advantage of modern camera technologies. LSFM can be operated with laser cutters and for fluorescence correlation spectroscopy. During the last few years, LSFM was used to record zebrafish development from the early 32-cell stage until late neurulation with sub-cellular resolution and short sampling periods (60-90 sec/stack). The recording speed was five 4-Megapixel large frames/sec with a dynamic range of 12-14 bit. We followed

  12. An analysis of autopsy cases of non-Hodgkin lymphoma-with special reference to those masquerading as acute febrile illness

    Directory of Open Access Journals (Sweden)

    Sonali Rajesh Saraf

    2016-01-01

    Conclusion: As NHL present with nonspecific symptoms, these tumours may not be detected in early stages and hence may not be treated appropriately. These patients have weakened immunity and hence are prone to infection and sepsis which can be a major cause of mortality. This autopsy study experience has shown that NHL can masquerade as acute febrile illness which if not detected early and treated adequately can turn fatal.

  13. Metabolic activation of pyrrolizidine alkaloids leading to phototoxicity and photogenotoxicity in human HaCaT keratinocytes.

    Science.gov (United States)

    Wang, Chia-Chi; Xia, Qingsu; Li, Meng; Wang, Shuguang; Zhao, Yuewei; Tolleson, William H; Yin, Jun-Jie; Fu, Peter P

    2014-01-01

    Pyrrolizidine alkaloids, produced by a large number of poisonous plants with wide global distribution, are associated with genotoxicity, tumorigenicity, and hepatotoxicity in animals and humans. Mammalian metabolism converts pyrrolizidine alkaloids to reactive pyrrolic metabolites (dehydropyrrolizidine alkaloids) that form covalent protein and DNA adducts. Although a mechanistic understanding is currently unclear, pyrrolizidine alkaloids can cause secondary (hepatogenous) photosensitization and induce skin cancer. In this study, the phototoxicity of monocrotaline, riddelliine, dehydromonocrotaline, dehydroriddelliine, and dehydroretronecine (DHR) in human HaCaT keratinocytes under ultraviolet A (UVA) irradiation was determined. UVA irradiation of HaCaT cells treated with dehydromonocrotaline, dehydroriddelline, and DHR resulted in increased release of lactate dehydrogenase and enhanced photocytotoxicity proportional to the UVA doses. UVA-induced photochemical DNA damage also increased proportionally with dehydromonocrotaline and dehydroriddelline. UVA treatment potentiated the formation of 8-hydroxy-2'-deoxyguanosine DNA adducts induced by dehydromonocrotaline in HaCaT skin keratinocytes. Using electron spin resistance trapping, we found that UVA irradiation of dehydromonocrotaline and dehydroriddelliine generates reactive oxygen species (ROS), including hydroxyl radical, singlet oxygen, and superoxide, and electron transfer reactions, indicating that cytotoxicity and genotoxicity of these compounds could be mediated by ROS. Our results suggest that dehydropyrrolizidine alkaloids formed or delivered to the skin cause pyrrolizidine alkaloid-induced secondary photosensitization and possible skin cancer.

  14. Voriconazole-induced periostitis post transplant: an illustrative review of thoracic computed tomography imaging manifestations.

    Science.gov (United States)

    Rheinboldt, M; Delproposto, Z; Agarwal, R

    2015-12-01

    Voriconazole, first commercially approved in 2002 as a second-generation antifungal agent, is commonly used in the immunocompromised setting as both a therapeutic and prophylactic agent. Since 2009, scattered case reports and small case series have detailed a secondary drug-related hyperfluorosis-induced painful periostitis that can occur in the treated patient population. We present a pictorial review of the thoracic imaging manifestations utilizing 3 illustrative cases in the setting of both solid organ and bone marrow transplantation. Knowledge of the relatively characteristic radiographic appearance and distribution, when coupled with the appropriate clinical context and associated laboratory findings, is important in narrowing an otherwise relatively broad differential diagnosis.

  15. Voriconazole-Induced Periostitis Mimicking Chronic Graft-versus-Host Disease after Allogeneic Stem Cell Transplantation

    Directory of Open Access Journals (Sweden)

    Karen Sweiss

    2016-01-01

    Full Text Available Voriconazole is an established first-line agent for treatment of invasive fungal infections in patients undergoing allogeneic stem cell transplantation (ASCT. It is associated with the uncommon complication of periostitis. We report this complication in a 58-year-old female undergoing HSCT. She was treated with corticosteroids with minimal improvement. The symptoms related to periostitis can mimic chronic graft-versus-host disease in patients undergoing HSCT and clinicians should differentiate this from other diagnoses and promptly discontinue therapy.

  16. Voriconazole-Induced Periostitis Mimicking Chronic Graft-versus-Host Disease after Allogeneic Stem Cell Transplantation.

    Science.gov (United States)

    Sweiss, Karen; Oh, Annie; Rondelli, Damiano; Patel, Pritesh

    2016-01-01

    Voriconazole is an established first-line agent for treatment of invasive fungal infections in patients undergoing allogeneic stem cell transplantation (ASCT). It is associated with the uncommon complication of periostitis. We report this complication in a 58-year-old female undergoing HSCT. She was treated with corticosteroids with minimal improvement. The symptoms related to periostitis can mimic chronic graft-versus-host disease in patients undergoing HSCT and clinicians should differentiate this from other diagnoses and promptly discontinue therapy.

  17. Plasma Fluoride Level as a Predictor of Voriconazole-Induced Periostitis in Patients With Skeletal Pain

    OpenAIRE

    Moon, Woo J.; Scheller, Erica L.; Suneja, Anupam; Livermore, Jacob A.; Malani, Anurag N.; Moudgal, Varsha; Kerr, Lisa E.; Ferguson, Eric; Vandenberg, David M.

    2014-01-01

    Periostitis has been an infrequently observed side effect of long-term, high-dose voriconazole therapy. We report a retrospective study correlating elevated plasma fluoride concentrations and the presence of periostitis among patients who received long-term voriconazole therapy and developed skeletal pain.

  18. Energetics of the binding of phototoxic and cytotoxic plant alkaloid sanguinarine to DNA: Isothermal titration calorimetric studies

    Science.gov (United States)

    Adhikari, Anupam; Hossain, Maidul; Maiti, Motilal; Suresh Kumar, Gopinatha

    2008-10-01

    Sanguinarine is a medically important plant alkaloid with remarkable pharmacological and biological activities. DNA binding is considered to be an important aspect in its mode of action. Isothermal titration calorimetric technique was used for the first time to derive the thermodynamic aspects of the interaction of the phototoxic and cytotoxic plant alkaloid sanguinarine with natural calf thymus DNA and four synthetic DNAs of differing base pair sequences under various environmental conditions The affinity of binding of sanguinarine (iminium form) was found to be in the order of 10 5 M -1 to calf thymus DNA. The binding affinity to calf thymus DNA decreased with increase of ionic strength and temperature. The salt dependence of the binding data showed that release of 0.55 U of the cations per bound alkaloid. The binding of the iminium form was exothermic under all conditions, but the uncharged alkanolamine form showed no binding to DNA. The heat capacity changes obtained from the temperature dependence of enthalpy indicated a value of -140 cal/mol K. Sanguinarine showed high specificity to alternating purine-pyrimidine sequences with affinity of the order 10 6 M -1 and the affinity to the polynucleotides varied in the order poly(dG-dC)·poly(dG-dC) > poly(dA-dT)·poly(dA-dT) > poly(dA)·poly(dT) > poly(dG)·poly(dC). The binding to alternating GC polymer was exothermic and enthalpy driven, to the homo GC polymer was exothermic and favoured by both negative enthalpy and positive entropy changes, to the alternating AT polymer was exothermic and enthalpy driven while to the homo AT polymer was endothermic and entropy driven.

  19. Pro-NP™ protect against TiO2 nanoparticle-induced phototoxicity in zebrafish model: exploring potential application for skin care.

    Science.gov (United States)

    Kim, Min-Sik; Stees, Melinda; Karuturi, Bala Vamsi K; Vijayaraghavalu, Sivakumar; Peterson, Richard E; Madsen, Gary L; Labhasetwar, Vinod

    2017-06-01

    Titanium dioxide nanoparticles (TiO2NPs) are used in sunscreen products to protect the skin from the sun's ultraviolet rays. However, following exposure to sunlight, the photocatalytic activity of TiO2NPs can produce an excess of reactive oxygen species (ROS), causing skin cell damage, triggering an inflammatory response. In zebrafish model, we evaluated how well Pro-NP™ (biodegradable NPs containing superoxide dismutase and catalase) could protect them from TiO2NP-induced photo-oxidative stress. We hypothesized that the antioxidant properties of Pro-NP™ would protect zebrafish embryos from the phototoxic effects of TiO2NPs, improving overall survival and growth. Dechorionated embryos were treated with TiO2NPs alone or co-treated with Pro-NP™, and then exposed to simulated sunlight. Pro-NP™ by itself caused no toxicity; however, for embryos exposed to 100 μg/ml TiO2NPs, zebrafish survival was reduced to ∼40% and at 500 μg/ml to ∼10%. In contrast, at 100 μg/ml TiO2NP, co-treatment with Pro-NP™ increased zebrafish survival in a dose-dependent manner. Co-treatment also improved percent of embryos hatching and resulted in normal growth of zebrafish. On the other hand, embryos treated with TiO2NPs alone developed deformities, had reduced pigmentation, and showed severely truncated growth. Pro-NP™ afforded a greater level of protection against TiO2NP-induced phototoxicity than other antioxidants (vitamin E or N-acetylcysteine) commonly used in topical skin care formulations. We conclude that Pro-NP™ exert significant protective effects against TiO2NP-induced phototoxicity and could be developed as a safe, effective skin care product, used alone or in combination with sunscreen products to protect the skin from sun's UV radiation.

  20. The PARP inhibitor PJ-34 sensitizes cells to UVA-induced phototoxicity by a PARP independent mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Lakatos, Petra; Hegedűs, Csaba [Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen (Hungary); Salazar Ayestarán, Nerea; Juarranz, Ángeles [Department of Biology, Faculty of Sciences, Universidad Autónoma of Madrid, 28049-Madrid (Spain); Kövér, Katalin E. [Department of Inorganic and Analytical Chemistry, Faculty of Sciences, University of Debrecen, Debrecen (Hungary); Szabó, Éva [Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen (Hungary); Virág, László, E-mail: lvirag@med.unideb.hu [Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen (Hungary); MTA-DE Cell Biology and Signaling Research Group, Debrecen (Hungary)

    2016-08-15

    Highlights: • PARP-1 is not a key regulator of photochemotherapy. • The PARP inhibitor PJ-34 sensitizes cells to UVA-induced phototoxicity by a PARP independent mechanism. • Photosensitization by PJ-34 is associated with increased ROS production and DNA damage. • Cells sensitized by PJ-34 undergo caspase-mediated apoptosis. - Abstract: A combination of a photosensitizer with light of matching wavelength is a common treatment modality in various diseases including psoriasis, atopic dermatitis and tumors. DNA damage and production of reactive oxygen intermediates may impact pathological cellular functions and viability. Here we set out to investigate the role of the nuclear DNA nick sensor enzyme poly(ADP-ribose) polymerase 1 in photochemical treatment (PCT)-induced tumor cell killing. We found that silencing PARP-1 or inhibition of its enzymatic activity with Veliparib had no significant effect on the viability of A431 cells exposed to 8-methoxypsoralen (8-MOP) and UVA (2.5 J/cm{sup 2}) indicating that PARP-1 is not likely to be a key player in either cell survival or cell death of PCT-exposed cells. Interestingly, however, another commonly used PARP inhibitor PJ-34 proved to be a photosensitizer with potency equal to 8-MOP. Irradiation of PJ-34 with UVA caused changes both in the UV absorption and in the 1H NMR spectra of the compound with the latter suggesting UVA-induced formation of tautomeric forms of the compound. Characterization of the photosensitizing effect revealed that PJ–34 + UVA triggers overproduction of reactive oxygen species, induces DNA damage, activation of caspase 3 and caspase 8 and internucleosomal DNA fragmentation. Cell death in this model could not be prevented by antioxidants (ascorbic acid, trolox, glutathione, gallotannin or cell permeable superoxide dismutase or catalase) but could be suppressed by inhibitors of caspase-3 and −8. In conclusion, PJ-34 is a photosensitizer and PJ–34 + UVA causes DNA damage and caspase

  1. Establishment and assessment in vitro MTT phototoxicity test on cosmetics%体外MTT法评价化妆品光毒性试验的建立与应用

    Institute of Scientific and Technical Information of China (English)

    徐薇; 蒋中仁; 李天舒; 贾红慧; 刘科亮; 金伟; 郑华; 周静

    2013-01-01

    目的 应用体外MTT法评价化妆品光毒性.方法 分别以MTT法、中性红试验评价5种物质的体外3T3细胞光毒性,并与动物试验结果相比较.结果 MTT法与中性红法均能正确判断光毒阳性物与光毒阴性物,对3种育发液的检测结果一致.上述结果与动物实验结果相符.结论 体外MTT法可作为光毒性动物试验的替代方法.%OBJECTIVE To assess phototoxicity of cosmetics by 3T3 MTT phototoxicity test.METHODS Five substances were detected by MTT PT,NRU PT and skin PT respectively,and the results were analyzed and compared.RESULTS The results of these three methods were consistent with each other.Both MTT PT and NRU PT could evaluate the phototoxicity of five substances correctly.CONCLUSION In vitro 3T3 MTT PT could be an alternative method for animal phototoxity test.

  2. Quinone-induced activation of Keap1/Nrf2 signaling by aspirin prodrugs masquerading as nitric oxide.

    Science.gov (United States)

    Dunlap, Tareisha; Piyankarage, Sujeewa C; Wijewickrama, Gihani T; Abdul-Hay, Samer; Vanni, Michael; Litosh, Vladislav; Luo, Jia; Thatcher, Gregory R J

    2012-12-17

    The promising therapeutic potential of the NO-donating hybrid aspirin prodrugs (NO-ASA) includes induction of chemopreventive mechanisms and has been reported in almost 100 publications. One example, NCX-4040 (pNO-ASA), is bioactivated by esterase to a quinone methide (QM) electrophile. In cell cultures, pNO-ASA and QM-donating X-ASA prodrugs that cannot release NO rapidly depleted intracellular GSH and caused DNA damage; however, induction of Nrf2 signaling elicited cellular defense mechanisms including upregulation of NAD(P)H:quinone oxidoreductase-1 (NQO1) and glutamate-cysteine ligase (GCL). In HepG2 cells, the "NO-specific" 4,5-diaminofluorescein reporter, DAF-DA, responded to NO-ASA and X-ASA, with QM-induced oxidative stress masquerading as NO. LC-MS/MS analysis demonstrated efficient alkylation of Cys residues of proteins including glutathione-S-transferase-P1 (GST-P1) and Kelch-like ECH-associated protein 1 (Keap1). Evidence was obtained for alkylation of Keap1 Cys residues associated with Nrf2 translocation to the nucleus, nuclear translocation of Nrf2, activation of antioxidant response element (ARE), and upregulation of cytoprotective target genes. At least in cell culture, pNO-ASA acts as a QM donor, bioactivated by cellular esterase activity to release salicylates, NO(3)(-), and an electrophilic QM. Finally, two novel aspirin prodrugs were synthesized, both potent activators of ARE, designed to release only the QM and salicylates on bioactivation. Current interest in electrophilic drugs acting via Nrf2 signaling suggests that QM-donating hybrid drugs can be designed as informative chemical probes in drug discovery.

  3. A masquerade-like serine proteinase homologue is necessary for phenoloxidase activity in the coleopteran insect, Holotrichia diomphalia larvae.

    Science.gov (United States)

    Kwon, T H; Kim, M S; Choi, H W; Joo, C H; Cho, M Y; Lee, B L

    2000-10-01

    Previously, we reported the molecular cloning of cDNA for the prophenoloxidase activating factor-I (PPAF-I) that encoded a member of the serine proteinase group with a disulfide-knotted motif at the N-terminus and a trypsin-like catalytic domain at the C-terminus [Lee, S.Y., Cho, M.Y., Hyun, J.H., Lee, K.M., Homma, K.I., Natori, S. , Kawabata, S.I., Iwanaga, S. & Lee, B.L. (1998) Eur. J. Biochem. 257, 615-621]. PPAF-I is directly involved in the activation of pro-phenoloxidase (pro-PO) by limited proteolysis and the overall structure is highly similar to that of Drosophila easter serine protease, an essential serine protease zymogen for pattern formation in normal embryonic development. Here, we report purification and molecular cloning of cDNA for another 45-kDa novel PPAF from the hemocyte lysate of Holotrichia diomphalia larvae. The gene encodes a serine proteinase homologue consisting of 415 amino-acid residues with a molecular mass of 45 256 Da. The overall structure of the 45-kDa protein is similar to that of masquerade, a serine proteinase homologue expressed during embryogenesis, larval, and pupal development in Drosophila melanogaster. The 45-kDa protein contained a trypsin-like serine proteinase domain at the C-terminus, except for the substitution of Ser of the active site triad to Gly and had a disulfide-knotted domain at the N-terminus. A highly similar 45-kDa serine proteinase homologue was also cloned from the larval cDNA library of another coleopteran, Tenebrio molitor. By in vitro reconstitution experiments, we found that the purified 45-kDa serine proteinase homologue, the purified active PPAF-I and the purified pro-PO were necessary for expressing phenoloxidase activity in the Holotrichia pro-PO system. However, incubation of pro-PO with either PPAF-I or 45-kDa protein, no phenoloxidase activity was observed. Interestingly, when the 45-kDa protein was incubated with PPAF-I and pro-PO in the absence, but not in the presence of Ca2+, the 45-k

  4. Invasive amebiasis and ameboma formation presenting as a rectal mass: An uncommon case of malignant masquerade at a western medical center

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    A 54-year-old man presented with rectal pain and bleeding secondary to ulcerated, necrotic rectal and cecal masses that resembled colorectal carcinoma upon colonoscopy. These masses were later determined to be benign amebomas caused by invasive Entamoeba histolytica, which regressed completely with medical therapy. In Western countries, the occurrence of invasive protozoan infection with formation of amebomas is very rare and can mistakenly masquerade as a neoplasm. Not surprisingly, there have been very few cases reported of this clinical entity within the United States. Moreover, we report a patient that had an extremely rare occurrence of two synchronous lesions, one involving the rectum and the other situated in the cecum. We review the current literature on the pathogenesis of invasive E. Histolytica infection and ameboma formation, as well as management of this rare disease entity at a western medical center.

  5. A case of papillary microcarcinoma of the thyroid with abundant colloid (masquerading as colloid goiter with papillary hyperplasia: Cytological evaluation with histopathological correlation

    Directory of Open Access Journals (Sweden)

    Elancheran Muthalagan

    2015-01-01

    Full Text Available Papillary thyroid carcinoma (PTC is the most common malignant neoplasm of the thyroid. On fine-needle aspiration (FNA cytology smears of conventional PTC, the background usually shows scanty, bubble gum-like colloid. But the macrofollicular variant and papillary microcarcinoma reveals abundant thin colloid in the background. We report a case of papillary carcinoma of thyroid in a 37-year-old female with abundant thin colloid, obscuring the nuclear morphology in many clusters, along with the presence of typical nuclear features within occasional clusters in FNA cytology and hence, masquerading as colloid goiter with papillary hyperplasia. Histopathological examination of the total thyroidectomy specimen revealed papillary microcarcinomatous focus in a background of nodular hyperplasia. The differential diagnosis of PTC should be entertained even in colloid-rich FNA smears if the typical nuclear features are present. Hence, a meticulous search for any fragment with nuclear features of PTC is mandatory before labeling the smears as benign nodular hyperplasia.

  6. Synthesis and phototoxicity of isomeric 7,9-diglutathione pyrrole adducts: Formation of reactive oxygen species and induction of lipid peroxidation

    Directory of Open Access Journals (Sweden)

    Liang Ma

    2015-09-01

    Full Text Available Pyrrolizidine alkaloids (PAs are hepatotoxic, genotoxic, and carcinogenic in experimental animals. Because of their widespread distribution in the world, PA-containing plants are probably the most common poisonous plants affecting livestock, wildlife, and humans. Upon metabolism, PAs generate reactive dehydro-PAs and other pyrrolic metabolites that lead to toxicity. Dehydro-PAs are known to react with glutathione (GSH to form 7-GSH-(+/−-6,7-dihydro-7-hydroxy-1-hydroxymethyl-5H-pyrrolizine (7-GS-DHP in vivo and in vitro and 7,9-diGS-DHP in vitro. To date, the phototoxicity of GS-DHP adducts has not been well studied. In this study, we synthesized 7-GS-DHP, a tentatively assigned 9-GS-DHP, and two enantiomeric 7,9-diGS-DHP adducts by reaction of dehydromonocrotaline with GSH. The two 7,9-diGS-DHPs were separated by high performance liquid chromatography (HPLC and their structures were characterized by 1H nuclear magnetic resonance (NMR and 1H–1H correlation spectroscopy (COSY NMR spectral analysis. Photoirradiation of 7-GS-DHP, 9-GS-DHP, and the two 7,9-diGS-DHPs as well as dehydromonocrotaline, dehydroheliotrine, and the 7-R enantiomer of DHP (DHR, by UVA light at 0 J/cm2, 14 J/cm2, and 35 J/cm2 in the presence of a lipid, methyl linoleate, all resulted in lipid peroxidation in a light dose-responsive manner. The levels of lipid peroxidation induced by the two isomeric 7,9-diGS-DHPs were significantly higher than that by 7-GS-DHP and 9-GS-DHP. When 7,9-diGS-DHP was irradiated in the presence of sodium azide (NaN3, the level of lipid peroxidation decreased; lipid peroxidation was enhanced when methanol was replaced by deuterated methanol. These results suggest that singlet oxygen is a product induced by the irradiation of 7,9-diGS-DHP. When irradiated in the presence of superoxide dismutase (SOD, the level of lipid peroxidation decreased, indicating that lipid peroxidation is also mediated by superoxide. These results indicate that lipid

  7. Enhanced cellular uptake and phototoxicity of Verteporfin-conjugated gold nanoparticles as theranostic nanocarriers for targeted photodynamic therapy and imaging of cancers

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Linlin [Tianjin Key Laboratory for Photoelectric Materials and Devices, School of Materials Science & Engineering, Tianjin University of Technology, Tianjin 300384 (China); Graduate School of Energy Science and Technology, Chungnam National University, Daejeon 305-764 (Korea, Republic of); Kim, Tae-Hyun; Kim, Hae-Won [Department of Nanobiomedical Science, Dankook University Graduate School, Cheonan 330-714 (Korea, Republic of); Institute of Tissue Regeneration Engineering (ITREN) & College of Dentistry, Dankook University, Cheonan 330-714 (Korea, Republic of); Ahn, Jin-Chul [Department of Biomedical Science, College of Medicine, Dankook University, Cheonan, 330-714 (Korea, Republic of); Kim, So Yeon, E-mail: kimsy@cnu.ac.kr [Graduate School of Energy Science and Technology, Chungnam National University, Daejeon 305-764 (Korea, Republic of); Department of Chemical Engineering Education, College of Education, Chungnam National University, Daejeon 305-764 (Korea, Republic of)

    2016-10-01

    Activatable theranostics with the capacity to respond to a given stimulus have recently been intensively explored to develop more specific, individualized therapies for various diseases, and to combine diagnostic and therapeutic capabilities into a single agent. In this work, we designed tumor-targeting ligand-conjugated block copolymer-gold nanoparticle (AuNP) conjugates as multifunctional nanocarriers of the hydrophobic photosensitizer (PS), verteporfin (Verte), for simultaneous photodynamic therapy and imaging of cancers. Folic acid (FA)-conjugated block copolymers composed of polyethylene glycol (PEG) and poly-β-benzyl-L-aspartate (PBLA) were attached to citrate-stabilized AuNPs through a bidentate dihydrolipoic acid (DHLA) linker. The resulting AuNP conjugates (FA-PEG-P(Asp-Hyd)-DHLA-AuNPs) were significantly more stable than unmodified AuNPs, and their optical properties were not affected by pH. The hydrophobic PS, Verte, was covalently incorporated onto the surfaces of the AuNP conjugates through a pH-sensitive linkage, which increased the water solubility of Verte from < 1 μg/ml to > 2000 μg/ml. The size of FA-PEG-P(Asp-Hyd)-DHLA-AuNPs-Verte as determined by light-scattering measurements was about 110.3 nm, and FE-SEM and FE-TEM images showed that these nanoparticles were spherical and showed adequate dispersivity after modification. In particular, an in vitro cell study revealed high intracellular uptake of FA-PEG-P(Asp-Hyd)-DHLA-AuNPs-Verte (about 98.62%) and marked phototoxicity after laser irradiation compared with free Verte. These results suggest that FA-PEG-P(Asp-Hyd)-DHLA-AuNPs-Verte has great potential as an effective nanocarrier for dual imaging and photodynamic therapy. - Highlights: • We designed theranostic nanocarriers for photodynamic therapy and imaging of cancers. • AuNP conjugates had a spherical shape and a narrow size distribution with a mean diameter of 110.3 nm. • Cellular uptake of free Verte was 18.86%, whereas that of Au

  8. 蝗虫趋光捕集行为的光振调控效应研究%Investigation of Locusts Phototoxic Trapping Be havior Regulat ed by Light and Vibration

    Institute of Scientific and Technical Information of China (English)

    刘启航; 丛晓霞; 周强

    2016-01-01

    利用光振激发蝗虫趋光滑移捕集测试装置,测试分析了光、振、滑移环境对蝗虫趋光滑移捕集行为的影响,研究了蝗虫趋光视觉捕集进入行为。结果表明:紫光激发的趋光视觉效应,可有效引起蝗虫对紫光中敏感光谱竖条纹光照的敏感辨识性感应,产生趋光视觉行为,同时,在光振滑移耦合环境中,Ra3.2、40HRC不锈钢滑板特性,弱化了30°倾斜面上蝗虫生物摩擦控制滑移行为的调控能力,且光照激发趋光视觉效应的趋态性增益和激振力调控足趾接触环境的动态性增效,能够降低蝗虫摩擦控制效应,加速捕集增益性弹跳碰撞滑移行为实现,提高滑移捕集效率,因此蝗虫光振滑移捕集行为是在光电诱导蝗虫趋光视觉效应的基础上,光振激发效应强化蝗虫生物摩擦控制减弱、行为调控能力降低而出现的结果。然而,光源及激振措施放置,影响蝗虫趋光捕集进入效果,且趋光捕集进入是实现滑移捕集的关键,因而,需在试验测定150 mm灯距、调控光照和下激振措施结合调控蝗虫趋光滑移捕集效果较优的基础上,探寻蝗虫趋光捕集进入的有效措施,以提高蝗虫趋光捕集率。%Using the testing device of locusts phototoxic slipping and trapping behavior effect stimulated by light and vibra-tion, analyzed the influence of light, vibration and slipping environment on locusts phototoxic trapping behavior, and investigated the phototoxic visual behavior of locusts trapped to enter.The results showed that the phototoxic visual effect stimulated by violet light caused locusts were sensitive to identify and respond to the sensitive spectral light of vertical stripes in the violet light, gener-ating the phototoxic visual behavior.Simultaneously, in the coupling environment of light, vibration and slanting slip plane, stain-less steel board features( Ra3.2, 40HRC) weakened the

  9. Phototoxic effect of UVR on wild type, ebony and yellow mutants of Drosophila melanogaster: Life Span, fertility, courtship and biochemical aspects

    Institute of Scientific and Technical Information of China (English)

    WANG ZhePeng; LIU RuiFang; WANG AnRu; DU LiLi; DENG XueMei

    2008-01-01

    Melanin plays an important role in protecting organisms from ultraviolet radiation (UVR). Therefore, it is possible that differently colored strains can show different sensitivities to UVR. In the present work, life span, fertility and courtship behavior of wild type (w), ebony (e) and yellow (y) strains of Drosophila melanogaster were studied to evaluate their sensitivity to ultraviolet (UV). Because a range of photo-toxic effects of UVR are mediated through generation of free radicals, levels of free radicals, lipid per-oxide (malondialdehyde, MDA) and superoxide dismutase (SOD) activity of three strains were examined to indicate their antioxidant defending ability and oxidative status. It was shown that w always had the highest lifespan and fertility not only in the control but also in UV-exposed groups. Moreover, lifespan and fertility of e were significantly higher (P0.05). MDA levels were increased in the UV dose-dependent manner (P=0.0495). In con-clusion, our results suggested that UVB can decrease life span and fertility of flies and do harm to courtship, which may be due to oxidative damage to flies tissues (e.g. central nervous system) induced by free radicals, w had the highest tolerance to UVR, which may be ascribed to its advantage of survival under the natural condition and at high level of SOD activity. Then differences of pigment between e and y in absorbing UV, shielding against UV and scavenging free radicals produced by UVR should be responsible for their different sensitivity to UVR.

  10. Phototoxic effects of silicon bis (dimetilaminoetanoxi)-phthalocyanine (SiPc) on the viability of Leishmania major and Leishmania braziliensis promastigotes

    Science.gov (United States)

    Guerra Pinto, Juliana; Ferreira-Strixino, Juliana; Mittmann, Josane

    2016-06-01

    American cutaneous leishmaniasis (ACL) is an infectious disease caused by protozoans of the genus Leishmania. The treatment may consist of pentavalent antimonials or pentamidine and amphotericin. However, these treatments are extremely aggressive. Photodynamic antimicrobial chemotherapy (PACT) involves the same mechanism of photodynamic therapy which associates a photosensitizer with oxygen and a light source generating a photochemical reaction leading to cell death. The aim of this study was to verify the potential use of silicon bis (dimetilaminoetanoxi)-phthalocyanine (SiPc) compound in photodynamic treatment through evaluation of its phototoxic effect in promastigotes of the genus Leishmania braziliensis and Leishmania major. Treatment with SiPc was able to drastically affect the viability of the parasites as well as affect their growth and morphology, after PACT treatment. The data shown in this study allows us to conclude that SiPc is a promising photosensitizer (PS) since it does not affect parasite growth and viability in the dark. After PACT with this phthalocyanine, over 99% of parasites were killed with the higher concentration and a light dose used. These results suggest that SiPc can be used in future to treat CL, however, further studies are necessary to determine whether the PS are toxic to mononuclear phagocytic cells and epithelial cells which will also be affected by therapy when applied topically.

  11. Masquerade detection based on shell commands and Markov chain models%基于shell命令和Markov链模型的用户伪装攻击检测

    Institute of Scientific and Technical Information of China (English)

    肖喜; 田新广; 翟起滨; 叶润国

    2011-01-01

    提出一种新的基于shell命令的用户伪装攻击检测方法.该方法在训练阶段充分考虑了用户行为的多变性和伪装攻击的特点,采用平稳的齐次Markov链对合法用户的正常行为进行建模,根据shell命令的出现频率进行阶梯式数据归并来划分状态,同现有的Markov链方法相比大幅度减少了状态个数和转移概率矩阵的存储量,提高了泛化能力.针对检测实时性需求和shell命令操作的短时相关性,采用了基于频率优先的状态匹配方法,并通过对状态短序列的出现概率进行加窗平滑滤噪处理来计算判决值,能够有效减少系统计算开销,降低误报率.实验表明,该方法具有很高的检测准确率和较强的可操作性,特别适用于在线检测.%A novel method for masquerade attack detection based on shell commands was proposed. At the training stage,the variability of users' behavior and the feature of masquerade attack were thoroughly considered, and stationary homogeneous Markov chains were employed to profile the normal users' behavior. The shell commands were gradationally merged into multiple sets according to their frequencies and then states were constructed accordingly, which significantly reduced the number of states and the memory of the transition probability matrix and improved the generalization of the detection system, compared with existing Markov chain methods. Considering the real-time detection demand and the short-time relevance of shell commands, the states were matched with a high-frequency-first scheme at the detection stage, and the decision measure was computed by smoothing the probabilities of short state sequences. This decreased computational complexity and the false-alarm rate. Experimental results indicate that our method can achieve high detection accuracy and practicability, and is especially applicable for on-line detection.

  12. In vitro cytotoxicity and phototoxicity of surface-modified gold nanoparticles associated with neutral red as a potential drug delivery system in phototherapy

    Energy Technology Data Exchange (ETDEWEB)

    Verissimo, Tanira V. [School of Health Sciences, University of Brasilia, Brasilia (Brazil); Laboratory of Photochemistry and Nanobiotechnology, Faculty of Ceilandia, University of Brasilia, Brasilia (Brazil); Santos, Naiara T. [School of Health Sciences, University of Brasilia, Brasilia (Brazil); Silva, Jaqueline R.; Azevedo, Ricardo B. [Institute of Biological Sciences, University of Brasilia, Brasilia (Brazil); Gomes, Anderson J., E-mail: ajgomes@unb.br [School of Health Sciences, University of Brasilia, Brasilia (Brazil); Laboratory of Photochemistry and Nanobiotechnology, Faculty of Ceilandia, University of Brasilia, Brasilia (Brazil); Lunardi, Claure N., E-mail: clunardi@unb.br [School of Health Sciences, University of Brasilia, Brasilia (Brazil); Laboratory of Photochemistry and Nanobiotechnology, Faculty of Ceilandia, University of Brasilia, Brasilia (Brazil)

    2016-08-01

    The surface of gold nanoparticles (AuNP) was modified, improving their interaction with neutral red (NR), by using sodium thioglycolate (TGA) as a covering agent. The resulting NR-AuNPTGA system was evaluated as a potential drug delivery system for photodynamic therapy (PDT). The associations of NR with the gold nanoparticles were evaluated using UV-vis spectrometry and measurement of their zeta potential and size distribution. The toxicity and phototoxicity of NR, AuNPTGA and NR-AuNPTGA were evaluated in NIH-3T3 fibroblast and 4T1 tumor cell lines. The compounds NR and NR-AuNPTGA induced toxicity in 4T1 tumor cells and NIH-3T3 fibroblasts under visible light irradiation. Modification of the surface of AuNP with TGA prevented nanoparticle aggregation and allowed greater association with NR molecules than for naked AuNP. The photosensitizer (PS) characteristics were not affected by its association with the modified surface of the gold nanoparticles, leading to a reduction of cell viability in both cell lines assayed. This NR-AuNPTGA system is a promising drug delivery system for photodynamic cancer therapy. - Highlights: • Modified gold nanoparticle (AuNP) by sodium thioglicolate (TGA) prevents aggregation. • Neutral red (NR) adsorbed on the surface of modified gold nanoparticles (AuNPTGA). • AuNPTGA is suitable as a platform to deliver the NR under irradiation process. • Photodamage of 90% was achieved by NR added to AuNPTGA in 4T1 and NIH-3T3 cells.

  13. Eliminated Phototoxicity of TiO2 Particles by an Atomic-Layer-Deposited Al2 O3 Coating Layer for UV-Protection Applications.

    Science.gov (United States)

    Jang, Eunyong; Sridharan, Kishore; Park, Young Min; Park, Tae Joo

    2016-08-16

    We demonstrate the conformal coating of an ultrathin Al2 O3 layer on TiO2 nanoparticles through atomic layer deposition by using a specifically designed rotary reactor to eliminate the phototoxicity of the particles for cosmetic use. The ALD reactor is modified to improve the coating efficiency as well as the agitation of the particles for conformal coating. Elemental and microstructural analyses show that ultrathin Al2 O3 layers are conformally deposited on the TiO2 nanoparticles with a controlled thickness. Rhodamine B dye molecules on Al2 O3 -coated TiO2 exhibited a long life time under UV irradiation, that is, more than 2 h, compared to that on bare TiO2 , that is, 8 min, indicating mitigation of photocatalytic activity by the coated layer. The effect of carbon impurities in the film resulting from various deposition temperatures and thicknesses of the Al2 O3 layer on the photocatalytic activity are also thoroughly investigated with controlled experimental condition by using dye molecules on the surface. Our results reveal that an increased carbon impurity resulting from a low processing temperature provides a charge conduction path and generates reactive oxygen species causing the degradation of dye molecule. A thin coated layer, that is, less than 3 nm, also induced the tunneling of electrons and holes to the surface, hence oxidizing dye molecules. Furthermore, the introduction of an Al2 O3 layer on TiO2 improves the light trapping thus, enhances the UV absorption.

  14. Cytological artifacts masquerading interpretation

    Science.gov (United States)

    Sahay, Khushboo; Mehendiratta, Monica; Rehani, Shweta; Kumra, Madhumani; Sharma, Rashi; Kardam, Priyanka

    2013-01-01

    Background: Cytological artifacts are important to learn because an error in routine laboratory practice can bring out an erroneous result. Aims: The aim of this study was to analyze the effects of delayed fixation and morphological discrepancies created by deliberate addition of extraneous factors on the interpretation and/or diagnosis of an oral cytosmear. Materials and Methods: A prospective study was carried out using papanicolaou and hematoxylin and eosin-stained oral smears, 6 each from 66 volunteer dental students with deliberate variation in fixation delay timings, with and without changes in temperature, undue pressure while smear making and intentional addition of contaminants. The fixation delay at room temperature was carried out at an interval of every 30 minutes, 1 day and 1 week and was continued till the end of 1 day, 1 week, and 1 month, respectively. The temperature variations included 60 to 70°C and 3 to 4°C. Results: Light microscopically, the effect of delayed fixation at room temperature appeared first on cytoplasm followed by nucleus within the first 2 hours and on the 4th day, respectively, till complete cytoplasmic degeneration on the 23rd day. However, delayed fixation at variable temperature brought faster degenerative changes at higher temperature than lower temperature. Effect of extraneous factors revealed some interesting facts. Conclusions: In order to justify a cytosmear interpretation, a cytologist must be well acquainted with delayed fixation-induced cellular changes and microscopic appearances of common contaminants so as to implicate better prognosis and therapy. PMID:24648667

  15. Cytological artifacts masquerading interpretation

    Directory of Open Access Journals (Sweden)

    Khushboo Sahay

    2013-01-01

    Conclusions: In order to justify a cytosmear interpretation, a cytologist must be well acquainted with delayed fixation-induced cellular changes and microscopic appearances of common contaminants so as to implicate better prognosis and therapy.

  16. Low-pressure cardiac tamponade masquerading as severe sepsis diagnosed with a bedside ultrasound and as the initial presentation of malignancy.

    Science.gov (United States)

    Conti, Ricardo Augusto Slaibi; Oppenheim, Ian Mandeville

    2014-01-01

    We report a patient with low-pressure cardiac tamponade masquerading as sepsis and as the initial presentation of malignancy. A quick diagnosis was done by the intensivist performing a bedside ultrasound. The diagnosis of low-pressure cardiac tamponade is a challenge because the classic physical signs of cardiac tamponade can be absent. It is made even more challenging when the vital sign changes and physical examination findings mimic severe sepsis. One of the benefits of a bedside ultrasound in the assessment of a patient with an initial diagnosis of severe sepsis or septic shock is the rapid diagnosis of cardiac tamponade if it is present. A 55-year-old male presented to the emergency department with weakness, cough, and syncope. His examination was notable only for dusky mottling of his cheeks, chest, and neck. Specifically, there was no jugular venous distension or pulsus paradoxus. A chest radiograph showed a right upper lobe infiltrate, whereas his electrocardiogram showed only sinus tachycardia. His white blood cell count and lactic acid were elevated. The sepsis protocol was started and a bedside ultrasound revealed signs of cardiac tamponade. The patient immediately improved after a pericardiocentesis. Analysis of the pericardial biopsy revealed adenocarcinoma, later determined to be from a pulmonary primary source. Because low-pressure cardiac tamponade is life-threatening and difficult to diagnose, evaluation of the pericardium with a bedside ultrasound should be considered in patients with syncope, severe sepsis, or shock.

  17. A Novel In Vivo Model of Focal Light Emitting Diode-Induced Cone-Photoreceptor Phototoxicity: Neuroprotection Afforded by Brimonidine, BDNF, PEDF or bFGF

    Science.gov (United States)

    García-Ayuso, Diego; Alarcón-Martínez, Luis; Jiménez-López, Manuel; Bernal-Garro, José Manuel; Nieto-López, Leticia; Nadal-Nicolás, Francisco Manuel; Villegas-Pérez, María Paz; Wheeler, Larry A.; Vidal-Sanz, Manuel

    2014-01-01

    We have investigated the effects of light-emitting diode (LED)-induced phototoxicity (LIP) on cone-photoreceptors and their protection with brimonidine (BMD), brain-derived neurotrophic factor (BDNF), pigment epithelium-derived factor (PEDF), ciliary neurotrophic factor (CNTF) or basic fibroblast growth factor (bFGF). In anesthetized, dark adapted, adult albino rats a blue (400 nm) LED was placed perpendicular to the cornea (10 sec, 200 lux) and the effects were investigated using Spectral Domain Optical Coherence Tomography (SD-OCT) and/or analysing the retina in oriented cross-sections or wholemounts immune-labelled for L- and S-opsin and counterstained with the nuclear stain DAPI. The effects of topical BMD (1%) or, intravitreally injected BDNF (5 µg), PEDF (2 µg), CNTF (0.4 µg) or bFGF (1 µg) after LIP were examined on wholemounts at 7 days. SD-OCT showed damage in a circular region of the superotemporal retina, whose diameter varied from 1,842.4±84.5 µm (at 24 hours) to 1,407.7±52.8 µm (at 7 days). This region had a progressive thickness diminution from 183.4±5 µm (at 12 h) to 114.6±6 µm (at 7 d). Oriented cross-sections showed within the light-damaged region of the retina massive loss of rods and cone-photoreceptors. Wholemounts documented a circular region containing lower numbers of L- and S-cones. Within a circular area (1 mm or 1.3 mm radius, respectively) in the left and in its corresponding region of the contralateral-fellow-retina, total L- or S-cones were 7,118±842 or 661±125 for the LED exposed retinas (n = 7) and 14,040±1,860 or 2,255±193 for the fellow retinas (n = 7), respectively. BMD, BDNF, PEDF and bFGF but not CNTF showed significant neuroprotective effects on L- or S-cones. We conclude that LIP results in rod and cone-photoreceptor loss, and is a reliable, quantifiable model to study cone-photoreceptor degeneration. Intravitreal BDNF, PEDF or bFGF, or topical BMD afford significant cone neuroprotection in this model

  18. Suicidio disimulado como accidente de tráfico: A propósito de un caso Suicide masquerading as traffic accident: case report

    Directory of Open Access Journals (Sweden)

    ME. Domínguez Pedroso

    2007-10-01

    Full Text Available Los motivos que inducen a una persona a enmascarar un suicidio simulando una muerte accidental pueden ser varios. Exponemos un caso en el que la víctima utiliza un accidente de tráfico para disimular un suicidio por arma de fuego y de esta forma conseguir que fuesen abonadas tanto la indemnización del Seguro de Automóviles como los incluidos en un seguro privado contratado poco antes. Sólo a través de una adecuada investigación del lugar de los hechos y de los antecedentes de la víctima junto a la realización del indispensable estudio necrópsico será posible determinar la verdadera etiología médico-legal de las muertes en accidente de tráfico, con especial atención en las que interviene sólo un vehículo con un único ocupante.There are several reasons that induce somebody to mask a suicide simulating an accidental death. We expose a case in which the victim uses a traffic accident to masquerade a suicide by shotgun. By this way, the author tries to receive the reimbursement of the car’s insurance as well as the money included in a private life insurance contracted just few days before. Only with the careful local death examination and the study of the victim's personal history, plus the essential autopsy, could we manage to understand the real aetiology of deaths in traffic accidents, especially focusing on those cases where there is a single car with a single passenger affected.

  19. Topical or oral administration with an extract of Polypodium leucotomos prevents acute sunburn and psoralen-induced phototoxic reactions as well as depletion of Langerhans cells in human skin

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, S.; Pathak, M.A.; Fitzpatrick, T.B. [Massachusetts General Hospital, Harvard Medical School, Dept. of Dermatology, Boston, MA (United States); Cuevas, J. [Hospital Universitario de Guadalajara, Dept. of Pathology, Guadalajara (Spain); Villarrubia, V.G. [I.F. Cantabria SA, Medical Dept., Immunology Sect., Madrid (Spain)

    1997-12-31

    Sunburn, immune suppression, photo-aging, and skin cancers result from uncontrolled overexposure of human skin to solar ultraviolet radiation (UVR). Preventive measures, including photo-protection, are helpful and can be achieved by topical sun-screening agents. Polypodium leucotomos (PL) has been used for the treatment of inflammatory diseases and has shown some in vitro and in vivo immunomodulating properties. Its beneficial photo-protective effects in the treatment of vitiligo and its antioxidant properties encouraged us to evaluate in vivo the potentially useful photo-protective property of natural extract of PL after topical application or oral ingestion. Twenty-one healthy volunteers [either untreated or treated with oral psoralens (8-MOP or 5-MOP)] were enrolled in this study and exposed to solar radiation for evaluation of the following clinical parameters: immediate pigment darkening (IPD), minimal erythema dose (MED), minimal melanogenic dose (MMD), and minimal phototoxic dose (MPD) before and after topical or oral administration of PL. Immunohistochemical assessment of CD1a-expressing epidermal cells were also performed. PL was found to be photo-protective after topical application as well as oral administration. PL increased UV dose required for IPD (P<0.01), MED (P<0.001) and MPD (P<0.001). After oral administration of PL, MED increased 2.,8{+-}0.59 times and MPD increased 2.75{+-}0.5 and 6.8{+-}1.3 times depending upon the type of psoralen used. Immunohistochemical study revealed photo-protection of Langherhans cells by oral as well as topical PL. The observed photo-protective activities of oral or topical PL reveal a new avenue in examining the potentially useful field of systemic photo-protection and suggests that PL can be used as adjunct treatment and can make photochemotherapy and phototherapy possibly safe and effective when the control of cutaneous phototoxicity to PUVA or UVB is a limiting factor in such photo-therapies. (au). 50 refs.

  20. The risk factors of phototoxic maculopathy caused by welding arc in occupational welders%电焊工人光损伤性黄斑病变的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    邵东平; 丁瑛; 杨晓然; 刘斐; 李敏超

    2013-01-01

    AIM :To investigate the risk factors that cause phototoxic maculopathy in occupational welders.METHODS: We examined a group of 68 male welders 136 eyes from some metal manufacturing enterprise from March 2012 to December 2012. Participants underwent thorough ophthalmologic examination including visual acuity, fundus photography, and high definition optical coherence tomography ( OCT) scan. A specialist of occupational medicine examined all participants of this study prior to the OCT. The clinical history of all subjects was screened carefully before the study. All the subjects were divided into three groups according to age, length of service, protection habits. The incidences of phototoxic maculopathy were compared in 3 groups.RESULTS: The incidences ofphototoxic maculopathy in less than or equal to 35 years old group, and more than 35 years old group were respectively 35.14%, 29. 03%, and difference was not statistically significant. The incidences of phototoxic maculopathy in less than or equal to 10-years-seniority group, and more than 10-years-seniority group were respectively 11. 76% and 33. 33%, and the difference was statistically significant. The incidences of phototoxic maculopathy in strict protection group, protective random group and sunglasses protection group were respectively 21. 88%, 36. 96%, and 50. 00%. The incidence in strict protection group was lower than the other two groups, the incidence was the highest in sunglasses protection group, and the difference was statistically significant.CONCLUSION: The risk factors of phototoxic maculopathy in occupational welders are the length of service and protection habits. The longer the length of service, the macular lesions probability is high; protection more strict, macular lesions rate is low. The phototoxic maculopathy occurs regardless of age.%目的:探讨影响电焊工人光损伤性黄斑病变发生的危险因素.方法:选取2012-03/12来自本地区相关工厂

  1. Features of OCT image of phototoxic maculopathy caused by arc light%电弧光所致黄斑区光损伤的OCT图像特征

    Institute of Scientific and Technical Information of China (English)

    邵东平; 杨晓然; 李敏超; 梁雪芬; 杨洁华

    2013-01-01

    Objective To investigate features of high resolution optical coherence tomography(HROCT) image of phototoxic maculopathy caused by arc light.Methods Sixty-eight local arc-welders(136 eyes) were recruited to receive thorough ophthalmological examination including pre-set lens fundoscopy,fundns colorized photography,automatic-perimeter examination of visual field and HROCT from March,2010 to December,2012.Medical histories of all subjects were carefully screened before the enrollment to eliminate those who had other fundus diseases,histories of intraocular surgery or had received other strong light in eyes.Results No obvious anomaly was found in anterior segment examination,fundus red reflex test or visual field examination.Of all the 136 eyes,26 eyes(19.12%) showed small round or oval luteotestaceous macular lesion with obscure boundary; Forty-four eyes (32.35%) showed varying degrees of disorder,fracture or miss of the inner segment/outer segment (IS/OS) layer and the retinal pigment epithelium (RPE) layer.Of the 44 damaged eyes,10 eyes (7.35%) suffered grade Ⅰ lesion;Twelve eyes(8.82%) suffered grade Ⅱ lesion;Sixteen eyes(11.76%) suffered grade Ⅲ lesion; Six eyes(4.41%) suffered grade Ⅳ lesion.The largest missing length was 416 μm.Conclusion HROCT is a reliable method to diagnose or screen early maculopathy,because it could help to observe small macular lesion before any vision symptom appears.%目的 探讨电弧光所导致的黄斑区慢性光损伤的高分辨率光学相干断层扫描(optical coherence tomography,OCT)图像的特征.方法 2010年3至2012年12月期间,选取来自本地区相关工厂从事电弧焊工作的焊工68人136眼进行详细的眼部检查,包括90 D前置镜眼底检查、眼底彩色照相、自动视野计检查和高分辨率的OCT检查.所有受试者的病史在入选前均经过仔细筛选,排除患有其他眼底疾病或曾有过眼内手术史以及接受过其他强光照射者.结果 所有受

  2. Photodynamic therapy: anti-tumour potentialities of bis (tri {pi}-hexyl-siloxy) silicon phthalocyanine against malignant achromic M6 melanocytes. EPR study of the photo-toxic mechanism; Phototherapie dynamique: etude des potentialites anti-tumorales de la bis (tri {pi}-hexylsiloxy) phtalocyanine de silicium sur melanocytes malins achromiques M6. Etude RPE desmecanismes phototoxiques

    Energy Technology Data Exchange (ETDEWEB)

    Decreau, R.; Viola, A.; Julliard, M. [Faculte des Sciences Saint-Jerome, 13 - Marseille (France). Laboratoire AM3-ESA CNRS; Hadjur, Ch.; Richard, M.J.; Favier, A. [Hopital Michallon, 38 - Grenoble (France). Laboratoire de Biochimie C; Jeunet, A. [Grenoble Universite, 38 - Saint-Martin-d' Heres (France). LEDSS-UMR CNRS

    1997-07-01

    Photodynamic therapy of cancerous cells is a technique relying upon the irradiation of tumorous cells after selective incorporation of a photo-sensitizer. The bis (tri n-hexyl-siloxy) silicon phthalocyanine is a second generation photo-sensitizer. Anti-cancerous potentialities of this molecule have been evaluated against the melanotic M6 cell line. Results have evidenced a high phototoxicity at low concentration and no dark toxicity under the same conditions. EPR studies on the photochemical pathways involved in phototoxicity processes have been realised in solvent and model membranes (liposomes). Results provide evidences for the production of singlet oxygen ({sup 1}O{sub 2}) as well as superoxide (O{sub 2}{sup 0-}) and hydroxyl radical ({sup 0}OH). (authors)

  3. Atividades antimicrobiana e fototóxica de extratos de frutos e raízes de Physalis angulata L. Antimicrobial and phototoxic activities of Physalis angulata L (Solanaceae extracts, fruits and roots

    Directory of Open Access Journals (Sweden)

    Deise Cristina D.X.P. Lopes

    2006-06-01

    Full Text Available Extratos e frações de frutos e raízes de Physalis angulata L. (Solanaceae foram ensaiados para encontrar atividade antimicrobiana. Aplicando o método de difusão em agar, todas as amostras foram testadas contra Staphylococcus aureus ATCC 6538. O extrato etanólico dos frutos apresentou atividade antibacteriana, a qual teve a atividade fototóxica estimada em cobaias quando expostas a luz ultravioleta, e não foram observados eritemas. Esses dados impulsionaram a pesquisar diferentes formas de obtenção de extratos da planta, com o objetivo de preparar formulações com atividade anti-séptica, que possam se apresentar mais eficazes e seguras, quando aplicadas no tratamento de doenças infecciosas.Extracts and fractions of Physalis angulata L. prepared from fruits and roots were assayed to find out antimicrobial activity. Using the agar diffusion method all samples were tested against Staphylococcus aureus ATCC 6538. The ethanolic extract of the fruits displayed bacterial activity. Phototoxic property was estimated with guinea pigs when they were exposed to ultraviolet light, no erythemas were observed. These data encouraged us to look for different forms of extracts wich could be applied as a safe and effective antiseptic product.

  4. Exogenous ochronosis masquerading refractory melasma

    OpenAIRE

    Swati Sharma; Raghavendra Rao

    2014-01-01

    Exogenous ochronosis is an infrequent dermatosis characterized by dark blue hyperpigmentation. It may be caused largely by hydroquinone, a fenolic compound which is used in the treatment of melasma and other skin hyperpigmentation. The exact etiopathology is still not understood and the results of various treatments offered are unsatisfactory. We present a case of exogenous ochronosis which resembled melasma but clinicopathologic evaluation led to the correct diagnosis. We also emphasize the ...

  5. Dermatomyositis masquerading as pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Mroz RM

    2009-12-01

    Full Text Available Abstract A 61-year-old Caucasian was admitted to Department of Chest Diseases and Tuberculosis, Medical University of Bialystok, Poland for progressive muscle weakness and weight loss. Eighteen months prior to admission, the patient had been diagnosed with pulmonary embolism. At that point he was started on Enoxaparin QD. Past medical history was unremarkable. In the interim, the patient developed fever, myalgia and progressive dyspnea. Physical examination on admission revealed a rash on his upper torso and back, and the extensor surfaces of all four extremities. Laboratory values included CPK 8229, MB fraction 219, LDH 981. Chest X-ray and CT scan revealed bilateral patchy consolidations and ground-glass opacities. EMG was consistent with myositis. The patient was started on solumedrol 40 mg i.v., b.i.d., and then switched to prednisone 40 mg b.i.d. His symptoms and muscle strength improved remarkably. The patient was discharged with prednisone with an outpatient follow up.

  6. When interpretation masquerades as explanation.

    Science.gov (United States)

    Spence, D P

    1986-01-01

    The principal goal of the clinical interpretation (and of the larger clinical narrative) is to bring about insight and change in the patient, and not to present a reasoned argument that relies on public data and shared rules of evidence and logic. When the clinical account is transposed to the public domain and presented as a form of explanation, it is no longer designed for the benefit of one individual but must now be accessible to all. We are still under the shadow of Freud's five famous cases which are literary landmarks of exposition and persuasion. As a result, we are less sensitive to what happens when interpretations are substituted for explanations. The time has come to develop a new genre and a new mode of clinical reporting that would allow the reader to participate in the argument, allow him to evaluate the proposed links between evidence and conclusion (instead of relying on the authority of the analyst-author), and open up the clinical report to the possibilities of refutation, disconfirmation, and falsification.

  7. Global Drums and Local Masquerades

    Directory of Open Access Journals (Sweden)

    Liwhu Betiang

    2013-12-01

    Full Text Available TV broadcasting has been in Nigeria for more than 50 years (1959-2009. Its development has brought about a series of local responses to global socioeconomic and political environments and “soft” stimuli. This conclusion is based on a critical, interpretive reading of the history, form, and content of television in Nigeria from Obafemi Awolowo’s Western Nigeria Television in Ibadan through the federal government’s reactive establishment of the national network: the Nigeria Television Authority, and later, states and private television stations. The ultimate deregulation of television broadcasting in 1992, perceived as Babangida’s “politically-correct” reaction to the pressures from the Bretton Woods institutions, opened up national media markets for global penetration, and fast-tracked media globalization and its effects in Nigeria. While television stations in Nigeria have multiplied in numerical terms, programming/content/form have followed the global market/technological determinism turning Nigerian TV into localized versions of commercialized western master-scripts with very little local ideological direction.

  8. Eumycetoma Masquerading As Malignant Melanoma

    Directory of Open Access Journals (Sweden)

    Janaki C

    1999-01-01

    Full Text Available Eumycetoma of the right foot caused by madurella mycetomatis with infection to regional inguinal lymph nodes has been described in a male patient along with the clinical, mycological and mycopathological features. The lesions never recurred in the follow up period of four years, after the excision of the sole lesions along with block dissection of the involved lymph nodes.

  9. Pseudomenigiocele masquerading as monomelic amyotrophy

    Directory of Open Access Journals (Sweden)

    William Jens

    2016-09-01

    Full Text Available Pseudomeningocele is a known cause of myelopathy, however this is classically associated with bilateral symptoms. We discuss a patient presenting with single upper extremity weakness, initially diagnoses as monomelic amyotrophy, which further investigation revealed to be a giant pseudomeningocele. This case illustrates a unique presentation of pseudomeningocele, including prominent changes in MRI, CT myelogram, and EMG. A review of the literature for pseudomeningocele including pathology, diagnosis, imaging, and treatment as well as the initial diagnosis of monomelic amyotrophy is provided.

  10. Pseudomenigiocele masquerading as monomelic amyotrophy

    OpenAIRE

    William Jens; Rae Bacharach; Sandip Savaliya; Divpreet Kaur

    2016-01-01

    Pseudomeningocele is a known cause of myelopathy, however this is classically associated with bilateral symptoms. We discuss a patient presenting with single upper extremity weakness, initially diagnoses as monomelic amyotrophy, which further investigation revealed to be a giant pseudomeningocele. This case illustrates a unique presentation of pseudomeningocele, including prominent changes in MRI, CT myelogram, and EMG. A review of the literature for pseudomeningocele including pathology, dia...

  11. Pituitary apoplexy masquerading as meningitis

    African Journals Online (AJOL)

    Ceftriaxone was commenced for the presumptive diagnosis of bacterial ... The patient recovered with conservative management consisting of hormonal replacement therapy .... CSF features of acute bacterial meningitis, who was unresponsive.

  12. Coccidioidomycosis Masquerading as Eosinophilic Ascites

    Directory of Open Access Journals (Sweden)

    Kourosh Alavi

    2015-01-01

    Full Text Available Endemic to the southwestern parts of the United States, coccidioidomycosis, also known as “Valley Fever,” is a common fungal infection that primarily affects the lungs in both acute and chronic forms. Disseminated coccidioidomycosis is the most severe but very uncommon and usually occurs in immunocompromised individuals. It can affect the central nervous system, bones, joints, skin, and, very rarely, the abdomen. This is the first case report of a patient with coccidioidal dissemination to the peritoneum presenting as eosinophilic ascites (EA. A 27-year-old male presented with acute abdominal pain and distention from ascites. He had eosinophilia of 11.1% with negative testing for stool studies, HIV, and tuberculosis infection. Ascitic fluid exam was remarkable for low serum-ascites albumin gradient (SAAG, PMN count >250/mm3, and eosinophils of 62%. Abdominal imaging showed thickened small bowel and endoscopic testing negative for gastric and small bowel biopsies. He was treated empirically for spontaneous bacterial peritonitis, but no definitive diagnosis could be made until coccidioidal serology returned positive. We noted complete resolution of symptoms with oral fluconazole during outpatient follow-up. Disseminated coccidioidomycosis can present in an atypical fashion and may manifest as peritonitis with low SAAG EA. The finding of EA in an endemic area should raise the suspicion of coccidioidal dissemination.

  13. Porokeratosis Masquerading As Lupus Vulgaris

    Directory of Open Access Journals (Sweden)

    Das Sudip

    2004-01-01

    Full Text Available Porokeratosis is a specific disorder of kerstinization characterized histologically by cornoid lamella. Lesions of porokeratosis present varied features, often mimicking other dermatological disorders. Herein, we report a case of porokeratosis of Mibelli presenting with verrucous lesions simulating lupus vulgaris.

  14. Exogenous ochronosis masquerading refractory melasma

    Directory of Open Access Journals (Sweden)

    Swati Sharma

    2014-10-01

    Full Text Available Exogenous ochronosis is an infrequent dermatosis characterized by dark blue hyperpigmentation. It may be caused largely by hydroquinone, a fenolic compound which is used in the treatment of melasma and other skin hyperpigmentation. The exact etiopathology is still not understood and the results of various treatments offered are unsatisfactory. We present a case of exogenous ochronosis which resembled melasma but clinicopathologic evaluation led to the correct diagnosis. We also emphasize the need to restrict the indiscriminate use of hydroquinone containing compounds without medical prescription.

  15. Primary extranodal marginal zone lymphoma of the uvea associated with massive diffuse epibulbar extension and focal infiltration of the optic nerve and meninges, clinically presented as uveitis masquerade syndrome: a case report.

    Science.gov (United States)

    Rasić, D M; Stanković, Z; Terzić, T; Kovacević, D; Koturović, Z; Marković, V

    2010-09-01

    To report a clinical, histopathological and immunohistochemical findings in a case of primary extranodal marginal zone lymphoma of the uvea associated with massive diffuse extraocular episcleral extension and focal infiltration of the optic nerve and meninges, clinically presented as longstanding uveitis masquerade syndrome. Interventional case reports with histopathological correlation. We describe a 80-year-old male patient with a 3-year history of chronic recurrent hypertensive (pan) uveitis associated with ocular pain, unresponsive to topical and systemic anti-inflammatory, immunosuppressive, antibiotic/antiviral and antiglaucomatous therapy. Because the eye was not salvageable with conservative treatment, enucleation of blind and painful eye was performed. Findings from histopathological and immunohistochemistry examination of the enucleated eye showed an extranodal marginal zone lymphoma of the uveal tract with massive epibulbar extension and optic nerve and meningeal penetration. During almost 3 years of clinical course and 6 months after the enucleation, there were no systemic manifestations of lymphoma, and patient has not required subsequent treatment. Primary lymphoproliferative lesions of the uvea, comprising the iris, ciliary body and choroid are very rare, associated with epibulbar extension extremely and with optic nerve and menigeal penetration exceptionally. Despite its rarity, primary lymphoma of the uvea should be included in the differential diagnosis particularly in older patients with longstanding recurrent uveitis.

  16. Optimization of a novel series of N-phenylindoline-5-sulfonamide-based acyl CoA:monoacylglycerol acyltransferase-2 inhibitors: Mitigation of CYP3A4 time-dependent inhibition and phototoxic liabilities.

    Science.gov (United States)

    Sato, Kenjiro; Takahagi, Hiroki; Kubo, Osamu; Hidaka, Kousuke; Yoshikawa, Takeshi; Kamaura, Masahiro; Nakakariya, Masanori; Amano, Nobuyuki; Adachi, Ryutaro; Maki, Toshiyuki; Take, Kazumi; Takekawa, Shiro; Kitazaki, Tomoyuki; Maekawa, Tsuyoshi

    2015-08-01

    Acyl CoA:monoacylglycerol acyltransferase-2 (MGAT2) has emerged as a potential peripheral target for the treatment of obesity and metabolic disorders. We previously identified a novel series of N-phenylindoline-5-sulfonamide derivatives exemplified by 2 as potent and orally bioavailable MGAT2 inhibitors. Despite its attractive potency, further assessment revealed that this compound exhibited time-dependent inhibition (TDI) of cytochrome P450 3A4 (CYP3A4). To remove the undesirable CYP3A4 TDI activity, structural modification was focused on the 2,4-difluoroaniline moiety on the basis of the assumption that this moiety would be involved in mechanism-based inhibition of CYP3A4 via oxidative metabolism. This led to the finding that the introduction of 4-chloro-2,6-difluoroaniline significantly improved CYP3A4 TDI risk. Further optimization resulted in the discovery of N-(4-chloro-2,6-difluorophenyl)-1-{5-[1-methyl-3-(trifluoromethyl)-1H-pyrazol-5-yl]pyrimidin-2-yl}-7-(2-oxopyrrolidin-1-yl)-2,3-dihydro-1H-indole-5-sulfonamide (27c) with potent MGAT2 inhibitory activity (IC50=7.8 nM) and excellent ADME-Tox profiles including metabolic stability, oral bioavailability, and CYP3A4 TDI. In a mouse oral fat tolerance test, compound 27c effectively and dose-dependently suppressed the elevation of plasma triacylglycerol levels after oral administration at doses of 1 and 3mg/kg. We also discuss mitigation of the phototoxic liability of biaryl derivatives on the basis of the HOMO-LUMO gap hypothesis during the course of optimization efforts.

  17. Masquerade Detection Based on Shell Commands and High-Order Markov Chain Models%基于Shell命令和多阶Markov链模型的用户伪装攻击检测

    Institute of Scientific and Technical Information of China (English)

    肖喜; 翟起滨; 田新广; 陈小娟; 叶润国

    2011-01-01

    Masquerade attacks are attempts by unauthorized users to gain access to confidential data or greater ater access privileges, while pretending to be legitimate users. This paper proposes a novel method to distinguish legitimate users from masqueraders.The uncertainty of the user's behavior and the relevance of the operation of shell commands are thoroughly considered. The method constructs specific high-order homogeneous Markov chain models to represent the normal behavior profiles of valid users. It defines the states by twofold hierarchical merging shell commands. Therefore this method increases the accuracy of describing the normal behavior profiles,improves the generalization of the detection system and sharply reduces the storage space. In the detection period,taking the real-time performance into account,it computes the categorical boolean variables only using the transition probabilities,which has little compuation workload, and then smoothes them to get the decision values used to determine whether the monitored user's behavior is normal or anomalous. Its performance is tested in computer simulation, showing higher detection accuracy and fewer computation costs than related methods'. The proposed method is especially suitable for on-line detection.%伪装攻击是指非授权用户通过伪装成合法用户来获得访问关键数据或更高层访问权限的行为.提出一种新的用户伪装攻击检测方法.该方法针对伪装攻击用户行为的多变性和审计数据shell命令的相关性,利用特殊的多阶齐次narkov链模型对合法用户的正常行为进行建模,并通过双重阶梯式归并shell命令来确定状态,提高了用户行为轮廓描述的准确性和检测系统的泛化能力,并大幅度减少了存储成本.检测阶段根据实时性需求,采用运算量小的、仅依赖于状态转移概率的分类值计算方法,并通过加窗平滑处理分类值序列得到判决值,进而对被监测用户的行为进行

  18. Silicon phthalocyanine 4 phototoxicity in Trichophyton rubrum.

    Science.gov (United States)

    Lam, Minh; Dimaano, Matthew L; Oyetakin-White, Patricia; Retuerto, Mauricio A; Chandra, Jyotsna; Mukherjee, Pranab K; Ghannoum, Mahmoud A; Cooper, Kevin D; Baron, Elma D

    2014-06-01

    Trichophyton rubrum is the leading pathogen that causes long-lasting skin and nail dermatophyte infections. Currently, topical treatment consists of terbinafine for the skin and ciclopirox for the nails, whereas systemic agents, such as oral terbinafine and itraconazole, are also prescribed. These systemic drugs have severe side effects, including liver toxicity. Topical therapies, however, are sometimes ineffective. This led us to investigate alternative treatment options, such as photodynamic therapy (PDT). Although PDT is traditionally recognized as a therapeutic option for treating a wide range of medical conditions, including age-related macular degeneration and malignant cancers, its antimicrobial properties have also received considerable attention. However, the mechanism(s) underlying the susceptibility of dermatophytic fungi to PDT is relatively unknown. As a noninvasive treatment, PDT uses a photosensitizing drug and light, which, in the presence of oxygen, results in cellular destruction. In this study, we investigated the mechanism of cytotoxicity of PDT in vitro using the silicon phthalocyanine (Pc) 4 [SiPc(OSi(CH3)2(CH2)3N(CH3)2)(OH)] in T. rubrum. Confocal microscopy revealed that Pc 4 binds to cytoplasmic organelles, and upon irradiation, reactive oxygen species (ROS) are generated. The impairment of fungal metabolic activities as measured by an XTT (2,3-bis[2-methoxy-4-nitro-5-sulfophenyl]-2H-tetrazolium-5-carboxyanilide inner salt) assay indicated that 1.0 μM Pc 4 followed by 670 to 675 nm light at 2.0 J/cm(2) reduced the overall cell survival rate, which was substantiated by a dry weight assay. In addition, we found that this therapeutic approach is effective against terbinafine-sensitive (24602) and terbinafine-resistant (MRL666) strains. These data suggest that Pc 4-PDT may have utility as a treatment for dermatophytosis.

  19. PHEX 3'-UTR c.*231A>G near the polyadenylation signal is a relatively common, mild, American mutation that masquerades as sporadic or X-linked recessive hypophosphatemic rickets.

    Science.gov (United States)

    Mumm, Steven; Huskey, Margaret; Cajic, Adela; Wollberg, Valerie; Zhang, Fan; Madson, Katherine L; Wenkert, Deborah; McAlister, William H; Gottesman, Gary S; Whyte, Michael P

    2015-01-01

    Heritable forms of hypophosphatemic rickets (HR) include X-linked dominant (XLH), autosomal recessive, and autosomal dominant HR (from deactivating mutations in PHEX, DMP1 or ENPP1, and activating mutations in FGF23, respectively). Over 30 years, we have cared for 284 children with HR. For those 72 deemed sporadic XLH, we preliminarily reported mutation analysis for 30 subjects. Eleven had PHEX mutations. However, the remaining 19 lacked readily identifiable defects in PHEX, DMP1, or FGF23. In 2008, a novel single-base change near the polyadenylation (pA) signal in the 3'-UTR of PHEX was identified in XLH by other investigators. This c.*231A > G mutation is 3-bp upstream of the putative pA signal (AATAAA) in PHEX. Accordingly, we investigated whether this 3'-UTR defect accounted for HR in any of these 19 sporadic XLH patients. PCR amplification and sequencing of their 3'-UTR region showed the c.*231A > G mutation in four unrelated boys. Then, among an additional 22 of our 72 "sporadic" XLH patients, one boy and one girl were found to have the 3'-UTR defect, totaling six patients. Among these 52 sporadic XLH patients with PHEX analysis, 36 were girls and 16 were boys; ie, a ∼2:1 gender ratio consistent with XLH. However, finding five boys and only one girl with this 3'-UTR mutation presented an unexplained gender bias (p = 0.02). Haplotyping for the five boys, all reportedly unrelated, showed a common core haplotype suggesting a founder. Five of their six mothers had been studied clinically and biochemically (three radiologically). Remarkably, the seemingly unaffected mothers of four of these boys carried the 3'-UTR mutation. These healthy women had normal height, straight limbs, lacked the radiographic presentation of XLH, and showed normal or slight decreases in fasting serum Pi levels and/or TmP/GFR. Hence, PHEX c.*231A > G can masquerade as sporadic or X-linked recessive HR.

  20. Evaluation of antimicrobial, antioxidant and phototoxic activities of extracts and isolated compounds from Stachytarpheta cayennensis (Rich. Vahl, Verbenaceae Avalição da atividade antimicrobiana, antioxidante e fototóxica dos extratos e compostos isolados de Stachytarpheta cayennensis (Rich. Vahl, Verbenaceae

    Directory of Open Access Journals (Sweden)

    Pierre André De Souza

    2010-12-01

    Full Text Available Stachytarpheta cayennensis (Rich. Vahl, Verbenaceae, plant extract, is a Brazilian medicinal plant externally used in folk medicine for purulent ulcers, skin lesions and internally for inflammations, fever, renal disorders and atherosclerosis. S. cayennesis was studied to identify potential bioactive compounds that may justify their therapeutic use against skin lesions and atherosclerosis. The antioxidant, antimicrobial and phototoxicity capacities of the crude ethanolic extract, fractions and isolated compounds from roots of S. cayennesis were evaluated through in vivo and in vitro tests. Strains of Saccharomyces cerevisiae, an eukaryotic cell model, were used to assess both the phototoxicity and the capacity to protect against the lethal oxidative stress caused by menadione and hydrogen peroxide. The extract, fractions and the two major isolated compounds, verbascoside and betulinic acid, of S. cayennensis were able to increase the tolerance and decrease the lipid peroxidation of S. cerevisiae to reactive oxygen species (ROS. The antioxidant activity was also evaluated by scavenging of 2,2-diphenyl-1-picrylhydrazyl (DPPH•. Verbascoside exhibited a moderate antimicrobial activity against Streptococcus pyogenes, S.epidermidis and Staphylococcus aureus. Neither the ethanolic extract nor fractions showed phototoxicity, indicating that the S. cayennensis extract is safe for use in the treatment of skin lesions and as an active cosmetic ingredient.Stachytarpheta cayennensis (Rich. Vahl, Verbenaceae, é uma planta utilizada na medicina popular brasileira contra úlceras e lesões de pele. Internamente é usada contra inflamações, febre, doenças renais e aterosclerose. Essa planta foi estudada com o objetivo de identificar os compostos bioativos majoritários que possam justificar seu uso terapêutico contra lesões de pele e arteriosclerose. A atividade antioxidante do extrato bruto etanólico, partições e os compostos majoritários isolados

  1. Severe hypothyroidism masquerading as renal impairment

    DEFF Research Database (Denmark)

    Bistrup, C; Jensen, Dorte Møller; Kvetny, J

    1996-01-01

    A case of severe hypothyroidism in a 51-year old male is presented. The patient was especially complaining of weakness, stiffness and moderate pain in the proximal muscle groups together with rhinorrhea and nasal stenosis. Because of severely elevated S-creatine-kinase combined with reduced...

  2. Neurocysticercosis masquerading psychotic disorder: A case report

    Directory of Open Access Journals (Sweden)

    Rachita Sarangi

    2013-01-01

    Full Text Available Psychotic manifestations are uncommon in neurocysticercosis. This article describes a ten year girl presented with manic–psychotic manifestation for which she was under treatment with antipsychotics for eight months. Eventually she developed generalized tonic clonic seizure and CT scan of brain revealed small isodense right posterior parietal lesion of 5 mm size with perifocal edema. CECT revealed intense nodular post contrast enhancement. This highlights the possible misdiagnosis of a case of neurocysticercosis as an organic psychotic disorder so it should be considered as a differential diagnosis in patients with neurological as well as psychiatric manifestations in endemic area like India.

  3. Pheochromocytoma Masquerading as “Diabetic Ketoacidosis”

    Directory of Open Access Journals (Sweden)

    Jeffrey Stephen Hedley MD

    2016-04-01

    Full Text Available Diabetic ketoacidosis is a routinely encountered diagnosis in medicine. Physicians are trained early on to look for precipitants. Most clinicians assess for medication compliance, infection, ischemia, and the like. We present a case of pheochromocytoma presenting as “diabetic ketoacidosis.” The case serves as an example for broadening the differential diagnosis for patients with similar presentations. Additionally, the case helps inform our understanding of the so-called “stress reactions” that are commonly invoked in clinical rationale.

  4. Taxol crystals can masquerade as stabilized microtubules.

    Directory of Open Access Journals (Sweden)

    Margit Foss

    Full Text Available Taxol is a potent anti-mitotic drug used in chemotherapy, angioplastic stents, and cell biology research. By binding and stabilizing microtubules, Taxol inhibits their dynamics, crucial for cell division, motility, and survival. The drug has also been reported to induce formation of asters and bundles composed of stabilized microtubules. Surprisingly, at commonly used concentrations, Taxol forms crystals that rapidly bind fluorescent tubulin subunits, generating structures with an uncanny resemblance to microtubule asters and bundles. Kinetic and topological considerations suggest that tubulin subunits, rather than microtubules, bind the crystals. This sequestration of tubulin from the subunit pool would be expected to shift the equilibrium of free to polymerized tubulin to disfavor assembly. Our results imply that some previously reported Taxol-induced asters or bundles could include or be composed of tubulin-decorated Taxol crystals. Thus, reevaluation of certain morphological, chemical, and physical properties of Taxol-treated microtubules may be necessary. Moreover, our findings suggest a novel mechanism for chemotherapy-induced cytotoxicity in non-dividing cells, with far-reaching medical implications.

  5. Brugada syndrome masquerading as febrile seizures.

    Science.gov (United States)

    Skinner, Jonathan Robert; Chung, Seo-Kyung; Nel, Carey-Anne; Shelling, Andrew Neil; Crawford, Jackie Robyn; McKenzie, Neil; Pinnock, Ralph; French, John Kerswell; Rees, Mark Ian

    2007-05-01

    Fever can precipitate ventricular tachycardia in adults with Brugada syndrome, but such a link has not been reported in children. A 21-month-old white girl presented repeatedly with decreased conscious level and seizures during fever. During a typical episode, rapid ventricular tachycardia was documented. The resting 12-lead electrocardiogram revealed a Brugada electrocardiogram signature. Resting electrocardiograms of the asymptomatic brother and mother were normal, but fever in the mother and pharmacologic stress with ajmaline in the brother revealed Brugada electrocardiogram features. Genetic testing revealed an SCN5A mutation in the affected family members.

  6. Botfly infestation (myiasis) masquerading as furunculosis.

    Science.gov (United States)

    Gewirtzman, A; Rabinovitz, H

    1999-02-01

    With air travel so prevalent, diseases endemic to certain regions may appear anywhere. The botfly (Dermatobia hominis) is not native to North America. We describe a case of a young boy and his father who presented with furunculosis secondary to infestation with the botfly. The infected patients live in South Florida and had been vacationing in Central America. Standard surgical treatment as well as multiple native remedies are described.

  7. Lymphocytic hypophysitis masquerading as pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Rajneesh Mittal

    2012-01-01

    Full Text Available Introduction: Pituitary hypophysitis (PH is characterized by pituitary infiltration of lymphocytes, macrophages, and plasma cells that could lead to loss of pituitary function. Hypophysitis may be autoimmune or secondary to systemic diseases or infections. Based on the histopathological findings PH is classified into lymphocytic, granulomatous, xanthomatous, mixed forms (lymphogranulomatous, xanthogranulomatous, necrotizing and Immunoglobulin- G4 (IgG4 plasmacytic types. Objective: To report a case of lymphocytic hypophysitis (LH. Case Report: A 15-year-old girl presented with history of headache, amenorrhea, and history of polyuria for past 4 months. Initial evaluation had suppressed follicular stimulating hormone (<0.01 mIU/ml, high prolactin levels (110.85 ng/ml and diabetes insipidus (DI. Magnetic resonance imaging of sella was suggestive of pituitary macroadenoma with partial compression over optic chiasma. Patient underwent surgical decompression. Yellowish firm tissue was evacuated and xanthochromic fluid was aspirated. Histopathology was suggestive of LH. She resumed her cycles postoperatively after 4 months, prolactin levels normalized, however, she continues to have DI and is on desmopressin spray. This case has been presented here for its rare presentation in an adolescent girl because it is mostly seen in young females and postpartum period and its unique presentation as an expanding pituitary mass with optic chiasma compression. Conclusion: Definitive diagnosis of LH is based on histopathological evaluation. Therapeutic approach should be based on the grade of suspicion and clinical manifestations of LH.

  8. Rare primary retroperitoneal teratoma masquerading as adrenal ...

    African Journals Online (AJOL)

    J.M. Ratkal

    investigation was found to have a right adrenal mass were collected. ... in children, but their prevalence in adults is exceedingly rare. The adrenal gland is ... tumors, the abdominal CT and chest X-ray images taken prior to surgery were.

  9. Foreign body aspiration masquerading as difficult asthma

    Directory of Open Access Journals (Sweden)

    Rai S

    2007-01-01

    Full Text Available It is important to assess patients of difficult/therapy resistant asthma carefully in order to identify whether there are any correctable factors that may contribute to their poor control. It is critical to make a diagnosis of asthma and to exclude other airway diseases. A 65-years-old lady presented with repeated acute episodes of dyspnoea and wheezing. She was on regular medication for bronchial asthma for 18 years. There was no history of foreign body aspiration or loss of consciousness. Her chest radiograph was normal. She showed poor response to corticosteroids and bronchodilators. Fibreoptic bronchoscopy (FOB showed intracordal cyst of the left vocal cord and 1cm size irregular piece of betel nut in right main bronchus, which was removed endoscopically with the help of dormia basket, following which her condition improved and asthma was controlled on inhaled bronchodilators.

  10. Rare adipose disorders (RADs) masquerading as obesity

    Institute of Scientific and Technical Information of China (English)

    Karen L HERBST

    2012-01-01

    Rare adipose disorders (RADs) including multiple symmetric lipomatosis (MSL),lipedema and Dercum's disease (DD) may be misdiagnosed as obesity.Lifestyle changes,such as reduced caloric intake and increased physical activity are standard care for obesity.Although lifestyle changes and bariatric surgery work effectively for the obesity component of RADs,these treatments do not routinely reduce the abnormal subcutaneous adipose tissue (SAT) of RADs.RAD SAT likely results from the growth of a brown stem cell population with secondary lymphatic dysfunction in MSL,or by primary vascular and lymphatic dysfunction in lipedema and DD.People with RADs do not lose SAT from caloric limitation and increased energy expenditure alone.In order to improve recognition of RADs apart from obesity,the diagnostic criteria,histology and pathophysiology of RADs are presented and contrasted to familial partial lipodystrophies,acquired partial lipodystrophies and obesity with which they may be confused.Treatment recommendations focus on evidencebased data and include lymphatic decongestive therapy,medications and supplements that support loss of RAD SAT.Associated RAD conditions including depression,anxiety and pain will improve as healthcare providers learn to identify and adopt alternative treatment regimens for the abnormal SAT component of RADs.Effective dietary and exercise regimens are needed in RAD populations to improve quality of life and construct advanced treatment regimens for future generations.

  11. Giant Adrenal Myelolipoma Masquerading as Heart Failure

    Directory of Open Access Journals (Sweden)

    Parijat S. Joy

    2014-03-01

    Full Text Available Adrenal myelolipomas are rare benign tumors of the adrenal cortex composed of adipose and hematopoietic cells. They have been postulated to arise from repeated stimulation by stress, inflammation and ACTH oversecretion. Myelolipomas are usually detected incidentally on imaging and do not require any active intervention besides regular follow-up by imaging. However, myelolipomas may insidiously grow to large sizes and cause mass effects and hemorrhage. Timely diagnosis and surgical resection are curative and lifesaving.

  12. Giant adrenal myelolipoma masquerading as heart failure.

    Science.gov (United States)

    Joy, Parijat S; Marak, Creticus P; Nashed, Nadia S; Guddati, Achuta K

    2014-01-01

    Adrenal myelolipomas are rare benign tumors of the adrenal cortex composed of adipose and hematopoietic cells. They have been postulated to arise from repeated stimulation by stress, inflammation and ACTH oversecretion. Myelolipomas are usually detected incidentally on imaging and do not require any active intervention besides regular follow-up by imaging. However, myelolipomas may insidiously grow to large sizes and cause mass effects and hemorrhage. Timely diagnosis and surgical resection are curative and lifesaving.

  13. Acute myopericarditis masquerading as acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  14. Turner syndrome masquerading as normal early puberty

    Science.gov (United States)

    Hong, Yong Hee

    2014-01-01

    Approximately 50% of patients with Turner syndrome (TS) have complete loss of one X chromosome, whereas the rest of the patients with TS display mosaicism or structural abnormalities of the X chromosome. Most well-known common features are short stature and gonadal failure. Approximately one third of girls with TS may enter spontaneous puberty, but only half those completed with menarche. However, some atypical features of TS have been described. Many studies have been conducted to verify and delineate proposed loci for genes pertaining to the TS phenotype, and correlations between karyotype and phenotype. A few rare cases of precocious puberty with TS have been described. Here we describe a case of TS with the Xp22.1 deletion presenting with short final stature, early normal onset of spontaneous puberty, and Graves' disease, without short stature during puberty. PMID:25654070

  15. Caecal tumour masquerading as an appendicular mass

    Directory of Open Access Journals (Sweden)

    Martha Nixon

    2011-12-01

    Full Text Available Appropriate management of appendix mass is based on an accurate diagnosis of the underlying pathology. This is a report of a complex patient presenting with an appendix mass, whose surgery was deferred due to severe comorbidities and who later died from severe metastatic disease. A 65-year-old lady presented with right iliac fossa pain and a mass. She was treated for an appendix mass initially and when the mass failed to resolve after four weeks, she was thoroughly investigated for the possibility of a tumour. Severe co-morbities had a significant impact on her management as definitive surgery was delayed. She represented 10 months after the initial admission with small bowel obstruction and died of metastatic caecal cancer. Management of appendix mass must entail a careful approach to investigating and treatment with emphasis on early intervention if the mass does not resolve promptly. This will avoid delayed diagnosis, treatment and a detrimental impact on prognosis.

  16. Pseudomonas aeruginosa endophthalmitis masquerading as chronic uveitis

    Directory of Open Access Journals (Sweden)

    Kalpana Badami Nagaraj

    2013-01-01

    Full Text Available A 65-year-old male presented with decreased vision in the left eye of 15-day duration after having undergone an uneventful cataract surgery 10 months back. He had been previously treated with systemic steroids for recurrent uveitis postoperatively on three occasions in the same eye. B-scan ultrasonography showed multiple clumplike echoes suggestive of vitreous inflammation. Aqueous tap revealed Pseudomonas aeruginosa sensitive to ciprofloxacin. The patient was treated with intravitreal ciprofloxacin and vancomycin along with systemic ciprofloxacin with good clinical response. Even a virulent organism such as P.aeruginosa can present as a chronic uveitis, which, if missed, can lead to a delay in accurate diagnosis and appropriate management.

  17. Diaphragmatic hernia masquerading as pleural effusion

    Directory of Open Access Journals (Sweden)

    Z Nalladaru

    2012-01-01

    Full Text Available Rupture of the diaphragm is almost always due to major trauma. We present here an unusual and rare case of late presentation of diaphragmatic hernia after an innocuous injury. The patient was initially misdiagnosed as a left pleural effusion on the basis of chest X-ray and ultrasound findings. Finally, the diagnosis was confirmed on computerized scanning.

  18. Marsupialized fungal mycetoma masquerading as conjunctival melanoma.

    Science.gov (United States)

    Sayyad, Fouad E; Karp, Carol L; Wong, James R; Weiss, Matthew J; Bermudez-Magner, J Antonio; Dubovy, Sander

    2014-07-01

    To report a case of a fungal mass misdiagnosed as a pigmented conjunctival melanoma. Case report. A 38-year-old woman was referred for a pigmented conjunctival lesion that was diagnosed as a melanoma. She had a history of a scleral buckle in that eye for retinal detachment 2 years before presentation. Slit-lamp examination revealed a pigmented mass from the 11- to 2-o'clock position. This was noted to be imbricated within the invagination of a conjunctival fold from the previous surgery. The mass was removed, cultured, and confirmed to be a fungal infection from Scytalidium sp. Scleral buckles can cause folds in the conjunctiva, which can be foci for fungal infection.

  19. Cushing's syndrome masquerading as treatment resistant depression

    Directory of Open Access Journals (Sweden)

    B N Anil Kumar

    2016-01-01

    Full Text Available Treatment resistant depression (TRD is a common clinical occurrence among patients treated for major depressive disorder. A significant proportion of patients remain significantly depressed in spite of aggressive pharmacological and psychotherapeutic approaches. Management of patient with treatment resistant depression requires thorough evaluation for physical causes. We report a case of recurrent depressive disorder, who presented with severe depressive episode without psychotic symptoms, not responding to multiple adequate trials of antidepressants, who on investigation was found to have Cushing's syndrome and responded well to Ketoconazole.

  20. Prinzmetals Angina Masquerading as Acute Pericarditis

    Science.gov (United States)

    Jayaram, Ashwal Adamane; Rao, Mugula Sudhakar; Padmakumar, R

    2017-01-01

    Coronary artery spasm is an intense vasoconstriction of the coronary arteries and may be responsible for the myocardial ischemia, myocardial infarction as well as sudden deaths. Coronary angiography is generally needed to identify the cause. Coronary artery spasm is a multifactorial disease with underlying mechanism still poorly understood. Here, we present case of a 48-year-old male with no significant past history who presented with acute episodic onset chest pain. Clinical, Electrocardiography (ECG) and echocardiographic findings suggested pericarditis but a diagnostic coronary angiography revealed significant coronary vasospasm. Patient’s symptoms significantly improved with calcium channel blockers and Nitroglycerine (NTG).

  1. Knee tuberculosis masquerading as pigmented villonodular synovitis

    Directory of Open Access Journals (Sweden)

    Sanjay Meena

    2014-01-01

    Full Text Available Tuberculosis (TB, once a disease confined to undeveloped or developing nations is currently in resurgence, which is attributable to pandemic human immunodeficiency virus (HIV infection and immigration from endemic areas. Tuberculous arthritis is difficult to diagnose early because of its atypical insidious clinical manifestations and nonspecific imaging findings. TB is also known as the ′great mimicker′. Specifically, monoarticular tuberculosis of the knee may mimic pigmented villonodular synovitis (PVNS. The present report describes a young patient with tuberculous arthritis of knee joint. Accurate diagnosis and appropriate management was delayed due to magnetic resonance imaging (MRI findings, such as, hemosiderin deposits and a nodular mass around the knee joint, suggestive of a diffuse type of PVNS. Our findings suggest that the first step in the diagnosis of tuberculous knee arthritis is to have a high index of suspicion.

  2. Gallbladder carcinoid masquerading as gallbladder carcinoma

    Institute of Scientific and Technical Information of China (English)

    Mallika Tewari; Vinay Kumar; Raghvendra Raman Mishra; Hari S Shukla

    2009-01-01

    BACKGROUND: Carcinoid of the gallbladder is rare. Since it often presents as a gallbladder mass it may be confused with gallbladder carcinoma. METHODS: A 35-year-old lady presented with pain in the right upper abdomen, and was radiologically found to have a gallbladder mass. A provisional diagnosis of gallbladder carcinoma was made. Laparotomy revealed a 20×20 cm, exophytic, friable growth arising from the fundus of the gallbladder. It was excised with segmentⅣb andⅤ of the liver and regional lymphadenectomy. RESULT: Histopathological examination revealed it was a neuroendocrine carcinoma, atypical carcinoid of the gallbladder. CONCLUSION: Gallbladder carcinoid has a poor outcome, requires aggressive treatment, and should be considered as one of the rare but possible gallbladder lesions.

  3. Brucella meningoencephalitis with hydrocephalus masquerading as tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Vishwanath Sathyanarayanan; Bekur Ragini; Abdul Razak; M Mukhya prana Prabhu

    2010-01-01

    Neurobrucellosis is a rare form of localized brucellosis usually with no systemic manifestations. We report a rare case of brucellosis presenting as meningoencephalitis associated with hydrocephalus. This patient had a lymphocytic predominantCSF and was initially treated with empirical anti tubercular therapy and steroids.A week later, when hisCSF culture grew Brucella species, the treatment was changed to a combination of streptomycin, doxycycline and rifampicin and the patient improved with this therapy. This case illustrates the need to consider neurobrucellosis as a close differential diagnosis of neurotuberculosis in endemic areas when the patient presents with meningo encephalitis with lymphocyticCSF.

  4. Ameloblastic fibro-odontoma masquerading as odontoma

    Directory of Open Access Journals (Sweden)

    Kanwar Deep Singh Nanda

    2011-01-01

    Full Text Available Ameloblastic fibro-odontoma (AFO is a rare, benign epithelial mixed odontogenic tumor. It occurs as an intraosseous lesion, generally asymptomatic and more prevalent in children and adolescent. AFO is found on radiographic evaluation of patients with unerupted or impacted teeth in many cases. Histological examination reveals a fibrous soft tissue, islands of odontogenic epithelium and a disordered mixture of dental tissues. The treatment modality in most cases involves conservative surgery with enucleation. We present a case of 13-year-old boy with a missing right central incisor, mimicking-like odontoma on radiograph but proved to be AFO and treated with enucleation with preservation of impacted tooth. There was no recurrence after one year of follow-up. This report discusses the clinical, radiographical, histological features and surgical assessment to preserve the impacted tooth associated with AFO.

  5. Renal cirsoid arteriovenous malformation masquerading as neoplasia.

    Science.gov (United States)

    Silverthorn, K; George, D

    1988-12-01

    A woman with renal colic and microscopic hematuria had filling defects in the left renal collecting system detected on excretory urography. A nephrectomy, performed because of suspected malignancy, might have been averted by renal angiography.

  6. Intestinal malignancy masquerading as primary ovarian carcinoma

    Directory of Open Access Journals (Sweden)

    Mona Asnani

    2015-06-01

    Full Text Available About 4-5 % of ovarian tumours are metastatic from other organs, most frequently from the female genital tract, the breast, or the gastrointestinal tract. Ovarian metastases constitute 76% of genital tract metastases from extragenital primary tumours, of which 78% arise in the gastrointestinal tract. Metastatic ovarian tumours, often mistaken as primary ovarian carcinomas. A 37 year old P2+0 presented with c/o - Abdominal distension since last 6 months. It was associated with anorexia, constipation and generalised weakness. Not having any menstrual complaint. P/A: moderate ascitis was there. A mass of 8x10 cm felt through right fornix extending up to right iliac fossa. Mass was firm in consistency with restricted mobility. Uterus felt separately from the mass. Left fornix clear. A right sided ovarian mass of approx. 10x15 cm of variegated consistency identified. Bladder wall was thickened. Small nodules of approximately 1 cm present over dome of bladder under visceral peritoneum. Omentum, ascending colon, transverse colon, descending colon, caecum, greater curvature and lesser curvature were thickened. Liver and spleen were normal. Total abdominal hysterectomy with bilateral Salpingo oophorectomy with partial omentectomy was done. Histopathology Revealed metastatic adenocarcinoma of the genital tract and B/L ovaries. So it was concluded that secondaries from intestinal malignancy can present as primary ovarian malignancy. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 848-850

  7. Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Kamel A. Gharaibeh

    2014-01-01

    Full Text Available Malignant metastasis to the psoas muscle is rare. We report a case that clinically mimicked psoas abscess that was subsequently proven to be from metastatic disease secondary to adenocarcinoma of the duodenum. A 62-year-old male presented with a seven-month history of right lower quadrant abdominal pain and progressive dysphagia. CT scan of abdomen-pelvis revealed a right psoas infiltration not amenable to surgical drainage. Patient was treated with two courses of oral antibiotics without improvement. Repeated CT scan showed ill-defined low-density area with inflammatory changes involving the right psoas muscle. Using CT guidance, a fine needle aspiration biopsy of the right psoas was performed that reported metastatic undifferentiated adenocarcinoma. Patient underwent upper endoscopy, which showed a duodenal mass that was biopsied which also reported poorly differentiated adenocarcinoma. In this case, unresponsiveness to medical therapy or lack of improvement in imaging studies warrants consideration of differential diagnosis such as malignancy. Iliopsoas metastases have shown to mimic psoas abscess on their clinical presentation and in imaging studies. To facilitate early diagnosis and improve prognosis, patients who embody strong risk factors and symptoms compatible with underlying malignancies who present with psoas imaging concerning for abscess should have further investigations.

  8. Central vein stenosis masquerading as venous thrombosis

    National Research Council Canada - National Science Library

    Nagapriya Vellalacheruvu; Naresh Monigari; Tom Devasia; Hashir Kareem

    2014-01-01

    .... 3 Learning points Central venous stenosis (CVS), although rare, is a known complication in patients requiring maintenance haemodialysis but symptomatic CVS requiring intervention is not common...

  9. Eyelid Mycetoma Masquerading as Sebaceous Carcinoma.

    Science.gov (United States)

    Zoroquiain, Pablo; Alghamdi, Sarah; Arthurs, Bryan; Levin, Leonard; Sheppard, Donald C; Ralph, Benjamin; Burnier, Julia; Burnier, Miguel N

    A 56-year-old Asian woman presented with an upper eyelid mass. The lesion was exposed after eversion of the eyelid revealing a thickened tarsus with yellowish areas. Working diagnosis was sebaceous carcinoma. Biopsy was performed. Histopathological studies showed a mycotic eumycetoma with Splendore-Hoeppli phenomena and - microbiologic cultures grew Scedosporium apiospermum. The patient was started on voriconazole 200 mg po bid with adequate serum levels. A complete response was observed after 18 weeks of voriconazole therapy. To the best of our knowledge, this is the first published case of S. apiospermum eumycotic mycetoma of the eyelid. It is important to consider mycotic infection in the differential diagnosis of eyelid tumors even in healthy patients.

  10. Primary Cutaneous Histoplasmosis Masquerading as Lepromatous Leprosy

    Science.gov (United States)

    Rani, Poonam; Aggarwal, Radhika; Kaushal, Seema

    2017-01-01

    Histoplasmosis is a genus of dimorphic fungi having various varieties of which the commonest one causing infection is Histoplasma capsulatum known to cause histoplasmosis. It has a varied disease spectrum ranging from an acute infection to chronic disease especially in lungs, disseminated disease and cutaneous disorder. Histoplasma capsulatum usually causes subclinical infection and serious infections only manifest in immunocompromised patients. Frank cases of infection are seen in pulmonary histoplasmosis. The spores of these organisms are seen to be strongly associated with droppings of birds and bats. A combination of these droppings and some soil types provide for an excellent environment for the proliferation of spores. Pulmonary histoplasmosis and disseminated disease are very common in AIDS patients and are a great cause of morbidity and mortality in these patients. Primary cutaneous histoplasmosis is very rare and occurs due to penetrating injuries. Once diagnosis is made, the lesions respond very well to oral itraconazole, fluconazole or amphotericicn B. We report a rare case of Cutaneous Histoplasmosis (CHP) in a 70-year-old male with complaints of multiple nodules all over his body in a HIV seronegative and otherwise immunocompetent patient. PMID:28273974

  11. Thyrotoxicosis and Choledocholithiasis Masquerading as Thyroid Storm

    Directory of Open Access Journals (Sweden)

    Christian L. Horn

    2017-01-01

    Full Text Available A 26-year-old female, thirteen months postpartum, presented to the emergency department for four weeks of epigastric abdominal pain, pruritus, new onset jaundice, and 11.3 kgs (25 lbs unintentional weight loss. On examination, she was afebrile, tachycardic, alert, and oriented and had jaundice with scleral icterus. Labs were significant for undetectable TSH, FT4 that was too high to measure, and elevated total bilirubin, direct bilirubin, alkaline phosphatase, and transaminases. Abdominal ultrasound revealed cholelithiasis without biliary ductal dilation. Treatment for presumed thyroid storm was initiated. Further work-up with magnetic resonance cholangiopancreatography (MRCP revealed an obstructing cholelith within the distal common bile duct. With the presence of choledocholithiasis explaining the jaundice and abdominal pain, plus the absence of CNS alterations, the diagnosis of thyroid storm was revised to thyrotoxicosis complicated by choledocholithiasis. Endoscopic retrograde cholangiopancreatogram (ERCP with sphincterotomy was performed to alleviate the biliary obstruction, with prompt symptomatic improvement. Thyroid storm is a rare manifestation of hyperthyroidism with a high rate of morbidity and mortality. The diagnosis of thyroid storm is based on clinical examination, and abnormal thyroid function tests do not correlate with disease severity. Knowledge of the many manifestations of thyroid storm will facilitate a quick and accurate diagnosis and treatment.

  12. Hybrid stars that masquerade as neutron stars

    Energy Technology Data Exchange (ETDEWEB)

    Mark Paris; Mark Alford; Matt Braby; Sanjay Reddy

    2004-11-01

    We show that a hybrid (nuclear + quark matter) star can have a mass-radius relationship very similar to that predicted for a star made of purely nucleonic matter. We show this for a generic parameterization of the quark matter equation of state, and also for an MIT bag model, each including a phenomenological correction based on gluonic corrections to the equation of state. We obtain hybrid stars as heavy as 2 M{sub solar} for reasonable values of the bag model parameters. For nuclear matter, we use the equation of state calculated by Akmal, Pandharipande, and Ravenhall using many-body techniques. Both mixed and homogeneous phases of nuclear and quark matter are considered.

  13. Idiopathic Adrenal Hematoma Masquerading as Neoplasm

    Directory of Open Access Journals (Sweden)

    Kazuki Sasaki

    2012-04-01

    Full Text Available We report herein a case of idiopathic adrenal hematoma. A 59-year-old Japanese man was referred to our hospital for evaluation of a 7.0 cm mass in the right upper abdominal cavity. The tumor was suspected to originate from either the posterior segment of the liver or the right adrenal gland. His chief complaint was weight loss of 8 kg over the previous 6 months. He had no past medical history and took no medications, including no anticoagulants. Laboratory data were almost normal except for a slight elevation of PIVKA-II. The origin of the tumor was found to be the adrenal gland, as angiography revealed the blood supply to the mass to derive from the right superior and inferior adrenal arteries. A fine needle biopsy of the lesion was unable to confirm the diagnosis. Open right adrenalectomy was performed. The histopathological findings of the surgical specimen revealed a hematoma with normal adrenal tissue. In the absence of any obvious etiology, the diagnosis was idiopathic adrenal hematoma.

  14. Ophthalmic masquerades of the atherosclerotic carotids

    Directory of Open Access Journals (Sweden)

    Anupriya Arthur

    2014-01-01

    Full Text Available Patients with carotid atherosclerosis can present with ophthalmic symptoms. These symptoms and signs can be due to retinal emboli, hypoperfusion of the retina and choroid, opening up of collateral channels, or chronic hypoperfusion of the globe (ocular ischemic syndrome. These pathological mechanisms can produce many interesting signs and a careful history can bring out important past symptoms pointing toward the carotid as the source of the patient′s presenting symptom. Such patients are at high risk for an ischemic stroke, especially in the subsequent few days following their first acute symptom. It is important for clinicians to be familiar with these ophthalmic symptoms and signs caused by carotid atherosclerosis for making an early diagnosis and to take appropriate measures to prevent a stroke. This review elaborates the clinical features, importance, and implications of various ophthalmic symptoms and signs resulting from atherosclerotic carotid artery disease.

  15. Masquerading Mycobacterium: Rectal Growth or Tuberculosis?

    Directory of Open Access Journals (Sweden)

    Nabajit Choudhury

    2013-01-01

    Full Text Available A 37-year old male presented to us with history of lower abdominal pain for 6 months. His physical examination revealed a rectal mass of approximately 1centimeter. He was investigated for possible rectal growth with sigmoidoscopy and biopsy. The histopathological examination (HPE showed a non-specific chronic inflammation in the tissue from the mass. Another tissue from the mass was sent for polymerase chain reaction (PCR for tuberculosis, which turned out to be positive. The patient was started on standard anti tubercular (ATT regimen and responded completely to the treatment. We discuss the patient and review some of the available literature on the topic and discuss the issue of considering a diagnosis of tuberculosis in cases with rectal mass specially when it has become a major public health issue with increasing number of HIV (Human Immunodeficiency Virus infected patients.

  16. Duodenal Amyloidosis Masquerading as Iron Deficiency Anemia

    Science.gov (United States)

    Hurairah, Abu

    2016-01-01

    The present study is a unique illustration of duodenal amyloidosis initially manifesting with iron deficiency anemia. It underscores the importance of clinical suspicion of amyloidosis while performing upper gastrointestinal endoscopy with a biopsy to establish the definite diagnosis in patients with unexplained iron deficiency anemia. PMID:27625911

  17. Ameloblastic fibro-odontoma masquerading as odontoma.

    Science.gov (United States)

    Nanda, Kanwar Deep Singh; Marwaha, Mohita

    2011-01-01

    Ameloblastic fibro-odontoma (AFO) is a rare, benign epithelial mixed odontogenic tumor. It occurs as an intraosseous lesion, generally asymptomatic and more prevalent in children and adolescent. AFO is found on radiographic evaluation of patients with unerupted or impacted teeth in many cases. Histological examination reveals a fibrous soft tissue, islands of odontogenic epithelium and a disordered mixture of dental tissues. The treatment modality in most cases involves conservative surgery with enucleation. We present a case of 13-year-old boy with a missing right central incisor, mimicking-like odontoma on radiograph but proved to be AFO and treated with enucleation with preservation of impacted tooth. There was no recurrence after one year of follow-up. This report discusses the clinical, radiographical, histological features and surgical assessment to preserve the impacted tooth associated with AFO.

  18. National ornament and the imperial masquerade

    Directory of Open Access Journals (Sweden)

    Nóra Veszprémi

    2015-12-01

    Full Text Available Review of Rebecca Houze, Textiles, Fashion, and Design Reform in Austria–Hungary before the First World War: Principles of Dress: Rebecca Houze’s book is a thoroughly researched and original study of the impact of design reform on textile production and fashion in Austria-Hungary in the late nineteenth and early twentieth century which centres its argument around the Bekleidungsprinzip (“principle of dress” put forward by Gottfried Semper. It discusses the role of newly founded applied arts museums, industrial exhibitions, the concept of “house industry,” and the upsurge of interest in folk crafts in this process, while also placing a strong emphasis on the role of women as producers of textiles. One of the main virtues of the book is its wide scope which manages to investigate endeavours informed by different and sometimes opposed national and imperial interests in their complicated interconnectedness. It is a pity that this broad perspective is narrowed down in the second part of the book which focuses on with turn-of-the-century Vienna and does not deal with modernist tendencies in Hungarian design. Nevertheless, this part of the book also provides a fascinating discussion of its own subject, and the monograph as a whole is a valuable contribution to its field of study.

  19. Eosinophilic mastitis masquerading as breast carcinoma.

    Science.gov (United States)

    Garg, M; Kumar, S; Neogi, S

    2012-06-01

    We report the sixth case of Eosinophilic Mastitis, presenting similarly enough to be confused with breast carcinoma. A 50 year old lady presented with a six month history of progressively enlarging asymptomatic breast lump, cough and breathlessness. Clinical examination, mammography and axillary lymphadenopathy suggested malignant disease. Ronchi were heard on chest auscultation. Needle cytology was twice inconclusive and Tru-cut biopsy showed acute on chronic inflammation. Blood investigations revealed significant peripheral eosinophilia. Open biopsy reported eosinophilic mastits, correlating with peripheral eosinophilia and pulmonary symptoms. The patient responded to conservative management. Eosinophilic infiltration of the breast is a rare manifestation of tissue involvement in peripheral eosinophilia. Asthma, Churgh-Strauss Syndrome and hyper-eosinophilic syndromes are associated. Importantly, if a clinically and radiologically malignant breast lump in asthmatic ladies with peripheral eosinophilia is not confirmed on cytology, this entity could be a diagnosis, potentially saving the patient from surgery.

  20. Deer tick masquerading as pigmented conjunctival lesion

    Directory of Open Access Journals (Sweden)

    Robin K. Kuriakose

    2017-04-01

    Conclusions and importance: Despite the low risk for Lyme disease, which is endemic to the Adirondack region where the patient was affected, doxycycline was prescribed for prophylaxis. In any case of suspected tick penetration to the ocular surface, immediate ophthalmologic consultation and prompt removal via the method mentioned above is recommended, as well as attention paid to the Infectious Diseases Society of America guidelines regarding prophylaxis.

  1. Pancreatoblastoma masquerading as hepatoblastoma: A diagnostic dilemma

    Science.gov (United States)

    Prabhu, Aruna; Bhagat, Monica; Ramadwar, Mukta; Qureshi, Sajid S.

    2016-01-01

    Clinicoradiological and histopathological differentiation of pancreatoblastoma from hepatoblastoma can often be a challenge in clinical practice owing to their peculiar resemblance. We report a case of a 4-year-old boy with a right hypochondriac region mass, which was diagnosed as hepatoblastoma on the basis of imaging, raised tumor marker, and biopsy; however, pancreatic origin of the mass was ascertained on exploration and pancreatoblastoma was confirmed on histopathology. PMID:27046982

  2.  Masquerade of a Silent Killer

    Directory of Open Access Journals (Sweden)

    Padmini Venkataramani

    2011-09-01

    Full Text Available   Congenital long QT syndrome (LQTS, referred to as a ticking time-bomb is a cause of sudden death in young infants, children and adults.1 Its prevalence is estimated to be 1 in 2500 to 1 in 10,000 individuals internationally, with no racial predilection.2 It should be viewed as an unrecognized rather than a rare condition.1 This is a descriptive report of eight children diagnosed to have congenital LQTS from 2000 to 2007 (Table 1, in Sarawak General Hospital, Kuching, Sarawak, Malaysia, the main tertiary referral hospital for Sarawak. The population of Sarawak (2006 Census was 2,357,500 and that of Kuching, 435,000.

  3. Carmine hypersensitivity masquerading as azithromycin hypersensitivity.

    Science.gov (United States)

    Greenhawt, Matthew; McMorris, Marc; Baldwin, James

    2009-01-01

    Macrolide hypersensitivity is a rarely reported event. However, carmine dye has become increasingly important as a provocative agent. We present a case of a woman with documented carmine hypersensitivity, who reported anaphylaxis 90 minutes after ingestion of a generic azithromycin. Our investigations revealed that this was an allergy to the carmine dye in the tablet's coating rather than to the antibiotic. Seven extracts were prepared including carmine dye, crushed dried female cochineal insects, crushed tablets of Zithromax (Pfizer Inc.) and generic azithromycin (Teva Pharmaceuticals), and the crushed colored coatings from both tablets. These were suspended in preservative-free normal saline, and then applied as a skin-prick test and read at 30 minutes. The skin-prick skin test results were 4+ to histamine and carmine dye, but negative to cochineal insect extract, Pfizer crushed tablets, and negative control. The patient was 1+ to the Teva crushed tablet, but was 4+ to the Teva brand coating and negative to the Pfizer brand coating, which did not contain carmine. The patient subsequently ingested Pfizer Zithromax without any sequelae. To our knowledge, this is the first reported case of carmine anaphylaxis attributed to carmine-containing medication. Careful history and skin-prick testing to the appropriate agents allowed elucidation of the subtlety of the true offending agent without unnecessary avoidance of the medication class. Patients with a carmine hypersensitivity should actively check with their pharmacy or prescribing physician to verify their medications are free of this offending agent.

  4. Cushing's syndrome masquerading as treatment resistant depression

    OpenAIRE

    Anil Kumar, B. N.; Sandeep Grover

    2016-01-01

    Treatment resistant depression (TRD) is a common clinical occurrence among patients treated for major depressive disorder. A significant proportion of patients remain significantly depressed in spite of aggressive pharmacological and psychotherapeutic approaches. Management of patient with treatment resistant depression requires thorough evaluation for physical causes. We report a case of recurrent depressive disorder, who presented with severe depressive episode without psychotic symptoms, n...

  5. Migrating implant masquerading as acute sinusitis

    OpenAIRE

    2008-01-01

    The author presents a case of migrating miniplate screw presenting as acute on chronic sinusitis. Mini plates have been used in osteosynthesis of the mandible and maxillofacial surgery. In the last decade there has been an increase in the incidence of use of miniplates to stabilise Lefort II and III fractures involving the maxilla. The case report highlights the rare presentation of screw impinging on inferior turbinate in a patient who is a known case of chronic sinusitis presenting as acute...

  6. Retrotracheal thymoma masquerading as esophageal submucosal tumor

    Institute of Scientific and Technical Information of China (English)

    Sheung-Fat Ko; Yuan-Hsiung Tsai; Hsuan-Ying Huang; Shu-Hang Ng; Fu-Ming Fang; Yeh Tang; Ming-Tse Sung; Ming-Jang Hsieh

    2005-01-01

    A 42-year-old man presented with a two-year history of progressive dysphagia and hoarseness. Esophagogram and endoscopy revealed submucosal mass effect on the upper esophagus. Computed tomography and magnetic resonance imaging revealed an elongated mass in the retrotracheal region of the lower neck with extension to the posterior mediastinum. Partial tumor resection and histopathological evaluation revealed a WHO type B2 thymoma. Adjuvant radiation and chemotherapy were subsequently administered resulting in complete tumor regression. To our knowledge, this is the first report of ectopic retrotracheal thymoma with clinical and imaging manifestations mimicking those for esophageal submucosal tumor.

  7. Schizophrenia masquerading as Dissociative Identity Disorder

    OpenAIRE

    Jegan Yogaratnam; Rajesh Jacob

    2012-01-01

    Dissociative symptoms can dominate the clinical picture in many psychiatric conditions and possess a huge challenge to the clinicians in management. We present a case report of a female with a strong family history of schizophrenia who initially presented with features suggestive of dissociative identity disorder, which is itself a rare clinical entity, was later diagnosed to have schizophrenia. Authors would like to emphasise that clinicians should have a high index of suspicion for schizoph...

  8. Childhood neuroblastoma masquerading as pheochromocytoma: case report

    OpenAIRE

    Moon SB

    2016-01-01

    Suk-Bae MoonDepartment of Surgery, Kangwon National University Hospital, Kangwon National School of Medicine, Kangwon National University, Chuncheon, South KoreaAbstract: Neuroblastoma is the most common extracranial solid tumor in children. Mild hypertension is a frequent symptom, presumably an effect of catecholamines that tumors release. Reported herein is the rare occurrence of severe hypertension and subsequent heart failure attributable to adrenal gland neuroblastoma. A 3-year-old boy p...

  9. Intrathoracic lipoma masquerading as subclavian artery trauma.

    LENUS (Irish Health Repository)

    Munro, P T

    2012-02-03

    A 58 year old man was admitted to the accident and emergency department following an industrial accident in which he sustained a three part fracture dislocation of his right humerus. Chest radiography revealed a large mass in the right upper hemithorax and, when the patient became hypotensive, an emergency thoracotomy was performed. The mass was found to be a massive intrathoracic lipoma. This case shows how preexisting intrathoracic lesions may be mistaken for subclavian or great vessel trauma following violent shoulder girdle injury. The differential diagnosis of traumatic and non-traumatic intrathoracic mass lesions in chest radiography should be considered carefully.

  10. Amebic liver abscesses masquerading as pyemic abscesses.

    Science.gov (United States)

    Nattakom, S; Serrato, P; Bright, T; Anaya, A; Stubbers, S; Verghese, A

    2001-12-15

    We describe a 50-year-old man who presented with multiple liver abscesses that suggested biliary sepsis or portal pyemia. A wet preparation of a sample of aspirate showed the presence of amebic trophozoites, and subsequent serological testing for amebae was strongly reactive.

  11. Phototoxic keratoconjunctivitis from coal-tar pitch volatiles.

    Science.gov (United States)

    Emmett, E A; Stetzer, L; Taphorn, B

    1977-11-25

    Roofers working with coal-tar pitch develop burning eyes and conjunctivitis which they subjectively associate with sun exposure. A coal-tar pitch distillate instilled in the conjunctivae of rabbits produced minimal or mild irritation in the absence of ultraviolet radiation, but irradiation with long-ultraviolet produced marked photophobia and severe keratoconjunctivitis.

  12. Theoretical characterization of aflatoxins and their phototoxic reactions

    Science.gov (United States)

    Guedes, Rita C.; Eriksson, Leif A.

    2006-05-01

    Key molecular properties are calculated for the 8 most common aflatoxins at the B3LYP/6-31 + G(d,p) level. Special attention is given the possibility of aflatoxins to generate reactive oxygen species (ROS). It is concluded that the excited triplet states of the aflatoxins have properties that make them very potent ROS generators, in addition to direct photoinduced addition reactions. The elevated toxicity of aflatoxin B1 is discussed in terms of its lower ionization potential, and the coincidence of higher lying triplet states with dominant low-lying singlet excitations, which enables rapid intersystem crossing and decay along the triplet channel to the T 1 state.

  13. The retina as a potential site of nanomaterial phototoxicity

    Science.gov (United States)

    Manufactured nanomaterials are designed for their unique properties, one of which is to be photoreactive. Photocatalysts are desirable in many applications including self-cleaning surfaces, sterilization and decontamination of polluted media, and photovoltaic devices. Photo-catal...

  14. In vitro cytotoxicity and phototoxicity study of cosmetics colorants.

    Science.gov (United States)

    Tomankova, K; Kejlova, K; Binder, S; Daskova, A; Zapletalova, J; Bendova, H; Kolarova, H; Jirova, D

    2011-09-01

    The aim of the work was early identification of preventable risk factors connected with the consumers usage of products of everyday use, such as cosmetics, toys and children products, and other materials intended for contact with human skin. The risk factor is represented by substances with irritation potential and subsequent possible sensitisation, resulting in negative impact on human physical and psychical health with social and societal consequences. The legislation for cosmetics, chemical substances and other products requires for hazard identification the application of alternative toxicological methods in vitro without the use of animals. For this reason we used a battery of alternative assays in vitro, based on cell cultures. Progressive methods of molecular biology, based on fluorimetry and fluorescence, were employed for identification of early morphological and functional changes on cellular level. Four colorants frequently used in cosmetics (P-WS Caramel, Chlorophyllin, Unicert Red K 7054-J and Unicert Red K 7008-J) were tested on cell line NIH3T3 (mouse fibroblast cell) and 3T3 Balb/c with/without UV irradiation (dose 5 J cm(-2)). Fluorescence methods for the study of cell damage using fluorescence probes offer results for the evaluation of cytotoxicity and cell viability of adherent cells. We detected intracellular production of ROS investigated by molecular probe CM-H(2)DCFDA, which is primarily sensitive to the increased production of hydrogen peroxide or its downstream products. Toxic effects on the cellular level were identified by viability tests using Neutral Red uptake and MTT assay, where the live cells reduce yellow soluble 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) to insoluble formazan crystals. The reaction was investigated on mitochondrial membrane of living cells and the type of cell death was determined using Apoptosis detection kit. Cytotoxicity tests revealed health risks of using Chlorophyllin and Unicert Red K 7054-J.

  15. Phototoxic effects of titanium dioxide nanoparticles on Daphnia magna

    Science.gov (United States)

    Mansfield, Charles M.

    Titanium dioxide nanoparticles (TiO2-NP) are one of the most abundantly utilized nanomaterials in the world. Studies have demonstrated the mechanism of acute toxicity in TiO2-NP to be the production of reactive oxygen species (ROS) leading to oxidative stress and mortality in exposed organisms. It has also been demonstrated that the anatase crystalline conformation is capable of catalyzing the cleavage of water molecules to further increase the concentration of ROS in the presence of ultraviolet radiation. This photoenhanced toxicity significantly lowers the toxicity threshold of TiO2-NP to environmentally relevant concentrations (ppb). The goal of this study was to determine whether dietary uptake and accumulation of TiO2-NP in the aquatic filter feeder Daphnia magna resulted in photoenhanced toxicity. D. magna and S. caprincornatum were exposed to aqueous solutions of 20ppm and 200ppm TiO2-NP for 24hrs and then transferred to clean moderately hard water. Samples were taken at various time points, dried, and TiO 2 quantified using ICP-MS. Toxicity assays were run on D. magna using three TiO2-NP (20ppm, 200ppm) exposure protocols and two ultraviolet radiation treatments. The first exposure group was exposed to aqueous solutions of TiO2-NP for the duration of the test. The second exposure group was exposed to TiO2-NP for an hour and then transferred to clean water. The third exposure group was fed S. capricornatum that had been allowed to adsorb TiO2-NP. All samples were then placed in an outdoor UV exposure system and exposed to either full spectrum sunlight (with UV) or filtered sunlight (no UV). Here we show that TiO2 uptake peaked at one hour of exposure likely due to sedimentation of the particles out of suspension, thus decreasing bioavailability for the duration of the test. Interestingly, when D. magna were moved to clean water, aqueous concentrations of TiO2 increase as a result of depuration from the gut tract. Data also suggests these excreted particles were bioavailable and re-consumed by D. magna. These data will contribute to the understanding of TiO2-NP environmental fate and toxicity.

  16. Biodegradation of phenol in static cultures by Penicillium chrysogenum ERK1: catalytic abilities and residual phototoxicity Biodegradación de fenol en cultivos estáticos por Penicillium chrysogenum ERK1: habilidades catalíticas y fitotoxicidad residual

    Directory of Open Access Journals (Sweden)

    Erika A Wolskm

    2012-06-01

    Full Text Available A phenol-degrading fungus was isolated from crop soils. Molecular characterization (using internal transcribed spacer, translation elongation factor and beta-tubulin gene sequences and biochemical characterization allowed to identify the fungal strain as Penicillium chrysogenum Thorn ERK1. Phenol degradation was tested at 25 °C under resting mycelium conditions at 6, 30, 60, 200, 350 and 400 mg/l of phenol as the only source of carbon and energy. The time required for complete phenol degradation increased at different initial phenol concentrations. Maximum specific degradation rate (0.89978 mg of phenol/day/mg of dry weight was obtained at 200 mg/l. Biomass yield decreased at initial phenol concentrations above 60 mg/l. Catechol was identified as an intermediate metabolite by HPLC analysis and catechol dioxygenase activity was detected in plate assays, suggesting that phenol metabolism could occur via ortho fission of catechol. Wheat seeds were used as phototoxicity indicators of phenol degradation products. It was found that these products were not phytotoxic for wheat but highly phytotoxic for phenol. The high specific degradation rates obtained under resting mycelium conditions are considered relevant for practical applications of this fungus in soil decontamination processes.Un aislamiento fúngico capaz de degradar fenol como única fuente de carbono y energía fue aislado de suelos agrícolas. La caracterización molecular (basada en el empleo de secuencias de espaciadores de transcriptos internos, de factores de la elongación de la traducción y del gen de la beta-tubulina y la caracterización bioquímica permitieron identificar a esta cepa como Penicillium chrysogenum Thom ERK1. Se estudió la degradación de fenol a 25 °C en cultivos estáticos con 6, 30, 60, 200, 350 y 400 mg/l de fenol inicial. El tiempo requerido para completar la degradación de fenol aumentó al elevarse las concentraciones iniciales de dicho compuesto. La m

  17. Percutaneous central line extravasation masquerading as an abscess.

    Science.gov (United States)

    Govind, Binu; Tete, Prakash Ignace; Thomas, Niranjan

    2014-04-01

    Percutaneous central line insertion is a common procedure in the neonatal intensive care unit. A preterm baby, who had a percutaneous central line inserted developed an erythematous swelling over the infraclavicular area. A diagnosis of abscess was made, and an incision and drainage done that revealed a white fluid with high triglyceride content, confirming lipid extravasation. The lesion healed completely few days after removal of the catheter. This case highlights the importance of proper placement and confirmation of central line position.

  18. Non-vehicular homicides masquerading as road traffic accidents.

    Science.gov (United States)

    Zine, K U; Mugadlimath, Anand B; Sane, Mandar Ramchandra; Bhuyyar, Chandrashekhar; Rathod, S N

    2016-03-01

    Interfering with or planting evidence to disguise the cause of a death is not uncommon in forensic practice. Homicides staged as road accidents are, however, rarely encountered by crime scene investigators. We report two homicides which were presented as road traffic accidents. Case 1: Dead body of a 35-year-old male was brought for autopsy with history of road traffic accident. Primary police inquiry suggested that the victim was knocked down by a speeding four-wheeler, while walking by the side of a high way with his friends. On postmortem examination the deceased's death was found due to homicidal smothering staged as a road traffic accident. Case 2: Dead body of 40-year-old male was brought for autopsy with history of road traffic accident. It was an unwitnessed crush by a speeding four-wheeler. However, on postmortem examination, the deceased was found to have died from homicidal multiple stab wounds with his death staged as a road traffic accident. Importance of meticulous autopsy to determine accurately the cause of death is emphasized. © The Author(s) 2015.

  19. Stiff Person Syndrome Masquerading as Acute Coronary Syndrome.

    Science.gov (United States)

    Sharma, Ashish; Soe, Myat Han; Singh, Jagdeep; Newsome, Scott D

    2016-01-01

    Stiff person syndrome (SPS) is a rare neuroimmunological disorder characterized by severe progressive muscle stiffness in axial and lower extremity musculature with superimposed painful muscle spasms. Although chest pain is a common reason for SPS patients presenting to the emergency room, this disorder is overlooked and not part of the differential diagnosis of chest pain. Herein, we report on a middle age male presenting with classic symptoms of SPS; however, due to the rarity of this disease, he was initially thought to have acute coronary syndrome. Clinicians should consider the diagnosis of SPS in patients with fluctuating muscle spasms in the torso and/or extremities in the setting of repeated hospitalizations without subsequent symptom relief.

  20. Prejudice Masquerading as Praise: The Negative Echo of Positive Stereotypes.

    Science.gov (United States)

    Siy, John Oliver; Cheryan, Sapna

    2016-07-01

    Five studies demonstrate the powerful connection between being the target of a positive stereotype and expecting that one is also being ascribed negative stereotypes. In Study 1, women who heard a man state a positive stereotype were more likely to believe that he held negative stereotypes of them than women who heard no stereotype. Beliefs about being negatively stereotyped mediated the relationship between hearing a positive stereotype and believing that the stereotyper was prejudiced. Studies 2 to 4 extended these results to Asian Americans and accounted for alternative explanations (e.g., categorization threat). In Study 5, the same positive stereotype (e.g., good at math) was directed to Asian American men's racial or gender identity. Their perceptions about whether negative racial or gender stereotypes were being applied to them depended on the identity referenced by the positive stereotype. Positive stereotypes signal a latent negativity about one's group, thereby explaining why they can feel like prejudice. © 2016 by the Society for Personality and Social Psychology, Inc.

  1. Mycobacterium haemophilum Masquerading as Leprosy in a Renal Transplant Patient

    Science.gov (United States)

    Copeland, Nathanial K.; Arora, Navin S.; Ferguson, Tomas M.

    2013-01-01

    Opportunistic infections following immunosuppression in solid organ transplant (SOT) patients are common complications with the skin being a common sight of infection. Nontuberculous mycobacteria (NTM) are rare but potential causes of skin infection in SOT patients. We present a case of an adult male immunosuppressed following renal transplantation who presented with an asymptomatic rash for several months. The patient's skin eruption consisted of erythematous papules and plaques coalescing into an annular formation. After failure of the initial empiric therapy, a punch biopsy was performed that demonstrated nerve involvement suspicious for Mycobacterium leprae. However, culture of the biopsy specimen grew acid-fast bacilli that were subsequently identified as M. haemophilum. His rash improved after a prolonged course of clarithromycin and ciprofloxacin. Both organisms are potential causes of opportunistic skin infections and can be difficult to distinguish with similar predilection for skin and other biochemical and genetic similarities. Ultimately they can be distinguished with culture as M. haemophilum will grow in culture and M. leprae will not. This case was unique due to nerve involvement on biopsy which is classically seen on biopsies of leprosy. PMID:24369511

  2. Liposarcoma of the Spermatic Cord Masquerading as an Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    William Londeree

    2014-01-01

    Full Text Available This is a case of a 70-year-old male who presented with a mass in his right testicle. He was treated with antibiotics for epididymitis while undergoing serial ultrasounds for one year due to testicular swelling and pain. His fourth ultrasound revealed a mild hydrocele with a large paratesticular mass of undescribed size, superior to the right testicle, thought to be an inguinal hernia. Preoperative CT scan demonstrated a large fat-containing inguinal hernia extending into the scrotal sac. An inguinal hernia repair was complicated by fatty tissue surrounding the testicle requiring a right orchiectomy. Pathology review of the tissue demonstrated well-differentiated liposarcoma with a small focus of dedifferentiation grade 2 tumor. Tumor was identified at the inked margins indicating an incomplete resection. It was decided that no further surgical intervention was needed and the patient would undergo surveillance for local tumor recurrence. Six-month follow-up MRI scan was negative for any recurrence of disease. A liposarcoma presenting as a paratesticular mass with spermatic cord involvement is rare, and imaging studies may fail to distinguish a liposarcoma from normal adipose tissue.

  3. Type II reaction without erythema nodosum leprosum masquerading as lymphoma.

    Science.gov (United States)

    Mahajan, Rahul; Dogra, Sunil; Kaur, Inderjeet; Yadav, Savita; Saikia, Uma Nahar; Budania, Anil

    2012-12-01

    Lepromatous leprosy is a multisystem disease that can involve many organ systems, with lymph nodes a common extra-cutaneous site to be affected. Rarely, multibacillary leprosy can be confused with other diseases like lymphomas and connective tissue diseases. Herein we report a patient of lepromatous leprosy with Type II lepra reaction involving lymph nodes who presented with generalised lymphadenopathy, acquired ichthyosis and constitutional symptoms but no cutaneous lesions to suggest erythema nodosum leprosum, and who was initially misdiagnosed as a case of Hodgkin's lymphoma.

  4. Leishmaniasis Panamensis Masquerading as Myiasis and Sporotrichosis: A Clinical Pitfall

    Science.gov (United States)

    Pavlidakey, Peter G.; Huynh, Thy; McKay, Kristopher Michael; Sami, Naveed

    2015-01-01

    We report a case of cutaneous leishmaniasis panamensis in nonendemic Costa Rica. A 19-year-old female presented with nonhealing, unilateral eruption of erythematous papules with superficial central ulceration in a sporotrichoid pattern on right upper arm and back. Given the clinical picture and geographic locale, the patient was initially diagnosed with myiasis or human botfly infestation; however, the sporotrichoid pattern of the bites is an unlikely finding in myiasis. Peripheral blood smear, Giemsa stain, and polymerase chain reaction (PCR) were consistent for Leishmania spp. Ulceration resolved with 20-day course of IV sodium stibogluconate. PMID:26413365

  5. Leishmaniasis Panamensis Masquerading as Myiasis and Sporotrichosis: A Clinical Pitfall

    Directory of Open Access Journals (Sweden)

    Peter G. Pavlidakey

    2015-01-01

    Full Text Available We report a case of cutaneous leishmaniasis panamensis in nonendemic Costa Rica. A 19-year-old female presented with nonhealing, unilateral eruption of erythematous papules with superficial central ulceration in a sporotrichoid pattern on right upper arm and back. Given the clinical picture and geographic locale, the patient was initially diagnosed with myiasis or human botfly infestation; however, the sporotrichoid pattern of the bites is an unlikely finding in myiasis. Peripheral blood smear, Giemsa stain, and polymerase chain reaction (PCR were consistent for Leishmania spp. Ulceration resolved with 20-day course of IV sodium stibogluconate.

  6. Massively dilated right atrium masquerading as a mediastinal tumor

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    Thomas Schroeter

    2011-04-01

    Full Text Available Severe tricuspid valve insufficiency causes right atrial dilatation, venous congestion, and reduced atrial contractility, and may eventually lead to right heart failure. We report a case of a patient with severe tricuspid valve insufficiency, right heart failure, and a massively dilated right atrium. The enormously dilated atrium compressed the right lung, resulting in a radiographic appearance of a mediastinal tumor. Tricuspid valve repair and reduction of the right atrium was performed. Follow up examination revealed improvement of liver function, reduced peripheral edema and improved New York Heart Association (NYHA class. The reduction of the atrial size and repair of the tricuspid valve resulted in a restoration of the conduit and reservoir function of the right atrium. Given the chronicity of the disease process and the long-standing atrial fibrillation, there is no impact of this operation on right atrial contraction. In combination with the reconstruction of the tricuspid valve, the reduction atrioplasty will reduce the risk of thrombembolic events and preserve the right ventricular function.

  7. Leprosy with Atypical Skin Lesions Masquerading as Relapsing Polychondritis

    Science.gov (United States)

    Munganda, Hariharan; Bangia, Amit; Rani, Uma; Budhiraja, Rajesh; Brajpuriya, Swapnil

    2016-01-01

    Leprosy can present with a variety of clinical manifestations depending on the immune status of the individual. After dermatological and neurological involvement, rheumatic features specially various forms of arthritis are the third most common manifestation of the disease. We describe a unique case of a 22-year-old patient presenting with external ear involvement mimicking relapsing polychondritis along with inflammatory joint symptoms and skin lesions. Ear involvement in relapsing polychondritis characteristically is painful and spares the noncartilaginous ear lobules, in contrast to painless ear involvement in leprosy affecting the lobules as well. Histopathology confirmed the diagnosis, although the ear and skin lesions were not classical of leprosy. Such a presentation of leprosy closely mimicking relapsing polychondritis has not been described previously. Tissue diagnosis should always be attempted whenever possible in patients presenting with autoimmune features, so that inappropriate therapy with immunosuppressants is avoided. PMID:28116186

  8. Migrated Mesh Plug Masquerading as a Bladder Tumor

    Science.gov (United States)

    Dajani, Daoud; Aron, Monish

    2017-01-01

    Abstract Background: The purpose of this case presentation is to demonstrate how erosion of mesh into the bladder can initially present with the same symptoms as bladder malignancy. Case Presentation: A 62-year-old Hispanic male presented with 2 years of hematuria along with imaging concerning for a bladder tumor. The patient underwent cystoscopy with biopsy of a lesion at the anterior bladder. It was ultimately determined that a mesh plug from a prior hernia repair had migrated into the bladder. The mesh plug was excised using the Da Vinci Si robot, which allowed for efficient mobilization of the bladder and other anatomic structures, as well as rapid recovery. Conclusion: Our case demonstrates the need to consider mesh erosion as a cause of hematuria and, furthermore, shows how the robotic approach can help facilitate excision of migrated mesh into the bladder. PMID:28164159

  9. Brunner gland hamartoma masquerading as malignancy; a rare case report.

    Science.gov (United States)

    Sen, Rajeev; Gupta, Veena; Sharma, Nisha; Chawla, Nitika; Kumar, Sanjay; Malik, Shivani

    2014-10-01

    Brunner's gland hamartoma is a rare benign tumour of the duodenum. It was first described by Cruveilhier in 1835. Presently around 200 cases have been reported in literature. No sex predilection is seen. Patients usually present in the fifth to sixth decades of life. They may be clinically silent or may present with variable symptoms and occasionally obstructive symptoms and chronic pancreatitis. Endoscopic presentation can be nodular, polypoid or diffuse glandular proliferation with thickening of duodenal wall and hence can be misdiagnosed as malignancy. We describe a case of duodenal tumor reported outside (on biopsy) as well differentiated adenocarcinoma which out as Brunner gland hamartoma upon complete resection. Brunner gland hamartoma may sometimes have a very unusual presentation. Extensive pre-operative evaluation is necessity to avoid radical surgical procedure.

  10. Wilson’s disease masquerading as nonalcoholic steatohepatitis

    Directory of Open Access Journals (Sweden)

    Sabina Mahmood

    2009-07-01

    Full Text Available Background: Wilson’s disease is one of the most common hereditary causes of unclear hepatopathy. Patient & Method: A 34-year old male patient with a history of hyperlipidemia was admitted with symptoms of abdominal pain and slight hematuria. Abnormal liver function tests, ultrasound reports and liver biopsy were suggestive of nonalcoholic steatohepatitis (NASH. The patient received preliminary treatment for NASH. However, on subsequent follow-up, NASH remained unresolved and liver histology showed fibrosis progression from fibrosis stage 1 to stage 3. Results: Biochemical tests revealed that the levels of serum ceruloplasmin were decreased (7mg/dl while the urinary excretion of copper was found to be increased (174.2 μg/day. Wilson’s disease was confirmed by diagnostic mutation analysis involving Direct Sequencing. Heterogeneity in the patients ATP7B gene confirmed Wilson’s disease. Administration of D-penicilamine resulted in a decrease in fat deposition in the liver and no further progression in fibrosis after 10 months. Conclusion: Adult patient presenting NASH as first symptoms need to be examined for Wilson’s disease and other metabolic conditions affecting the liver, prior to initiation of treatment.

  11. Tracheal adenoid cystic carcinoma masquerading asthma: A case report

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    Kurul Cuneyt

    2004-10-01

    Full Text Available Abstract Background Tracheal tumors are often misdiagnosed as asthma and are treated with inhaled steroids and bronchodilators without resolution. Case Presentation Here, a patient with tracheal adenoid cystic carcinoma who had been previously diagnosed with difficult asthma was reported. The possibility of the presence of localized airway obstruction was raised when the flow-volume curve suggesting fixed airway obstruction, was obtained. Conclusion The presenting case report emphasizes the fact that not all wheezes are asthma. It is critical to bear in mind that if a patient does not respond to appropriate anti-asthma therapy, localized obstructions should be ruled out before establishing the diagnosis of asthma.

  12. Intravenous Glomus Tumor Masquerading as Lateral Antebrachial Cutaneous Neuroma.

    Science.gov (United States)

    Chim, Harvey; Al-Qattan, Husain; Valencia, Herbert; Brathwaite, Carole; Price, Andrew; Grossman, John A I

    2017-03-01

    Background: Intravenous glomus tumors are extremely rare. Methods: We report a patient with an intravenous glomus tumor within a venous aneurysm misdiagnosed as a neuroma of the lateral antebrachial cutaneous nerve, based on clinical exam, electrodiagnostic studies, and findings on a magnetic resonance imaging neurogram. Results: After surgical resection, the patient's symptoms, including pain and localized hypersensitivity, totally resolved. Conclusions: This case illustrates 2 important points. First, unlike extradigital glomus tumors, magnetic resonance imaging is not reliable in diagnosing intravenous glomus tumors. Second, in the presence of chronic localized neuroma type pain and sensitivity in the upper limb without a clear cause, an extradigital cutaneous or intravenous glomus tumor must be considered in the differential diagnosis.

  13. Intraosseous ameloblastoma masquerading as exophytic growth: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Ramachandra, Prashanth; Ramnarayan, BK; Sanjay, CJ; David, Chaya M [Dr Shyamala Reddy Dental College and Hospital, Bangalore (India); Kaul, Rachna [Dayananda Sagar College of Dental Sciences, Bangalore (India)

    2011-06-15

    Intraosseous ameloblastoma is the most common and simple type of ameloblastoma prevalent among odontogenic tumors. Clinico-radiographically intraosseous ameloblastoma presents as slow, painless swelling or expansion of the jaws and described as multilocular expansile radiolucency that occurs most frequently in mandibular molar/ramus area. This article describes a case of follicular ameloblastoma involving 45 year old male which is different from the usual presentation, which includes-exophytic growth, different location and without expansion of the cortex.

  14. Hypothalamic germinoma masquerading as superior mesenteric artery (SMA) syndrome.

    Science.gov (United States)

    Vethakkan, Shireene R; Venugopal, Yogeswari; Tan, Alexander T B; Paramasivam, Sharmila S; Ratnasingam, Jeyakantha; Razak, Rohaya A; Alias, Azmi; Kassim, Fauziah; Choong, Karen

    2013-01-01

    To report a case of superior mesenteric artery (SMA) syndrome secondary to hypothalamic germinoma. We describe the clinical presentation, diagnostic work-up, management, and clinical course of a patient admitted with SMA syndrome who was subsequently found to have a hypothalamic germinoma. An adolescent boy was admitted to the surgical ward with progressive weight loss over a 2 year period and postprandial vomiting. He was diagnosed with SMA syndrome based on evidence of proximal duodenal dilatation, extrinsic compression of the distal duodenum, and a narrowed aortomesenteric angle (16°). Investigations performed to exclude thyrotoxicosis unexpectedly revealed secondary hypothyroidism and further evaluation demonstrated evidence of pan-hypopituitarism. Psychiatric evaluation excluded anorexia nervosa and bulimia. Magnetic resonance imaging (MRI) of the brain revealed a heterogeneously enhancing hypothalamic lesion, but a normal pituitary gland. Hormone replacement with hydrocortisone, desmopressin, testosterone, and thyroxine resulted in weight gain and resolution of gastrointestinal symptoms. A transventricular endoscopic biopsy subsequently confirmed a hypothalamic germinoma and he was referred to an oncologist. SMA syndrome secondary to severe weight loss is an uncommon cause of upper gastrointestinal obstruction. While there have been reports of poorly controlled diabetes mellitus and thyrotoxicosis manifesting as SMA syndrome, there are no published reports to date of SMA syndrome secondary to hypothalamic/pituitary disease. Management of SMA syndrome is conservative, as symptoms of intestinal obstruction resolve with weight gain following treatment of the underlying cause. Awareness of this uncommon presentation of endocrine cachexia/hypothalamic disease will prevent unnecessary laparotomies and a misdiagnosis of an eating disorder.

  15. Basidiobolomycosis of the Colon Masquerading as Stenotic Colon Cancer

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    M. Ezzedien Rabie

    2011-01-01

    Full Text Available Basidiobolus ranarum is a widespread saprophyte fungus with pathogenic potential. It affects mainly the subcutaneous tissues of the trunk and limbs. Relatively recently, occasional reports of gastrointestinal basidiobolomycosis appeared in the literature. Due to the rarity of the condition and the nonspecific presenting features, the correct diagnosis is usually hard to reach. In this paper, we describe the clinical course of an otherwise healthy female, who presented with a colonic mass. She received subtotal colectomy followed by oral itraconazole, with successful outcome.

  16. Neurocysticercosis masquerading psychotic disorder:A case report

    Institute of Scientific and Technical Information of China (English)

    Rachita Sarangi; Surjeet Sahoo; Satyasunder Mohapatra

    2013-01-01

    Psychotic manifestations are uncommon in neurocysticercosis. This article describes a ten year girl presented with manic–psychotic manifestation for which she was under treatment with antipsychotics for eight months. Eventually she developed generalized tonic clonic seizure and CT scan of brain revealed small isodense right posterior parietal lesion of 5 mm size with perifocal edema. CECT revealed intense nodular post contrast enhancement. This highlights the possible misdiagnosis of a case of neurocysticercosis as an organic psychotic disorder so it should be considered as a differential diagnosis in patients with neurological as well as psychiatric manifestations in endemic area like India.

  17. Parathyroid carcinoma masquerading as morning sickness in pregnancy.

    Science.gov (United States)

    Panchani, Roopal; Varma, Tarun; Goyal, Ashutosh; Tripathi, Sudhir

    2013-10-01

    Incidence of primary hyperparathyroidism (PHP) in pregnancy is 8/100,000 population/year with less than 200 cases reported. Physiological changes associated with pregnancy make a diagnosis of PHP difficult and 80% are asymptomatic. High index of suspicion is required as physiological hypocalcemia related to hemodilution, increased glomerular filtration rate resulting in maternal hypercalciuria and gestational hypoalbuminemia can mask hypercalcemia of PHP. Maternal and fetal complication rates are high. Early recognition followed by appropriate management and treatment significantly reduces complications. Here, we present a rare case of parathyroid carcinoma in pregnancy and highlight the difficulties in diagnosis given the non-specific symptoms related to hypercalcemia. We have also discussed the management of PHP during the pregnancy. PHP is a preventable cause of fetal and maternal morbidity and mortality.

  18. Parathyroid carcinoma masquerading as morning sickness in pregnancy

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    Roopal Panchani

    2013-01-01

    Full Text Available Incidence of primary hyperparathyroidism (PHP in pregnancy is 8/100,000 population/year with less than 200 cases reported. Physiological changes associated with pregnancy make a diagnosis of PHP difficult and 80% are asymptomatic. High index of suspicion is required as physiological hypocalcemia related to hemodilution, increased glomerular filtration rate resulting in maternal hypercalciuria and gestational hypoalbuminemia can mask hypercalcemia of PHP. Maternal and fetal complication rates are high. Early recognition followed by appropriate management and treatment significantly reduces complications. Here, we present a rare case of parathyroid carcinoma in pregnancy and highlight the difficulties in diagnosis given the non-specific symptoms related to hypercalcemia. We have also discussed the management of PHP during the pregnancy. PHP is a preventable cause of fetal and maternal morbidity and mortality.

  19. Primary Pancreatic Head Tuberculosis: Great Masquerader of Pancreatic Adenocarcinoma

    Science.gov (United States)

    Gupta, Dhaval; Patel, Jatin; Rathi, Chetan; Ingle, Meghraj; Sawant, Prabha

    2015-01-01

    Isolated pancreatic tuberculosis (TB) is considered an extremely rare condition, even in the developing countries. Most reported cases of pancreatic TB are diagnosed after exploratory laparotomy or autopsy. Pancreatic TB is a potential mimic of invasive pancreatic malignancy and the presence of vascular invasion does not distinguish one condition from the other. Every effort should be made for the earliest diagnosis of this condition as TB is a treatable condition and it avoids unnecessary management of pancreatic carcinoma. Here we report a rare case of primary pancreatic head TB in a 58-year-old male who presented with hypodense lesion in head of pancreas with double duct sign and portal vein invasion mimicking non-resectable pancreatic carcinoma. PMID:27785295

  20. Primary hyperparathyroidism masquerading as rickets: diagnostic challenge and treatment outcomes.

    Science.gov (United States)

    Dutta, Deep; Kumar, Manoj; Das, Ram Narayan; Datta, Saumik; Biswas, Dibakar; Ghosh, Sujoy; Mukhopadhyay, Satinath; Chowdhury, Subhankar

    2013-01-01

    Primary hyperparathyroidism (PHPT) is extremely uncommon among children and is more likely to be associated with genetic syndromes, multiglandular involvement, and more severe symptoms. Rickets can very rarely be the presenting feature of PHPT in children. Rickets was diagnosed in a 12-year-old girl presenting with short stature, genu valgum, eversion deformity at the ankle joints, and flat feet. Radiograms showed generalized osteopenia, widening of the distal ends of the long bones along with splaying, cupping and fraying. Biochemical evaluation revealed low serum calcium (7.8 mg/dL), low phosphorus (1.4 mg/dL), vitamin-D deficiency [25-hydroxy-vitamin-D (25(OH)D): 8.7 ng/mL], and elevated intact parathyroid hormone (PTH, 811 pg/mL). Re-evaluation due to lack of clinical improvement following vitamin-D and calcium supplementation revealed hypercalcemia 11.9 mg/dL, normal 25(OH)D 41 ng/mL, persistence of elevated PTH 632 pg/mL. A 99mTc-sestamibi scan showed increased uptake at the lower pole of the right lobe of the thyroid. A right inferior parathyroidectomy was performed. Histopathology revealed chief cell type parathyroid adenoma. Last evaluated 4 months after surgery, the bone pains and proximal weakness had resolved, with significant improvement in the patient's quality of life. Rickets in the setting of PHPT often masks the classical phenotype of PHPT. In a child with rickets, lack of improvement following vitamin-D supplementation, hypercalcemia at presentation or following vitamin-D supplementation are warning signs which necessitate further evaluation to rule out PHPT.

  1. Head and neck cancers masquerading as deep neck abscesses.

    Science.gov (United States)

    Soon, Sue Rene; Kanagalingam, Jeevendra; Johari, Shirish; Yuen, Heng Wai

    2012-12-01

    Deep neck space abscesses are common otolaryngological emergencies, and prompt incision and drainage is the treatment of choice. Head and neck cancers often present with cervical metastases that may become secondarily infected. Clinical presentation is similar to a deep neck abscess. Surgical drainage of such collections has implications on subsequent treatment. In this case series, we describe six cases with this unusual presentation that were subsequently found to have a head and neck malignancy, and where three patients had their abscesses treated surgically. We aim to raise awareness of this unusual presentation of a head and neck carcinoma, and to avoid a potential pitfall in the management of deep neck abscess.

  2. Pulmonary Strongyloidiasis Masquerading as Exacerbation of Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Pradhan, Gourahari; Behera, Priyadarshini; Bhuniya, Sourin; Mohapatra, Prasanta Raghab; Turuk, Jyotirmayee; Mohanty, Srujana

    2016-01-01

    Pulmonary strongyloidiasis is an uncommon presentation of Strongyloides infection, usually seen in immunocompromised hosts. The manifestations are similar to that of acute exacerbation of chronic obstructive pulmonary disease (COPD). Therefore, the diagnosis of pulmonary strongyloidiasis could be challenging in a COPD patient, unless a high index of suspicion is maintained. Here, we present a case of Strongyloides hyperinfection in a COPD patient mimicking acute exacerbation, who was on chronic steroid therapy. PMID:27790284

  3. Asymptomatic free-floating vitreous cyst masquerading as cysticercosis.

    Science.gov (United States)

    Ganger, Anita; Agarwal, Rinki; Kumar, Vinod

    2016-11-02

    A male patient aged 37 years, referred with the diagnosis of right eye intravitreal cysticercosis, was diagnosed as asymptomatic free-floating vitreous cyst after thorough evaluation. The patient was kept under observation, since baseline visual acuity was unaffected. No change was noted over the period of 6 months.

  4. Spinal accessory nerve schwannomas masquerading as a fourth ventricular lesion

    Directory of Open Access Journals (Sweden)

    Shyam Sundar Krishnan

    2015-01-01

    Full Text Available Schwannomas are benign lesions that arise from the nerve sheath of cranial nerves. The most common schwannomas arise from the 8 th cranial nerve (the vestibulo-cochlear nerve followed by trigeminal and facial nerves and then from glossopharyngeal, vagus, and spinal accessory nerves. Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are very rare. We report a very unusual spinal accessory nerve schwannoma which occupied the fourth ventricle and extended inferiorly to the upper cervical canal. The radiological features have been detailed. The diagnostic dilemma was due to its midline posterior location mimicking a fourth ventricular lesion like medulloblastoma and ependymoma. Total excision is the ideal treatment for these tumors. A brief review of literature with tabulations of the variants has been listed.

  5. Renal disease masquerading as pyrexia of unknown origin

    Directory of Open Access Journals (Sweden)

    D Korivi

    2013-01-01

    Full Text Available Pyrexia of unknown origin is a challenging clinical problem. Infections, malignancies, and connective tissue diseases form the major etiologies for this condition. We report a case of a 57-year-old diabetic male who presented with fever of unknown origin for several months. The course of investigations led to a kidney biopsy which clinched the cause of his fever as well as the underlying diagnosis. The light microscopy findings of expansile storiform fibrosis with a dense inflammatory infiltrate suggested the diagnosis which was confirmed by positive staining of Immunoglobulin G4, the dense lympho-plasmacytic infiltrate and elevated serum IgG4 concentrations. A course of steroids followed by mycophenolate mofetil as maintenance immunosuppression rendered the patient afebrile with improvement of renal function.

  6. Mucormycosis of the hard palate masquerading as carcinoma

    Directory of Open Access Journals (Sweden)

    Bhari Sharanesha Manjunatha

    2012-02-01

    Full Text Available A growing number of medically compromised patients are encountered by dentists in their practices. Opportunistic fungal infections such as mucormycosis usually occur in immunocompromised patients but can infect healthy individuals as well. Mucormycosis is an acute opportunistic, uncommon, frequently fatal fungal infection, caused by a saprophytic fungus that belongs to the class of phycomycetes. Among the clinical differential diagnosis we can consider squamous cell carcinoma. Such cases present as chronic ulcers with raised margins causing exposure of underlying bone. There is a close histopathological resemblance between mucormycosis and aspergillosis. Microscopically, aspergillosis has septate branching hyphae, which can be distinguished from mucormycotic hyphae by a smaller width and prominent acute angulations of branching hyphae. A definitive diagnosis of mucormycosis can be made by tissue biopsy that identifies the characteristic hyphae, by positive culture or both. The culture of diseased tissue may be negative and histopathologic examination is essential for early diagnosis. Mucormycosis was long regarded as a fatal infection with poor prognosis. However with early medical and surgical management survival rates are now thought to exceed 80%. In the present case, the fungus was identified by hematoxylin and eosin stain and confirmed by Grocott’s silver methenamine special staining technique. Removal of the necrotic bone, which acted as a nidus of infection, was done. Post-operatively patient was advised an obturator to prevent oronasal regurgitation. Since mucormycosis occurs infrequently, it may pose a diagnostic and therapeutic dilemma for those who are not familiar with its clinical presentation.

  7. GASTROINTESTINAL MUCORMYCOSIS OF NEONATE MASQUERADING AS NECROTISING ENTEROCOLITIS

    Directory of Open Access Journals (Sweden)

    Shenbagam Jeevakarunyam

    2016-06-01

    Full Text Available Mucormycosis is a rare opportunistic invasive fungal infection that seldom infects healthy persons. Mucormycosis can affect any organ in the body among which gastrointestinal mucormycosis is very rare. Antemortem or preoperative diagnosis of gastrointestinal mucormycosis is not possible until histopathological demonstration of the fungal elements is done. Treatment consists of surgical debridement with systemic antifungal therapy with amphotericin B. The high mortality rate associated with GIMN (Gastrointestinal Mucormycosis of Neonate is not only due to delay in diagnosis, but also because of inadequate and inappropriate treatment. All the infants with bowel surgery done for perforating or inflammatory lesions should be subjected to careful histopathological examination, else atypical causes for bowel perforations like GIM might be missed. Herewith presenting a rare case of gastrointestinal mucormycosis that occurred in a full-term, 5-day-old immunocompetent neonate.

  8. Melioidosis of Chest Wall Masquerading as a Tubercular Cold ...

    African Journals Online (AJOL)

    involvement, and is highly fatal if not appropriately treated.[2]. There is a paucity of reports of .... lung disease, thalassemia, malignancies, steroid therapy, ... incision and drainage); (b) Abscess over the left lower chest wall after incision and ...

  9. Metastatic endometrial stromal sarcoma masquerading as pulmonary lymphangioleiomyomatosis.

    OpenAIRE

    Mahadeva, R; Stewart, S.; Wallwork, J

    1999-01-01

    A 39 year old female presented with bilateral pneumothoraces and interstitial shadowing on chest x ray. A diagnosis of lymphangioleiomyomatosis was made following an open lung biopsy. Over the next eight years she developed respiratory failure leading to single lung transplantation but she died in the immediate postoperative period. Necropsy examination and review of the previous open lung biopsy revealed multiple pulmonary metastases from a low grade endometrial stromal sarcoma of the uterus...

  10. Arrhythmogenic right ventricular dysplasia masquerading as an abdominal episode.

    Science.gov (United States)

    Kaya, Mehmet Gungor; Yalcin, Ridvan; Ozin, Bulent; Altunkan, Sekip; Cengel, Atiye

    2007-01-01

    A 19-year-old woman presented with abdominal pain. Aside from epigastric tenderness, the patient's physical examination was unremarkable. She developed ventricular tachycardia with left bundle branch block morphology shortly after admission. Echocardiography revealed a thin, enlarged, and hypokinetic right ventricle. Electron beam computed tomography demonstrated hypodense areas in the right ventricular free wall suggestive of fatty infiltration, which suggested arrhythmogenic right ventricular dysplasia. The diagnosis was confirmed with the use of cardiac magnetic resonance imaging. The patient received an implantable cardioverter-defibrillator. This case illustrates a noncardiac presentation of a rare yet treatable cardiac condition.

  11. Focal cemento-osseous dysplasia masquerading as a residual cyst

    Directory of Open Access Journals (Sweden)

    Rajat Bhandari

    2012-01-01

    Full Text Available Focal cemento-osseous dysplasia (FCOD is a benign fibroosseous condition that can be seen in dentulous and edentulous patients. It is an asymptomatic lesion and needs no treatment; however, follow-up is essential due to the possibility that it can progress to a condition called florid cemento-osseous dysplasia. We report a case of FCOD of mandible in a 25-year-old female. Clinically, the lesion resembled periapical pathosis of odontogenic origin. An attempt has been made to discuss the clinical and histopathologic features along with differential diagnosis of cemento-osseous dysplasia.

  12. Focal cemento-osseous dysplasia masquerading as a residual cyst.

    Science.gov (United States)

    Bhandari, Rajat; Sandhu, Simarpreet V; Bansal, Himanta; Behl, Rashi; Bhullar, Ramanpreet Kaur

    2012-04-01

    Focal cemento-osseous dysplasia (FCOD) is a benign fibroosseous condition that can be seen in dentulous and edentulous patients. It is an asymptomatic lesion and needs no treatment; however, follow-up is essential due to the possibility that it can progress to a condition called florid cemento-osseous dysplasia. We report a case of FCOD of mandible in a 25-year-old female. Clinically, the lesion resembled periapical pathosis of odontogenic origin. An attempt has been made to discuss the clinical and histopathologic features along with differential diagnosis of cemento-osseous dysplasia.

  13. Brunn nests masquerading as bladder tumor: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Hee; Byun, Kyung Hwan; Jeon, Ji Min [College of Medicine, Pochon CHA University, Pochon (Korea, Republic of)

    2005-07-15

    Brunn nests are the most common proliferative lesions of the bladder uroepithelium, but exuberant proliferation can mimic bladder tumor on radiologic imaging and cystoscopy. We describe a case of pathologically proven Brunn nests in a 34-year-old man, misdiagnosed as bladder tumor on preoperative imaging studies.

  14. An Uncommon Presentation of Brucella Endocarditis Masquerading as Neurobrucellosis

    Science.gov (United States)

    Agrawal, Neha; Mathew, Thomas; Vidyasagar, Sudha; Kudaravalli, Pujitha

    2017-01-01

    Brucella endocarditis is a rare but a severe complication of brucellosis, observed in less than 2% of cases. It is the main cause responsible for up to 80% of deaths in brucellosis. Herein, we present a case of brucella endocarditis that developed on a native aortic valve, but presented to us with fever for several months and acute neurological symptoms. This case report signifies the importance of considering brucella endocarditis as one of the differentials in patients presenting with Pyrexia of Unknown Origin (PUO) and Central Nervous System (CNS) manifestations.

  15. Adenocarcinoma of lung masquerading as systemic auto-immune disease.

    Science.gov (United States)

    Naha, Kushal; Thakare, Sayali; Vivek, G; Prabhu, Mukhyaprana

    2012-06-14

    A 40-year-old previously healthy male presented with acute onset painless dimness of vision in both eyes since the past week and low-grade fever, anorexia and weight loss for the past 1 month. He had been evaluated at a local hospital and diagnosed to have a posterior cerebral artery territory infarct on the left side on the strength of cranial CT. Shortly after receiving antiplatelets and warfarin he had developed severe coagulopathy as evidenced by haematemesis, epistaxis and haematuria. Preliminary investigation revealed prolonged clotting parameters, renal failure and anaemia. Cerebral MRI showed multiple areas of cortical haemorrhage. In the course of his hospital stay, he developed further stigmata of auto-immunity including Coomb's positive haemolytic anaemia, recurrent venous thromboses and a palpable purpuric truncal rash. He was eventually diagnosed to have an adenocarcinoma of the lung, and was subsequently referred to an oncologist for further therapy.

  16. How not to miss autoinflammatory diseases masquerading as urticaria

    DEFF Research Database (Denmark)

    Krause, K; Grattan, C E; Bindslev-Jensen, C;

    2012-01-01

    symptoms including recurrent fever attacks, arthralgia or arthritis and fatigue. Autoinflammatory diseases are often associated with a diagnostic delay of many years and do not respond to antihistamines and other treatments of urticaria. Also, the chronic inflammation may lead to long-term complications...

  17. Biphasic Malignant Pleural Mesothelioma Masquerading as a Primary Skeletal Tumor

    Science.gov (United States)

    Diacovo, Maria Julia

    2016-01-01

    Biphasic malignant pleural mesothelioma is a rare malignant tumor, usually presenting as a pleural-based mass in a patient with history of chronic asbestos exposure. We herein report a case of a 41-year-old man who presented with chest pain and had a chest computed tomography (CT) scan suggestive of a primary skeletal tumor originating from the ribs (chondrosarcoma or osteosarcoma), with no history of asbestos exposure. CT-guided core needle biopsies were diagnosed as malignant sarcomatoid mesothelioma. Surgical resection and chest wall reconstruction were performed, confirming the diagnosis and revealing a secondary histologic component (epithelioid), supporting the diagnosis of biphasic malignant mesothelioma. PMID:27660729

  18. Pelvic congestion syndrome masquerading as osteoarthritis of the hip

    Directory of Open Access Journals (Sweden)

    Scott J Dos Santos

    2016-12-01

    Full Text Available Objectives: Pelvic congestion syndrome (PCS is associated with pelvic vein reflux (PVR, occasionally secondary to venous compression. Its symptoms, usually intra-pelvic, are alleviated following the abolition of this reflux by pelvic vein embolisation (PVE. The objective of this report is to present two cases of left hip pain, erroneously diagnosed as osteoarthritis, which disappeared after successful PVE and abolition of PVR. Methods: Two females presented with lower limb varicose veins, and also had a history of left-sided hip pain. Both had previously been investigated for the hip pain and diagnosed as osteoarthritis despite minimal arthritic changes on pelvic X-rays. During investigation for lower limb varicose veins, both showed a pelvic origin for their leg veins and hence underwent transvaginal duplex ultrasound. This revealed PVR, and PVE was planned in both patients. Results: Both patients underwent PVE and reported ‘miraculous’ resolution of left hip pain and also PCS symptoms including pelvic pain, irritable bowel issues and the disappearance of pelvic dragging, with almost immediate disappearance of vulval and vaginal varicosities. One patient also noted reduced clitoral sensitivity. Conclusion: Manifestations of PCS may vary in terms of intra- or extra-pelvic signs. PCS and PVR should be considered in the differential diagnosis of patients with arthritic symptoms in the hip without evident radiographic evidence.

  19. Delayed Diaphragmatic Herniation Masquerading as a Complicated Parapneumonic Effusion

    Directory of Open Access Journals (Sweden)

    John Tsang

    1999-01-01

    Full Text Available Injury to the diaphragm following blunt or penetrating thoraco-abdominal trauma is not uncommon. Recognition of this important complication of trauma continues to be a challenge because of the lack of specific clinical and plain radiographic features, the frequent presence of other serious injuries and the potential for delayed presentation. Delayed diaphragmatic herniation often presents with catastrophic bowel obstruction or strangulation. Early recognition of diaphragmatic injury is required to avoid this potentially lethal complication. The case of a 35-year-old man with a history of a knife wound to the left flank 15 years previously, who presented with unexplained acute hypoxemic respiratory failure and a unilateral exudative pleural effusion that was refractory to tube thoracostomy drainage, is reported. After admission to hospital, he developed gross dilation of his colon; emergency laparotomy revealed an incarcerated colonic herniation into the left hemithorax. Interesting clinical features of this patient's case included the patient's hobby of weightlifting, a persistently deviated mediastinum despite drainage of the pleural effusion and deceptive pleural fluid biochemical indices.

  20. Two Cases of Ectopic Hamartomatous Thymoma Masquerading as Sarcoma

    Science.gov (United States)

    Sato, Yukiko; Tanaka, Hiroko; Sasaki, Toru; Kawabata, Kazuyoshi; Mitani, Hiroki; Yonekawa, Hiroyuki; Fukushima, Hirofumi; Shimbashi, Wataru

    2017-01-01

    Ectopic hamartomatous thymoma (EHT) is an extremely rare benign tumor. EHTs are difficult to differentiate from sarcomas, especially synovial sarcomas. We encountered two cases of EHT that were referred from other hospitals because sarcoma was suspected. In these cases, fusion gene detection via polymerase chain reaction or fluorescence in situ hybridization was useful for differentiating EHT from synovial sarcoma. EHT requires accurate diagnosis before surgery to avoid excessive treatment. Both tumor location and the presence of fat inside the tumor are important imaging findings for EHT, and confirmation of spindle cells, epithelial cells, and mature adipose cells in the tumor is an important pathological finding. It is important to exclude synovial sarcoma from the differential diagnosis via fusion gene analysis. PMID:28168073

  1. A Case of Neuromyelitis Optica Masquerading as Miller Fisher Syndrome

    Directory of Open Access Journals (Sweden)

    Yuka Furutani

    2014-10-01

    Full Text Available A 22-year-old woman presented with double vision that she had experienced since an infection 2 weeks previously. A neurological examination showed limited bilateral eye abduction, mimicking Miller Fisher syndrome. However, T2-weighted magnetic resonance imaging of her brain revealed hyperintense areas in the tegmentum of the pons, including the abducens nucleus, and her serum anti-aquaporin-4 antibody test was positive. She was finally diagnosed with neuromyelitis optica. Intravenous high-dose steroid therapy immediately improved the patient's abduction palsy, but bilateral optic neuritis manifested during the treatment. Subsequent treatment with plasma exchange improved her optic neuritis symptoms.

  2. Neoliberalism, Social Darwinism, and Consumerism Masquerading as School Reform

    Science.gov (United States)

    Tienken, Christopher H.

    2013-01-01

    Education reform policies harvested from neoliberalism, social Darwinism, consumerism, and free-market ideologies have begun to replace the pragmatic progressivism of the pre-World War II era. In this article, I use three federal and state education reform policies and programs--No Child Left Behind Act, Common Core State Standards Initiative, and…

  3. Benign multicystic mesothelioma masquerading as a urachal cyst.

    Science.gov (United States)

    Marien, Tracy; Zhou, Min; Brucker, Benjamin

    2014-12-01

    Benign multicystic mesothelioma (BMM) is a benign intra-abdominal lesion that generally occurs in women in their reproductive years. A urachal cyst occurs when the epithelial-lined urachal canal fails to completely obliterate. We report a case of a 38-year-old female presenting with abdominal pain found to have a lesion highly suspicious for a urachal cyst. On pathologic evaluation the lesion was identified as a BMM. This is the first report of BMM presenting as a lesion suspected to be a urachal cyst.

  4. Hydatidosis of the Pelvic Cavity: A Big Masquerade

    Directory of Open Access Journals (Sweden)

    Peyman Varedi

    2008-01-01

    Full Text Available We report and discuss a case of primary hydatidosis of the pelvic cavity in a woman who presented with severe weight loss and abdominal pain. This unusual presentation was initially considered as a tumor process until surgical exploration and microscopic studies confirmed the diagnosis. The gynecologists should be aware of possibility of primary hydatid cyst of the pelvic cavity and should be considered in the differential diagnosis of cystic pelvic masses, especially in areas where the disease is endemic.

  5. Neurodegenerative disorder masquerading as psychosis in a forensic psychiatry setting.

    Science.gov (United States)

    Sommerlad, Andrew; Lee, James; Warren, Jason; Price, Gary

    2014-06-13

    A man presenting in his 50s, following conviction for a non-violent crime, to forensic psychiatric services, and then to a neuropsychiatry service with an unusual presentation of psychosis: second person auditory hallucinations, grandiose delusions and somatic delusions. Detailed collateral and family history revealed a background of progressive cognitive deficit and a family history of motor neuron disease. MRI of the brain revealed asymmetrical parieto-occipital volume loss and genetic testing demonstrated a pathogenic expansion of the chromosome 9 open reading frame 72 (C9ORF72) gene consistent with familial frontotemporal dementia caused by a hexanucleotide repeat expansion at C9ORF72, a recently discovered cause of familial frontotemporal dementia/motor neuron disease. This form of frontotemporal dementia should be considered as an important potential differential diagnosis for patients presenting with psychotic symptoms in later life, in whom a detailed family history and thorough cognitive assessment is essential.

  6. Tuberculosis of the patella masquerading as prepatellar bursitis.

    Science.gov (United States)

    MacLean, S; Kulkarni, S

    2013-01-01

    Tuberculosis of bone is an uncommon entity in the western world. We present a case of tuberculosis of the patella mimicking prepatellar bursitis in an otherwise fit and well woman of Bangladeshi origin. We believe tuberculosis of bone should form a differential diagnosis of the swollen knee in high-risk patients.

  7. Bilateral patellar tuberculosis masquerading as infected infrapatellar bursitis.

    Science.gov (United States)

    Sreenivasan, Ravi; Haq, Rehan Ul

    2017-04-01

    A 30-year-old woman presented to our outpatient department with complaints of pain and swelling in bilateral infrapatellar regions and a discharging sinus in the right knee over the duration of one year. Radiographs showed lytic regions in bilateral patellae. Samples sent from material curetted from sinus yielded no organism but histopathology reported granulomatous inflammation. Following a fresh magnetic resonance imaging (MRI) scan that revealed the infrapatellar pad of fat communicating with the patellar lesions, an exploration and evacuation was done. Material sent revealed epithelioid cell granulomas with caseous necrosis consistent with tuberculosis (TB). The patient was put on first line anti-tubercular treatment (ATT) and has responded favourably with healing of sinus and patellar lesions. Bilateral infrapatellar bursitis is not rare. However patellar TB as a cause for OMIT is not a common diagnosis. A bilateral patellar involvement has not been reported in literature to the best of our knowledge.

  8. Hidradenoma masquerading digital ganglion cyst: A rare phenomenon

    Directory of Open Access Journals (Sweden)

    Navnit Makaram

    2016-09-01

    Discussion: This is the first reported case of this rare tumour presenting as mucous cyst. We conduct a review of the literature of nodular hidradenomas, illustrating the immunohistologic findings in this tumour to emphasise the atypical features.We emphasise the importance of considering hidradenoma in the differential diagnosis of such lesions of the finger, in view of its high recurrence rate and the possibility of malignant transformation.

  9. Fruit-induced FPIES masquerading as hereditary fructose intolerance.

    Science.gov (United States)

    Fiocchi, Alessandro; Dionisi-Vici, Carlo; Cotugno, Giovanna; Koch, Pierluigi; Dahdah, Lamia

    2014-08-01

    Hereditary fructose intolerance (HFI) symptoms develop at first introduction of fruit during weaning. We report on an infant with suspected HFI who presented with repeated episodes of vomiting and hypotension after ingestion of fruit-containing meals. The first episode occurred at age 4 months. Despite negative genetic testing for HFI, strict avoidance of fruit ingestion resulted in lack of recurrence of symptoms. Oral-fructose-tolerance testing conducted with an apple mousse did not determine hypoglycemia or fructosuria but caused severe hypotension. Allergy evaluations were negative, and the history was diagnostic for fruit-induced food protein-induced enterocolitis syndrome. Because this non-immunoglobulin E-mediated gastrointestinal food hypersensitivity manifests as profuse, repetitive vomiting, often with diarrhea, leading to acute dehydration and lethargy, it may be misinterpreted as HFI. We advise pediatricians to consider food protein-induced enterocolitis syndrome in the differential diagnosis when there is a suspicion of HFI.

  10. Neuromyelitis Optica Masquerading as Lumbosacral Radiculopathy: A Case Report

    Science.gov (United States)

    2016-01-01

    Neuromyelitis optica spectrum disorders (NMOSD) is a demyelinating syndrome of the central nervous system. This case report describes a 31-year-old woman whose electromyography revealed radiculopathy in the left L5-S1 spinal segment without anatomical abnormalities on lumbosacral magnetic resonance imaging (MRI). She was diagnosed with NMOSD based on gadolinium contrast whole spine and brain MRI and anti-aquaporin-4 antibody findings. Her peripheral nervous system might have been damaged during the early course of NMOSD. Therefore, it is necessary to consider NMOSD for patients who have radiculopathy in electromyography if lumbosacral MRI shows no abnormalities. PMID:27847726

  11. Acute Lymphocytic Leukemia with Bilateral Renal Masses Masquerading as Nephroblastomatosis

    Directory of Open Access Journals (Sweden)

    Poonam Thakore

    2015-01-01

    Full Text Available Acute lymphoblastic leukemia (ALL is the most common malignancy in the pediatric patient population. However, renal involvement as the primary manifestation of ALL is rare. We report a case of a 4-year-old boy with bilateral renal lesions resembling nephroblastic rests as the first finding of early stage ALL preceding hematological changes and subsequent classic clinical findings by two weeks. These renal hypodensities completely resolved after one week of induction chemotherapy. This case demonstrates that renal involvement can be the only initial presenting finding of leukemia. Children with lesions resembling nephroblastic rests need appropriate surveillance due to the risk of malignant disease.

  12. Squamous cell carcinoma of esophagus masquerading as solitary thyroid nodule

    Directory of Open Access Journals (Sweden)

    Basu S

    2005-01-01

    Full Text Available Secondary neoplasm of the thyroid mimicking a primary thyroid lesion is a rare finding, especially in an individual without a past history of malignancy. A case of squamous cell carcinoma metastatic to the thyroid (presenting as a solitary thyroid nodule, who had an unsuspected primary in the esophagus is described. Usually, multiple areas of the gland are involved in the secondary involvement of the thyroid. The clinical presentation of an apparently asymptomatic mass with neck lymphadenopathy, normal thyroid functions, and a cold nodule on 99mTcO4- thyroid scan can often lead to a misdiagnosis as primary thyroid neoplasm. The present case underscores the fact that due importance to the subtle signs and symptoms and a high degree of suspicion, whenever the histology is unusual for a thyroid primary, is needed and the workup should include ruling out other primary malignancies.

  13. Jervell and Lange-Nielson Syndrome masquerading as intractable epilepsy

    Directory of Open Access Journals (Sweden)

    Jagdish P Goyal

    2012-01-01

    Full Text Available The long QT syndrome (LQTS is a cause of syncope and sudden death. Jervell and Lange-Nielson syndrome (JLNS is an uncommon form of LQTS, having autosomal recessive transmission, and is associated with congenital deafness. We report a case of JLNS in a child who presented to us with refractory epilepsy. The cardiac cause of seizures was suspected as the child was hypotensive and pulseless during the episode of seizures. The child was diagnosed as JLNS based on Schwartz diagnostic criteria for LQTS and congenital sensorineural deafness. The child responded well to β-blocker therapy. Antiepileptic drugs were stopped. The screening of family members with ECG revealed a QT interval more than required for diagnosis of LQTS but they were asymptomatic. All asymptomatic family members were also put on metoprolol. All of them showed great improvement with the reduction of the QT interval on ECG. The patient was doing well on immediate follow-up.

  14. Tuberculous epididymo-orchitis masquerading as acute scrotum.

    Science.gov (United States)

    Kinnear, Ned; Hoh, Ivan; Campillo, Pedro; Bolt, John

    2016-02-04

    An 18-year-old boy, a refugee from Afghanistan, with no significant medical history, presented after 1 day of severe left testicular pain. History, clinical examination and scrotal ultrasound suggested the diagnosis of epididymo-orchitis. He was discharged on a 2-week course of amoxicillin/clavulanic acid. Six weeks later, he re-presented with a testicular abscess, continuous with the epididymal head. Incision and drainage led to laboratory confirmation of tuberculous infection. He was treated with isoniazid, rifampicin, ethambutol, pyrazinamide and vitamin B6 for 9 months, with good response. Despite meeting high-risk criteria for tuberculosis, our patient had a delayed diagnosis. We present the case and discuss the lessons learned.

  15. Vocal Cord Dysfunction Masquerading as Astma Like Symptoms

    Directory of Open Access Journals (Sweden)

    Sami Ozturk

    2007-04-01

    Full Text Available Vocal cord dysfunction (VCD is a nonorganic disorder of the larynx that involves unintentional paradoxical adduction of the vocal cords while breathing. VCD is a relatively rare condition that may mimic asthma or upper airway obstruction. VCD often coexists with asthma, and should be suspected in any patient in whom asthma treatment fails. Confirming the diagnosis involves direct visualization of abnormal vocal cord motion, and this usually only occurs during symptoms. In this report, we describe a 65-years-old male patient who has psychological problems due to a relative loss, and a military collage student who experiencing respiratory problems during vigorous exercises. [TAF Prev Med Bull 2007; 6(2.000: 148-150

  16. Retroperitoneal Necrotizing Fasciitis Masquerading as Perianal Abscess - Rare and Perilous.

    Science.gov (United States)

    Amaranathan, Anandhi; Sahoo, Ashok Kumar; Barathi, Deepak; Shankar, Gomathi; Sistla, Sarath Chandra

    2017-01-17

    Necrotizing fasciitis is one of the uncommon presentations of a rapidly spreading subcutaneous tissue infection. Although the actual cause is unclear in many cases, most of them are due to the rapid proliferation of microorganisms. Retroperitoneal necrotizing fasciitis is extremely rare. It is a potentially lethal infection that requires immediate and aggressive surgical care. Early diagnosis is the key to a better prognosis. The possibility of retroperitoneal necrotizing fasciitis should be suspected in patients with symptoms of sepsis that are disproportionate to clinical findings. The rapid deterioration of the patient also gives a clue towards the diagnosis. We report a 35-year-old male with perianal abscess who had been progressed to retroperitoneal necrotizing fasciitis. The patient was managed successfully with aggressive debridement and drainage after laparotomy. Appropriate antibiotics were used to combat the sepsis. The patient recovered well at follow up, three months after discharge. Another patient, a 45-year-old male with a retroperitoneal abscess, progressed to retroperitoneal necrotizing fasciitis, and extra peritoneal drainage and debridement was done. Antibiotics depending upon the culture and sensitivity were used to control sepsis. But the patient succumbed to death 45 days after surgery due to uncontrolled sepsis. Necrotizing fasciitis of any anatomical site needs aggressive surgical care with early intervention. But retroperitoneal necrotizing fasciitis needs an extra effort for diagnosis. After diagnosis, it needs timely surgical intervention and appropriate antibiotic therapy for the recovery of the patients.

  17. Little Masquerade: Russia’s Evolving Employment Of Maskirovka

    Science.gov (United States)

    2016-05-26

    in German and received orders before the German eastern front chain of command would receive them. 64 Geoffrey Jukes, Kursk: The Clash of Armour (New...United States. The deployment of Soviet soldiers occurred under the title of Operation Anadyr which itself was another means of disinformation intended to...with the invasion. Soviet intentions became clear once Czechoslovakia was under the control of the Soviet Union. In line with Soviet efforts during the

  18. Cutaneous diphtheria masquerading as a sexually transmitted disease

    Directory of Open Access Journals (Sweden)

    Vetrichevvel T

    2008-01-01

    Full Text Available A 41 year-old, sexually promiscuous, married male, an agricultural laborer by occupation, presented to our sexually transmitted diseases (STD clinic with multiple ulcers over the scrotum and genitalia of 20 days′ duration. Bacterial culture from swabs taken from the genital ulcer, grew organisms morphologically and biochemically characteristic of Corynaebacterium diphtheriae. He made a complete and uneventful recovery after two weeks of therapy with antidiphtheria serum and crystalline penicillin. This case brings into light this hitherto unreported presentation of wound diphtheria mimicking a sexually transmitted genital ulcer disease and thus, underlines the importance of considering diphtheria as differential in atypical, long-standing genital ulcers.

  19. Accessory breast tissue in axilla masquerading as breast cancer recurrence

    Directory of Open Access Journals (Sweden)

    Goyal Shikha

    2008-01-01

    Full Text Available Ectopic or accessory breast tissue is most commonly located in the axilla, though it may be present anywhere along the milk line. Development is hormone dependent, similar to normal breast tissue. These lesions do not warrant any intervention unless they produce discomfort, thus their identification and distinction from other breast pathologies, both benign and malignant, is essential. We report a case with locally advanced breast cancer who presented with an ipsilateral axillary mass following surgery, radiotherapy, and chemotherapy. Subsequent evaluation with excision biopsy showed duct ectasia in axillary breast tissue and the patient was continued on hormone therapy with tamoxifen.

  20. Clinical features of retinal diseases masquerading as retrobulbar optic neuritis

    Institute of Scientific and Technical Information of China (English)

    JIANG Li-bin; SHEN Ce-ying; CHEN Fei; YAN Wei-yu; Timothy Y.Y.Lai; WANG Ning-li

    2013-01-01

    Background Managements of optic neuritis (ON) included high-dose corticosteroids or combined with systemic immunomodulatory agents.It was important to make a correct diagnosis of ON before initiation of treatment.The purpose of the study was to report and analyze the clinical features of retinal diseases in patients who were misdiagnosed as having retrobulbar ON.Methods Retrospective review of 26 patients (38 eyes) initially diagnosed with retrobulbar ON but were ultimately diagnosed with retinal or macular diseases.Data obtained from fundus examination,fluorescence fundus angiogrephy (FFA),automated static perimetry,full-field electroretinogram (ffERG),multifocal electroretinogram (mfERG),and optical coherence tomography (OCT) were evaluated.Results Thirty-eight eyes of 26 patients were found to have misdiagnosis of retrobulbar ON,based on normal or slight abnormal fundus findings and abnormal visual evoked potentials (VEP).The mean age of the patients was 34 years and the correct diagnosis of the patients included acute zonal occult outer retinopathy (AZOOR,15 eyes,14 patients),occult macular dystrophy (OMD,8 eyes,4 patients),cone or cone-rod dystrophy (10 eyes,5 patients),acute macular neuroretinopathy (AMNR,3 eyes,2 patients),and cancer-associated retinopathy (CAR,2 eyes,1 patient).Conclusion When attempting to diagnose retrobulbar ON in clinical practice,it is crucial to carry out necessary examinations of the retinal function and morphology to decrease misdiagnosis.

  1. Cardiac tamponade masquerading as gastritis: a case report.

    Science.gov (United States)

    Ahmed, Abuzaid; Harsha, Tella Sri; Hamza, Tantoush; Allen, Ameri; Mohamed, Elkhashab

    2014-07-30

    Pericardial effusion and cardiac tamponade can develop in patients with virtually any condition that affects the pericardium. A high index of suspicion with proper diagnostic scheme can lessen the concomitant morbidity and mortality. Although cardiac tamponade mimics many medical conditions, internists and primary care physicians should be aware of the physiological and clinical aspects of the disease spectrum. A 31-year-old Caucasian man, with no significant past medical history, presented to our emergency room with acute upper abdominal heaviness of 2 hours' duration after drinking excessive amounts of alcohol in a short period of time (binge drinking). The coexistence of recent alcohol binge drinking and nonspecific abdominal complaints usually presume a diagnosis of gastritis in our daily encounters in the absence of hepatic, biliary or pancreatic derangements. We present a case in which the presenting abdominal pain turned out to be related to cardiac tamponade. Cardiac tamponade is a sort of cardiogenic shock and is a medical emergency. Clinicians should understand the cardiac tamponade physiology, especially in cases without large pericardial effusion, and correlate the signs of clinical tamponade together with the echocardiographic findings. Drainage of cardiac tamponade is life-saving. A high index of suspicion with proper diagnostic arcades lessens the concomitant morbidity and mortality.

  2. Enterobiasis-related inflammatory caecal polyp masquerading as a malignancy.

    Science.gov (United States)

    Elsaid, Nada; Mahmood, Humza; Tekkis, Paris; Tan, Emile

    2014-01-15

    A 55 -year-old Asian man was seen in the emergency department with bleeding per rectum. He was a teetotaller and had no previous abdominal surgery. He did, however, report a change in bowel habit towards constipation. He underwent colonoscopy which revealed a lesion, highly suspicious of malignancy, in the caecum. On review by two consultants, a decision to completely resect this lesion was made. Histological analysis of the polypoidal growth showed it to be a consequence of chronic infection with the helminth Enterobius vermicularis. Importantly, there was no evidence of dysplastic or malignant cells. The patient was subsequently discharged with a 3-day course of antihelminthic mebendazole and reassured that his per rectal bleeding was most likely due to haemorrhoids discovered at rectal examination.

  3. The evolutionary masquerade: genetic and epigenetic contributions to the neocortex.

    Science.gov (United States)

    Krubitzer, Leah; Stolzenberg, Danielle S

    2014-02-01

    The neocortex is a defining feature of the mammalian brain and its expansion is one of the hallmarks of human evolution. Given the complexity of human behavior, it is tempting to think that as a species humans are exclusive compared to other animals. However, comparative studies indicate that human brains follow the same rules of construction and that alterations to the human neocortex take a similar form as in other mammals. Studies from a number of disciplines indicate that many of the morphological specializations associated with the vocal tract, ear and hand were present in early hominins and thus our ancestors had the capacity for speech, language and sophisticated manual abilities, yet much of modern human behavior evolved very recently. In this review, we discuss the possibility that phenotypic changes in modern human brains and behavior may have been mediated by epigenetic mechanisms that allowed for context dependent changes to the cortical phenotype. Further, we consider whether these epigenetic mechanisms may be more readily engaged in humans than in other species in order to rapidly meet the demands of a dynamic environment. We suggest that perhaps it is the extent to which the neocortex incorporates these context dependent alterations that distinguishes humans from other mammals.

  4. Biphasic Malignant Pleural Mesothelioma Masquerading as a Primary Skeletal Tumor

    Directory of Open Access Journals (Sweden)

    James Benjamin Gleason

    2016-01-01

    Full Text Available Biphasic malignant pleural mesothelioma is a rare malignant tumor, usually presenting as a pleural-based mass in a patient with history of chronic asbestos exposure. We herein report a case of a 41-year-old man who presented with chest pain and had a chest computed tomography (CT scan suggestive of a primary skeletal tumor originating from the ribs (chondrosarcoma or osteosarcoma, with no history of asbestos exposure. CT-guided core needle biopsies were diagnosed as malignant sarcomatoid mesothelioma. Surgical resection and chest wall reconstruction were performed, confirming the diagnosis and revealing a secondary histologic component (epithelioid, supporting the diagnosis of biphasic malignant mesothelioma.

  5. Panayiotopoulos syndrome in a child masquerading as septic shock

    Science.gov (United States)

    Zaki, Syed Ahmed; Verma, Devendra Kumar; Tayde, Pavan

    2016-01-01

    Panayiotopoulos syndrome (PS) is a benign childhood epilepsy with predominant autonomic symptoms. The syndrome can have varied presentations resulting in diagnostic dilemma. We herein describe a 3-year-old boy with PS, who had manifestations similar to septic shock. His investigations were normal and had a complete recovery. Through this case, we wish to highlight the unusual presentation of PS as septic shock. Physicians should be aware of the different ways in which this syndrome can present to ensure its early diagnosis and treatment. PMID:27390462

  6. A case of congenital myopathy masquerading as paroxysmal dyskinesia

    Directory of Open Access Journals (Sweden)

    Harsh Patel

    2014-01-01

    Full Text Available Gastroesophageal reflux (GER disease is a significant comorbidity of neuromuscular disorders. It may present as paroxysmal dyskinesia, an entity known as Sandifer syndrome. A 6-week-old neonate presented with very frequent paroxysms of generalized stiffening and opisthotonic posture since day 22 of life. These were initially diagnosed as seizures and he was started on multiple antiepileptics which did not show any response. After a normal video electroencephalogram (VEEG was documented, possibility of dyskinesia was kept. However, when he did not respond to symptomatic therapy, Sandifer syndrome was thought of and GER scan was done, which revealed severe GER. After his symptoms got reduced to some extent, a detailed clinical examination revealed abnormal facies with flaccid quadriparesis. Muscle biopsy confirmed the diagnosis of a specific congenital myopathy. On antireflux measures, those episodic paroxysms reduced to some extent. Partial response to therapy in GER should prompt search for an underlying secondary etiology.

  7. Pediatric epidermoid cysts masquerading as ranulas: A case series.

    Science.gov (United States)

    Reddy, Abhita; Kreicher, Kathryn L; Patel, Neha A; Schantz, Stimson; Shinhar, Shai

    2016-02-01

    Pediatric neck masses represent a variety of differential diagnoses. A common pathology in pediatric cystic neck tumors include ranulas, mucus retention cysts due to salivary gland obstruction. Epidermoid cysts are lesions infrequently encountered in the pediatric population and may appear similarly to ranulas on computed tomography imaging. MRI more easily differentiates these masses, and should therefore be the preferred imaging modality. Due to their distinct intraoperative management, ranulas and epidermoid cysts should be distinguished preoperatively through proper workup.

  8. Contact dermatitis to alcohol swabs masquerading as vaccine allergy.

    Science.gov (United States)

    Storer, Emma; Marshman, Gillian; Kupa, Ann

    2004-05-01

    A 14-year-old girl developed an eruption on her upper arm of pruritic, follicular papules each time she received a vaccination. This was initially thought to be a local reaction to the vaccines. After a similar rash appeared at a venepuncture site, a contact allergy to the alcohol swabs used before the procedures was postulated. A repeated open application test clarified this observation.

  9. Demyelinating disease masquerading as a surgical problem: a case series

    Directory of Open Access Journals (Sweden)

    Awang Saufi M

    2009-08-01

    Full Text Available Abstract Introduction We report three cases of demyelinating disease with tumor-like presentation. This information is particularly important to both neurosurgeons and neurologists who should be aware that inflammatory demyelinating diseases can present as a mass lesion, which is indistinguishable from a tumor, both clinically and radiologically, especially when there is no evidence of temporal dissemination of this disease. Case presentation The first patient was a 42-year-old Malay woman who developed subacute onset of progressive quadriparesis with urinary incontinence. Magnetic resonance imaging of her spine showed an intramedullary lesion at the C5-C7 level. She was operated on and biopsy was suggestive of a demyelinating disease. Retrospective history discovered two episodes of acute onset of neurological deficits with partial recovery and magnetic resonance imaging of her brain revealed demyelinating plaques in the centrum semiovale. The second patient was a 16-year-old Malay boy who presented with symptoms of raised intracranial pressure. A computed tomography brain scan revealed obstructive hydrocephalus with a lesion adjacent to the fourth ventricle. An external ventricular drainage was inserted. Subsequently, a stereotactic biopsy was taken and histopathology was reported as demyelination. Retrospective history revealed similar episodes with full recovery in between episodes. The third case was a 28-year-old Malay man who presented with acute bilateral visual loss and confusion. Magnetic resonance imaging of his brain showed a large mass lesion in the right temporoparietal region. Biopsy was consistent with demyelinating disease. Reexamination of the patient revealed bilateral papillitis and not papilledema. Visual evoked potential was prolonged bilaterally. In all three cases, lumbar puncture for cerebrospinal fluid study was not carried out due to lack of patient consent. Conclusions These cases illustrate the importance of considering a demyelinating disease in the differential diagnosis of a mass lesion. Critical analyses of clinical presentations coupled with good physical examination are vital in assisting clinicians to reach the correct diagnosis.

  10. Adrenal Lymphangioma Masquerading as a Catecholamine Producing Tumor

    Directory of Open Access Journals (Sweden)

    Israel Hodish

    2015-01-01

    with an adrenal cystic lesion and biochemical testing concerning for pheochromocytoma. The pertinent diagnostic and imaging features of adrenal lymphangiomas are reviewed. Methods. We describe a 59-year-old patient who presented with hyperhidrosis and a 2.2 by 2.2 cm left adrenal nodule. Biochemical evaluation revealed elevated plasma-free normetanephrine, urine normetanephrine, urine vanillylmandelic acid, and urine norepinephrine levels. Elevated plasma norepinephrine levels were not suppressed appropriately with clonidine administration. Results. Given persistent concern for pheochromocytoma, the patient underwent adrenalectomy. The final pathology was consistent with adrenal lymphangioma. Conclusions. Lymphangiomas are benign vascular lesions that can very rarely occur in the adrenal gland. Imaging findings are generally consistent with a cyst but are nonspecific. Excluding malignancy in patients presenting with adrenal cysts can be difficult. Despite its benign nature, the diagnosis of adrenal lymphangioma may ultimately require pathology.

  11. Cannabinoid hyperemesis syndrome masquerading as an eating disorder.

    Science.gov (United States)

    Brewerton, Timothy D; Anderson, Odette

    2016-08-01

    The case of a 22 year old woman with cannabinoid hyperemesis syndrome (CHS) presenting as an eating disorder is described. The importance of recognizing chronic cannabis use as a cause of episodic vomiting is emphasized, given that CHS can be confused with self-induced purging and cyclic vomiting. This case was further complicated by the well-defined history of anorexia nervosa (binge-purge type), major depressive disorder, obsessive-compulsive disorder, migraine headache, and the initial denial of cannabis use. However, collateral history and a positive drug screen confirmed the diagnosis. The signs, symptoms and pathophysiological mechanisms of CHS are reviewed in light of clinical presentations that mimic eating disorder phenomenology complicated by addiction. Given the trend for increasing legalization of recreational marijuana as well as medical marijuana, CHS is an important and potentially complicating disorder that eating disorder clinicians need to be aware of. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:826-829). © 2016 Wiley Periodicals, Inc.

  12. Spontaneous Bladder Rupture Masquerading as Pseudo-diverticulum

    Directory of Open Access Journals (Sweden)

    M. Raghavendran

    2017-05-01

    Full Text Available Spontaneous bladder rupture is rare. Presentation is non-specific and in absence of history of trauma, radiation, inflammatory conditions and other leading causes, there is considerable diagnostic delay. Absence of clear cut diagnostic signs leads to increased morbidity and mortality. In many patients, omentum seals perforation, giving diverticular appearance in Cystogram. The objective of this case report is to highlight important specific diagnostic points in history and radiology which will help in clear, early diagnosis and treatment causing immense benefit to the patient. We would also like to highlight a specific radiological point to distinguish true from pseudo-diverticulum.

  13. Multiple intraductal papillomas of breast clinically masquerading as malignancy

    Directory of Open Access Journals (Sweden)

    Singh Pallavi

    2010-01-01

    Full Text Available Background: Intraductal papilloma is characterized by proliferation of epithelial and myoepithelial cells overlying fibro-vascular stalks creating an arborescent structure within the lumen of duct. Some times multiple papillomas with florid proliferation of epithelium may be confused with malignancy. A case of multiple intraductal papillomas of breast with ulceration of overlying skin and large lump leading to clinical diagnosis of malignancy is documented here. Case Report: A 45-year-old female presented with ulcerated mass of six months duration in the left breast. On examination, a firm, immobile lump of 8× 10 cm in size involving nipple with excoriation of surrounding skin and serosanguinous discharge from nipple was present. There was no axillary lymphadenopathy. No family history of carcinoma breast was present. Fine needle aspiration smears showed benign cellular changes with apocrine metaplasia. Biopsy from an area adjacent to nipple showed intraductal papilloma. Simple mastectomy showed lobulated dirty white mass with well circumscribed nodules below the nipple and areola. On histology with immunohistochemistry a diagnosis of multiple intraductal papillomas was made. Patient is on regular follow-up and doing well. Conclusion: The case highlights the problem in differentiating marked papillomatosis from a malignant lesion of breast and importance of biopsy with immunohistochemistry in such cases for proper management.

  14. Amelanotic Melanoma Masquerading as a Granular Cell Lesion

    Directory of Open Access Journals (Sweden)

    Deepak Pandiar

    2013-01-01

    Full Text Available Amelanotic melanoma (AM presents a diagnostic challenge due to its wide clinical presentations, lack of pigmentation, and varied histological appearances. Immunohistochemistry plays a crucial role in the diagnosis of these lesions. Amelanotic melanoma of oral mucosa is an uncommon lesion. We report a case of a 50-year-old male patient with a growth on the anterior mandibular gingiva of seven-month duration. In the present case, histologically, the tumour resembled a granular cell lesion, which has not been reported previously in AM. Diagnosis was possible by a sequential panel of immunohistochemical markers, of which finally vimentin, S100, HMB45, and Melan-A were positive. The tumor was surgically excised, and postsurgical radiotherapy was given.

  15. A masquerader: A report of rapid progressive primary intraocular lymphoma

    Directory of Open Access Journals (Sweden)

    Siti Hajar Mat Abu

    2013-01-01

    Full Text Available Primary intraocular lymphoma (PIOL is an uncommon subset of primary central nervous system lymphoma (PCNSL. We report a rapid progressive of this disease in a 73 years old lady who presented with one year history of left eye floaters, associated with deterioration of left vision. Examination revealed left eye vitritis and typical vitreous clumps. Left vitrectomy and vitreous biopsy was performed with result showed few singly dispersed atypical lymphoid cells. She was diagnosed to have Primary Intraocular lymphoma and was started on intravitreal methotrexate. Initially she responded well but later the tumour spread to liver, breast and brain within a year. She finally succumbed to the disease. High index of suspicion of PIOL is mandatory in all elderly patients presenting with panuveitis. Co-management with the Neurologist is vital in the continuous management of these patients in view of the high rate of mortality.

  16. Tolosa-Hunt syndrome masquerading as a carotid artery dissection

    Directory of Open Access Journals (Sweden)

    Taylor EJ

    2014-04-01

    Full Text Available Elise J Taylor,1 Ursula M Anders,1 Joseph R Martel,1–4 James B Martel1–4 1Research Center, Martel Eye Medical Group, Rancho Cordova, 2Graduate Medical Education, California Northstate University College of Medicine, Elk Grove, 3Department of Ophthalmology, Sutter Medical Health, Sacramento, 4Department of Ophthalmology, Dignity Health, Carmichael, CA, USA Purpose: To demonstrate the difficulties of diagnosing a patient with Tolosa-Hunt syndrome (THS due to its complicated presentation and extensive diagnostic testing, and how to manage the treatment of a patient in an emergent setting. Patients and methods: A female patient with THS affecting the left eye was examined using two magnetic resonance imaging (MRI scans. The patient was treated with high-dose methylprednisolone (Solu-Medrol® and prednisone. A follow-up MRI and magnetic resonance angiogram (MRA was also performed 4 months later. Results: The second MRI scan disclosed a 5x9x10 mm lesion in the left superior orbital fissure/cavernous sinus. After administration of methylprednisolone and prednisone, the patient’s pain completely resolved, and the left eye regained full duction and eyelid mobility. The MRI and MRA obtained after the treatment showed no abnormalities. Conclusion: The rarity of THS makes it difficult to diagnose, especially when there is a question of accuracy and reproducibility of the testing performed. An ophthalmologic consultation in such cases is crucial. Keywords: granulomatous lesion, painful ophthalmoplegia, idiopathic orbital inflammation, multiple cranial nerve palsies  

  17. A De Garengeot Hernia masquerading as a strangulated femoral hernia

    Directory of Open Access Journals (Sweden)

    A. Hussain

    2014-01-01

    CONCLUSION: A De Garengeot's hernia should be considered as a differential diagnosis in patients presenting with clinical signs of a strangulated femoral hernia. It is often an incidental finding during an emergency operation. Although mesh repairs in the presence of appendicitis have been reported, the safest approach remains a primary suture repair.

  18. Panayiotopoulos syndrome in a child masquerading as septic shock

    Directory of Open Access Journals (Sweden)

    Syed Ahmed Zaki

    2016-01-01

    Full Text Available Panayiotopoulos syndrome (PS is a benign childhood epilepsy with predominant autonomic symptoms. The syndrome can have varied presentations resulting in diagnostic dilemma. We herein describe a 3-year-old boy with PS, who had manifestations similar to septic shock. His investigations were normal and had a complete recovery. Through this case, we wish to highlight the unusual presentation of PS as septic shock. Physicians should be aware of the different ways in which this syndrome can present to ensure its early diagnosis and treatment.

  19. Phototoxic action of light emitting diode in the in vitro viability of Trichophyton rubrum.

    Science.gov (United States)

    Amorim, José Cláudio Faria; Soares, Betania Maria; Alves, Orley Araújo; Ferreira, Marcus Vinícius Lucas; Sousa, Gerdal Roberto; Silveira, Lívio de Barros; Piancastelli, André Costa Cruz; Pinotti, Marcos

    2012-01-01

    Trichophyton rubrum is the most common agent of superficial mycosis of the skin and nails causing long lasting infections and high recurrence rates. Current treatment drawbacks involve topical medications not being able to reach the nail bed at therapeutic concentrations, systemic antifungal drugs failing to eradicate the fungus before the nails are renewed, severe side effects and selection of resistant fungal isolates. Photodynamic therapy (PDT) has been a promising alternative to conventional treatments. This study evaluated the in vitro effectiveness of toluidine blue O (TBO) irradiated by Light emitting diode (LED) in the reduction of T. rubrum viability. The fungal inoculums' was prepared and exposed to different TBO concentrations and energy densities of Light emitting diode for evaluate the T. rubrum sensibility to PDT and production effect fungicidal after photodynamic treatment. In addition, the profiles of the area and volume of the irradiated fungal suspensions were also investigated. A small reduction, in vitro, of fungal cells was observed after exposition to 100 µM toluidine blue O irradiated by 18 J/cm² Light emitting diode. Fungicidal effect occurred after 25 µM toluidine blue O irradiation by Light emitting diode with energy density of 72 J/cm². The analysis showed that the area and volume irradiated by the Light emitting diode were 52.2 mm² and 413.70 mm³, respectively. The results allowed to conclude that Photodynamic therapy using Light emitting diode under these experimental conditions is a possible alternative approach to inhibit in vitro T. rubrum and may be a promising new treatment for dermatophytosis caused by this fungus.

  20. Biogenic gold nanoparticles enhance methylene blue-induced phototoxic effect on Staphylococcus epidermidis

    Science.gov (United States)

    Maliszewska, Irena; Leśniewska, Agata; Olesiak-Bańska, Joanna; Matczyszyn, Katarzyna; Samoć, Marek

    2014-06-01

    There is considerable current interest in photodynamic inactivation (PDI) as potential antimicrobial therapy. This study reports successful implementation of PDI of Staphylococcus epidermidis using methylene blue (MB) in combination with biogenic gold nanoparticles (GNP). Monodispersed colloidal GNP were synthesized by reduction of Au+3 in the presence of cell-free filtrate of Trichoderma koningii and were characterized by a number of techniques including UV-Vis and fluorescence spectroscopy, transmission electron microscopy (TEM), and Fourier transform infrared spectroscopy (FTIR) to be 12 ± 3 nm spherical gold particles coated with proteins. Studies on the role of the cell-free filtrate proteins in the synthesis of the GNP indicate that the process is nonenzymatic but involves interactions of various amino acids with gold ions. A Xe lamp (550-780 nm) or a He-Ne laser (632 nm) was used as light sources to study the effect of MB alone, the GNP alone, and the MB-GNP mixture on the viability of bacterial cells. Lethal photosensitization of S. epidermidis with the MB-GNP mixture was achieved after 5 and 10 min exposure to laser or Xe lamp, respectively. It has been found that the MB-GNP mixture exhibits a significant antibacterial activity already in the absence of any light source and gives an enhanced antimicrobial response when using either a laser or a Xe lamp source for photosensitization.

  1. Phototoxicity of TiO2 nanoparticles to zebrafish (Danio rerio) is dependent on life stage

    Science.gov (United States)

    The zebrafish (Danio rerio) embryo has been increasingly used as a model to evaluate toxicity of manufactured nanomaterials. Many studies indicate that the embryo chorion may protect animals from toxic effects of nanomaterials, suggesting that post-hatch life stages may be more s...

  2. The Phototoxicity of ’Blue Light’ on the Functional Properties of the Retinal Pigment Epithelium

    Science.gov (United States)

    1990-10-15

    MONITORING AGENCY NAME(S) AND AOORISS(ES) 1. SPONSOPEN /MONITORUNG T. JAN CERVENY, Lt Col, USAF A AFOSR/NL Building 410 Bolling AFB, DC 20332 il...characterization and identity with acidic and basic fibroblast growth factor. Biochemistry 24, 7855-7860. 4. Bazan , N.G., Reddy, T.S., Redmond, T.M., Wiggert, B

  3. Towards cancer cell-specific phototoxic organometallic rhenium(I) complexes

    OpenAIRE

    Leonidova, Anna; Pierroz, Vanessa; Rubbiani, Riccardo; Heier, Jakob; Ferrari, Stefano; Gasser, Gilles

    2014-01-01

    Over the recent years, several Re(i) organometallic compounds have been shown to be toxic to various cancer cell lines. However, these compounds lacked sufficient selectivity towards cancer tissues to be used as novel chemotherapeutic agents. In this study, we probe the potential of two known N,N-bis(quinolinoyl) Re(i) tricarbonyl complex derivatives, namely Re(i) tricarbonyl [N,N-bis(quinolin-2-ylmethyl)amino]-4-butane-1-amine () and Re(i) tricarbonyl [N,N-bis(quinolin-2-ylmethyl)amino]-5-va...

  4. Towards cancer cell-specific phototoxic organometallic rhenium(I) complexes.

    Science.gov (United States)

    Leonidova, Anna; Pierroz, Vanessa; Rubbiani, Riccardo; Heier, Jakob; Ferrari, Stefano; Gasser, Gilles

    2014-03-21

    Over the recent years, several Re(I) organometallic compounds have been shown to be toxic to various cancer cell lines. However, these compounds lacked sufficient selectivity towards cancer tissues to be used as novel chemotherapeutic agents. In this study, we probe the potential of two known N,N-bis(quinolinoyl) Re(I) tricarbonyl complex derivatives, namely Re(I) tricarbonyl [N,N-bis(quinolin-2-ylmethyl)amino]-4-butane-1-amine (Re-NH₂) and Re(I) tricarbonyl [N,N-bis(quinolin-2-ylmethyl)amino]-5-valeric acid (Re-COOH), as photodynamic therapy (PDT) photosensitizers. Re-NH₂ and Re-COOH proved to be excellent singlet oxygen generators in a lipophilic environment with quantum yields of about 75%. Furthermore, we envisaged to improve the selectivity of Re-COOH via conjugation to two types of peptides, namely a nuclear localization signal (NLS) and a derivative of the neuropeptide bombesin, to form Re-NLS and Re-Bombesin, respectively. Fluorescent microscopy on cervical cancer cells (HeLa) showed that the conjugation of Re-COOH to NLS significantly enhanced the compound's accumulation into the cell nucleus and more specifically into its nucleoli. Importantly, in view of PDT applications, the cytotoxicity of the Re complexes and their bioconjugates increased significantly upon light irradiation. In particular, Re-Bombesin was found to be at least 20-fold more toxic after light irradiation. DNA photo-cleavage studies demonstrated that all compounds damaged DNA via singlet oxygen and, to a minor extent, superoxide production.

  5. Phototoxicity of strained Ru(ii) complexes: is it the metal complex or the dissociating ligand?

    Science.gov (United States)

    Azar, Daniel F; Audi, Hassib; Farhat, Stephanie; El-Sibai, Mirvat; Abi-Habib, Ralph J; Khnayzer, Rony S

    2017-07-27

    A photochemically dissociating ligand in Ru(bpy)2(dmphen)Cl2 [bpy = 2,2'-bipyridine; dmphen = 2,9-dimethyl-1,10-phenanthroline] was found to be more cytotoxic on the ML-2 Acute Myeloid Leukemia cell line than Ru(bpy)2(H2O)2(2+) and prototypical cisplatin. Our findings illustrate the potential potency of diimine ligands in photoactivatable Ru(ii) complexes.

  6. Modern Computational Physical Chemistry : An Introduction to Biomolecular Radiation Damage and Phototoxicity

    OpenAIRE

    2004-01-01

    The realm of molecular physical chemistry ranges from the structure of matter and the fundamental atomic and molecular interactions to the macroscopic properties and processes arising from the average microscopic behaviour. Herein, the conventional electrodic problem is recast into the simpler molecular problem of finding the electrochemical, real chemical, and chemical potentials of the species involved in redox half-reactions. This molecular approach is followed to define the three types of...

  7. Theoretical study of the phototoxicity of naproxen and the active form of nabumetone.

    Science.gov (United States)

    Musa, Klefah A K; Eriksson, Leif A

    2008-10-30

    Density functional theory using the hybrid functional B3LYP has been employed in order to study the mechanisms of photoinduced decomposition of the closely related nonsteroidal anti-inflammatory drugs naproxen (NP) and 6-methoxy-2-naphthylacetic acid (MNAA; the active form of nabumetone). The photochemical properties and computed energies of various species obtained in this study show that both drugs dominate in their deprotonated forms at physiological pH. The deprotonated acids are unable to decarboxylate from their excited singlets; instead, they decarboxylate from their first excited triplet states with high efficiency, overcoming energy barriers less than 3 and 1 kcal/mol for MNAA and NP, respectively. The ultraviolet and visible spectra of the neutral, deprotonated, and decarboxylated moieties of MNAA and NP are more-or-less similar but with higher probabilites (oscillator strength) for the latter. This fact, as well as the higher reactivity of NP, is explained in terms of the electron-donating effect of the additional methyl group present in NP. Singlet oxygen, superoxide radical anion, and corresponding peroxyl radical species are expected to be formed in different steps throughout the proposed photodegradation pathways of both drugs, which give rise to their effects on biomolecules, for example, lipid peroxidation.

  8. Assessment of the Phototoxicity of Weathered Alaska North Slope Crude Oil to Juvenile Pink Salmon

    Science.gov (United States)

    Petroleum products are known to have greater toxicity to the translucent embryos and larvae of aquatic organisms in the presence of ultraviolet radiation (UV) compared to toxicity determined in tests performed under standard laboratory lighting with minimal UV. This study assesse...

  9. Docetaxel-Induced Systemic Sclerosis with Internal Organ Involvement Masquerading as Congestive Heart Failure.

    Science.gov (United States)

    Park, Bumsoo; Vemulapalli, Raghavendra C; Gupta, Amit; Shreve, Maria E; Rees, Della A

    2017-01-01

    Systemic sclerosis, or scleroderma, is a complex medical disorder characterized by limited or diffuse skin thickening with frequent involvement of internal organs such as lungs, gastrointestinal tract, or kidneys. Docetaxel is a chemotherapeutic agent which has been associated with cutaneous side effects. An uncommon cutaneous side effect of docetaxel is scleroderma-like skin changes that extend from limited to diffuse cutaneous systemic sclerosis. Several case reports have been published regarding the association of docetaxel and systemic sclerosis. However, those reports demonstrated the association between docetaxel and scleroderma-like skin changes without internal organ involvement. Here, we report a case of systemic sclerosis with pulmonary arterial hypertension and a microangiopathic kidney involvement induced by docetaxel chemotherapy. After an exhaustive literature review, this could be the first case of docetaxel-induced systemic sclerosis involving internal organs.

  10. A molar masquerading as an ectopic pregnancy in the early first trimester: a salutary lesson.

    Science.gov (United States)

    Govind, Abha; Lakhi, Nisha

    2012-01-01

    The authors report a case in which a molar pregnancy was mistaken for an ectopic pregnancy in the early first trimester. This confusion delayed diagnosis and caused distress; follow-up led to the final diagnosis of complete hydatidiform mole. Correct preoperative diagnosis of molar pregnancy by ultrasound in early pregnancy may be tricky. It is important to obtain histological evidence to make the final diagnosis of gestational trophoblastic disease. While relatively rare, consideration of molar pregnancy in the differential diagnosis of early pregnancy loss may avoid unnecessary distress.

  11. Candida Albicans Infection Masquerading as a Soft Tissue Tumour Diagnosed by Fine Needle Aspiration Cytology

    Science.gov (United States)

    Govind, Abhishek Mandya; Pechiat, Tony; Manchaih, Sanjay; Shankar, Shivshankar Vijay

    2017-01-01

    A 60-year-old male, diabetic presented with a soft tissue mass over the right forearm of 15 days duration. The swelling was 5 x 3 cm and a clinical diagnosis of neurofibroma was made. Fine Needle Aspiration Cytology (FNAC) was done using standard technique. Smears showed predominantly suppurative inflammation, foreign body giant cells, granulomas and fungal hyphae. KOH mount, culture and germ tube test was positive. Final diagnosis of fungal granuloma was made. Fungal infections should be included in the differential diagnosis of a soft tissue mass lesion. All soft tissue suppurative inflammatory lesions should be diligently screened to look for pathogens if any. Diagnostics in medicine have taken a major leap with advent of molecular technologies. Despite this, simple old traditional methods like FNAC supplemented by other basic laboratory techniques like KOH mount and culture still form the cream of a diagnostic laboratory and can come as a savior for the pathologist, the clinicians and the patients.

  12. Mixed germ cell tumor of mediastinum/lung masquerading as hemangioma in fine needle biopsy

    Directory of Open Access Journals (Sweden)

    Rathna Nuti

    2013-01-01

    Full Text Available The histological predominance of one component in a germ cell tumor can lead to a mistaken diagnosis. Here, we describe a mediastinal teratoma with predominant vascular proliferation (>90% which on fine needle biopsy was diagnosed as a pulmonary hemangioma. Later, resection specimen revealed other components constituting ~4%, changing the diagnosis while illustrating theimportance of careful evaluation. A 37-year-old Caucasian male with shortness of breath, weight loss, and history of recently resolved pneumonia was diagnosed with hemangioma, after a computed tomography guided fine needle biopsy of a -16.3-cm mediastinal pulmonary mass revealed abundant benign vascular elements. Following tumor excision, ~94% of the sample exhibited predominant vascular elementsThe mass also exhibited rare focal areas of malignant epithelium in a reticular arrangement and undifferentiated pleomorphic cells associated with vascular invasion. These atypical epithelial cells were positive for CD30, pan CK, AFP, β-HCG and CD 117, thusprocuring a diagnosis of mediastinal mixed germ cell tumor. Although mixed germ cell tumors consist of various tissue types, diagnosis can be easily overlooked if one component dominates. Therefore, obtaining adequate representative neoplasm samples, and sectioning the samples thoroughly, searching for coexisting tissue types is critical for accurate diagnosis.

  13. Herpes Simplex Viral Encephalitis Masquerading as a Classic Left MCA Stroke

    Directory of Open Access Journals (Sweden)

    Peter A. Abdelmalik

    2015-01-01

    Full Text Available Objective. Stroke is a clinical diagnosis, with a history and physical examination significant for acute onset focal neurological symptoms and signs, often occurring in patients with known vascular risk factors and is frequently confirmed radiographically. Case Report. A 79-year-old right-handed woman, with a past medical history of hypertension, hyperlipidemia, and prior transient ischemic attack (TIA, presented with acute onset global aphasia and right hemiparesis, in the absence of fever or prodrome. This was initially diagnosed as a proximal left middle cerebral artery (MCA stroke. However, CT perfusion failed to show evidence of reduced blood volume, and CT angiogram did not show evidence of a proximal vessel occlusion. Furthermore, MRI brain did not demonstrate any areas of restricted diffusion. EEG demonstrated left temporal periodic lateralized epileptiform discharges (PLEDs. The patient was empirically loaded with a bolus valproic acid and started on acyclovir, both intravenously. CSF examination demonstrated a pleocytosis and PCR confirmed the diagnosis of herpes simplex viral encephalitis (HSVE. Conclusions. HSVE classically presents in a nonspecific fashion with fever, headache, and altered mental status. However, acute focal neurological signs, mimicking stroke, are possible. A high degree of suspicion is required to institute appropriate therapy and decrease morbidity and mortality associated with HSVE.

  14. Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage.

    Science.gov (United States)

    Camus, Marine; Jensen, Dennis M; Matthews, Jason D; Ohning, Gordon V; Kovacs, Thomas O; Jutabha, Rome; Ghassemi, Kevin A; Machicado, Gustavo A; Dulai, Gareth S

    2014-10-14

    To describe the prevalence, diagnosis, treatment, and outcomes of end stage liver disease (ESLD) patients with severe epistaxis thought to be severe upper gastrointestinal hemorrhage (UGIH). This observational single center study included all consecutive patients with ESLD and epistaxis identified from consecutive subjects hospitalized with suspected UGIH and prospectively enrolled in our databases of severe UGIH between 1998 and 2011. A total of 1249 patients were registered for severe UGIH in the data basis, 461 (36.9%) were cirrhotics. Epistaxis rather than UGIH was the bleeding source in 20 patients. All patients had severe coagulopathy. Epistaxis was initially controlled in all cases. Fifteen (75%) subjects required posterior nasal packing and 2 (10%) embolization in addition to correction of coagulopathy. Five (25%) patients died in the hospital, 12 (60%) received orthotopic liver transplantation (OLT), and 3 (15%) were discharged without OLT. The mortality rate was 63% in patients without OLT. Severe epistaxis in patients with ESLD is (1) a diagnosis of exclusion that requires upper endoscopy to exclude severe UGIH; and (2) associated with a high mortality rate in patients not receiving OLT.

  15. Adult-Onset Still’s Disease Masquerading as Sepsis in an Asplenic Active Duty Soldier

    Directory of Open Access Journals (Sweden)

    Nathan T. Jaqua

    2012-01-01

    Full Text Available This is a case of a 26-year-old active duty male with a history of idiopathic thrombocytopenic purpura (ITP and surgical asplenia who presented with a one-week history of fevers, myalgias, arthralgias, and rigors. His evaluation upon presentation was significant for a temperature of 103 degrees F, white blood cell count of 36 K with a granulocytic predominance, and elevated transaminases. He was treated empirically with broad-spectrum antibiotics with concern for a systemic infection with an encapsulated organism. During his stay, he developed four SIRS criteria and was transferred to the progressive care unit for suspected sepsis. He continued to have twice-daily fevers and a faint, salmon-colored centripetal rash was eventually observed during his febrile episodes. After a nondiagnostic microbiologic and serologic workup, he was diagnosed with adult-onset Still’s Disease and started on intravenous methylprednisolone with brisk response. He was discharged on oral prednisone and was started on anakinra. Adult-onset Still’s disease is a rare condition that presents with varying severity, and this is the first reported case, to our knowledge, of its diagnosis in an asplenic patient. Its management in the setting of asplenia is complicated by the need for antibiotic therapy with each episode of fever.

  16. Binary Source Event Masquerading as Planet: A New Manifestation of the Binary-Source Degeneracy

    CERN Document Server

    Jung, Y K; Yee, J C; Sumi, T; Gould, A; Han, C; Albrow, M D; Lee, C -U; Kim, S -L; Chung, S -J; Hwang, K -H; Ryu, Y -H; Shin, I -G; Zhu, W; Cha, S -M; Kim, D -J; Lee, Y; Park, B -G; Pogge, R W; Pietrukowicz, P; Kozlowski, S; Poleski, R; Skowron, J; Mroz, P; Szymanski, M K; Soszynski, I; Pawlak, M; Ulaczyk, K; Abe, F; Bennett, D P; Asakura, Y; Bhattacharya, A; Donachie, M; Freeman, M; Fukui, A; Hirao, Y; Itow, Y; Koshimoto, N; Li, M C A; Ling, C H; Masuda, K; Matsubara, Y; Muraki, Y; Nagakane, M; Oyokawa, H; Sharan, A; Sullivan, D J; Suzuki, D; Tristram, P J; Yamada, T; Yamada, T; Yonehara, A

    2016-01-01

    We present the analysis of the microlensing event OGLE-2016-BLG-0733, which introduces a new type of degeneracy between binary source and planetary perturbations. The light curve of the event exhibits a long-term asymmetric perturbation that would appear to be due to a planet. From detailed analysis of the light curve, however, we find that the perturbation originates from the binarity of the source rather than the lens. This result demonstrates that binary sources with roughly equal-luminosity components can mimic long-term perturbations induced by planets with projected separations near the Einstein ring. The result also signifies the importance of considering various interpretations of planet-like perturbations and of high-cadence observation not only for resolving the degeneracy but also for ensuring the unambiguous detection of the planet.

  17. Parkinson's disease without tremor masquerading as mechanical back pain; a case report.

    Science.gov (United States)

    Burton, Robert R

    2008-08-01

    The clinical features of a 67-year-old female suffering recurrent low back pain (LBP) who developed Parkinson's disease (PD) are presented. PD is a progressive, age-specific neuro-degenerative disorder characterized by a combination of bradykinesia (slowness of movement), rest tremor (initially unilaterally and usually of the hands), rigidity or stiffness of the arms, legs or neck, and/or postural instability. Other non-motor and cognitive symptoms may accompany these features. Tremor, at rest, is usually the earliest and most prominent cardinal symptom of PD, but is absent in approximately 30% of patients. Considering mechanical back pain commonly presents with slowed movement and gait disturbance due to pain avoidance behavior, and considering Canada's population is aging and living longer will inevitably cause the number of Parkinson's patients to increase, it is important for chiropractic doctors to maintain an awareness of the condition to facilitate its early referral, diagnosis and management.

  18. Photoletter to the editor: Squamous cell carcinoma associated with and masquerading as molluscum contagiosum.

    Science.gov (United States)

    Binitha, Manikoth Payyanadan; Sarita, Sasidharan Pillai; Manju, Mohan

    2013-01-01

    Squamous cell carcinoma is a non-melanoma skin cancer with a significant risk of mortality if not diagnosed promptly. A high index of suspicion is required, since it may mimic many benign conditions. Molluscum contagiosum is an innocuous viral infection which can also mimic a wide variety of other conditions. We report a case of squamous cell carcinoma on the anterior chest wall resembling a giant molluscum contagiosum, where the patient also had molluscum contagiosum at other sites. In addition, he developed herpes zoster of the left fifth thoracic dermatome. After surgical removal of the cancer, there was prompt subsidence of the molluscum contagiosum lesions without any specific treatment. This report highlights the importance of early biopsy in the diagnosis of squamous cell carcinoma. As the patient had no other conditions or therapy that could account for the immunosuppression, we hypothesize that the occurrance of molluscum contagiosum and zoster along with the squamous cell carcinoma indicates possible immunosuppression due to the carcinoma, though no metastatic spread could be detected.

  19. Aspergillosis of bilateral breast and chest wall in an immunocompetent male masquerading as breast cancer

    Directory of Open Access Journals (Sweden)

    Jitendra G Nasit

    2013-01-01

    Full Text Available Fungal species are not frequently encountered in an immunocompetent host. Invasive aspergillosis typically occurs in severely immunocompromised patient. Aspergillus infection of breast and chest wall are rarely encountered in an immunocompetent as well as in immunocompromised host. Till date only 13 cases of fungal infection of breast and chest wall have been reported in the literature. This report presents a case of aspergillosis of bilateral breast and chest wall in an immunocompetent male, clinically mimicking breast cancer. Diagnosis was achieved by fine-needle aspiration cytology and subsequently Aspergillus flavus was identified on fungal culture. The patient was successfully treated with voriconazole. Prompt diagnosis by cytology and appropriate treatment is necessary to prevent adverse outcome. Here, we present this rare case of fungal infection of breast and chest wall with relevant review of the literature.

  20. Botfly larva masquerading as periorbital cellulitis: identification by point-of-care ultrasonography.

    Science.gov (United States)

    Minakova, Elena; Doniger, Stephanie J

    2014-06-01

    Myiasis, or the infiltration of the botfly larvae, is a relatively frequent problem encountered by travelers to parts of Latin America. This is a novel case report that documents a Dermatobia hominis infestation of the left facial region with secondary periorbital cellulitis diagnosed by point-of-care ultrasonography.

  1. Mixed germ cell tumor of mediastinum/lung masquerading as hemangioma in fine needle biopsy.

    Science.gov (United States)

    Nuti, Rathna; Bodhireddy, Surender; Thirumala, Seshadri

    2013-01-01

    The histological predominance of one component in a germ cell tumor can lead to a mistaken diagnosis. Here, we describe a mediastinal teratoma with predominant vascular proliferation (>90%) which on fine needle biopsy was diagnosed as a pulmonary hemangioma. Later, resection specimen revealed other components constituting ~4%, changing the diagnosis while illustrating theimportance of careful evaluation. A 37-year-old Caucasian male with shortness of breath, weight loss, and history of recently resolved pneumonia was diagnosed with hemangioma, after a computed tomography guided fine needle biopsy of a -16.3-cm mediastinal pulmonary mass revealed abundant benign vascular elements. Following tumor excision, ~94% of the sample exhibited predominant vascular elementsThe mass also exhibited rare focal areas of malignant epithelium in a reticular arrangement and undifferentiated pleomorphic cells associated with vascular invasion. These atypical epithelial cells were positive for CD30, pan CK, AFP, β-HCG and CD 117, thusprocuring a diagnosis of mediastinal mixed germ cell tumor. Although mixed germ cell tumors consist of various tissue types, diagnosis can be easily overlooked if one component dominates. Therefore, obtaining adequate representative neoplasm samples, and sectioning the samples thoroughly, searching for coexisting tissue types is critical for accurate diagnosis.

  2. Osteosarcoma of the Mandible Masquerading as a Dental Abscess: Report of a Case

    Directory of Open Access Journals (Sweden)

    Sukumaran Anil

    2012-01-01

    Full Text Available An aggressive and fatal case of osteosarcoma of the mandible in a 19-year-old female is reported. Six weeks after the clinical appearance of the swelling, the patient died. This paper is unique in that the age of occurrence and the biologic behavior of the tumor were not consistent with the reported literature. The case report is followed by a brief review of osteosarcoma of the jaw with a note on its clinical presentation, diverse radiologic appearance, varied histopathologic picture, and prognosis.

  3. Masquerading Machismo: La India and the Staging of Chusmerfa on the Salsa Scene

    DEFF Research Database (Denmark)

    Derno, Maiken Tandgård

    2002-01-01

    Genre, gender, performance, boundaries, feminism, salsa machismo, music industri, Latina identity......Genre, gender, performance, boundaries, feminism, salsa machismo, music industri, Latina identity...

  4. Ovarian Teratoma with Torsion Masquerading as Intussusception in 4-Year-Old Child

    Directory of Open Access Journals (Sweden)

    Smith, Carl J

    2008-11-01

    Full Text Available Background: Ovarian torsion (OT occurs primarily in women of child-bearing age, but is rare in the pediatric population. The clinical presentation often consists of nonspecific abdominal complaints making the diagnosis difficult. Radiologic and sonographic evidence can be misleading. Although the delay in diagnosis from symptom onset is common, rapid diagnosis of ovarian torsion is imperative to prevent morbidity.Case Report: We present the case of a four-year-old female who presented to the emergency department (ED with a five-day history of intermittent abdominal pain and emesis. Initial diagnosis was suspicious for intussusception; however, on operative exploration, she was found to have a right adnexal torsion secondary to an ovarian teratoma. A right salpingo-oophorectomy was performed.Conclusion: Early diagnosis of ovarian torsion may increase ovarian salvage and reduce morbidity. Faced with abdominal pain of uncertain etiology in a female child, emergency physicians should include ovarian torsion secondary to an ovarian mass in the differential diagnosis.[WestJEM. 2008;9:228-231.

  5. Squamous cell carcinoma masquerading as a trophic ulcer in a patient with Hansen's disease.

    Science.gov (United States)

    Venkatswami, Sandhya; Anandan, S; Krishna, Nikilesh; Narayanan, C D

    2010-12-01

    Nonhealing trophic ulcers in leprosy are a common phenomenon, but acute malignant transformations of the same are relatively rare. This study reports on a 35-year-old man previously treated for Hansen's disease with a squamous cell carcinoma involving the right foot with rapid lymphatic spread. He was being treated as a benign trophic ulcer for more than 12 months until he started developing huge inguinal lymph nodes and the ulcer rapidly increased in size. Squamous cell carcinomas are known to occur in ulcers of considerable duration but such rapid growth in such a short duration and rapid lymphatic spread is unusual in Marjolin's ulcer as the lymphatics are usually destroyed because of previous inflammation and scarring.

  6. A case of steroid-dependent myeloid granulocytic sarcoma masquerading as Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Lola Y Kwan; Stephan R Targan; David Q Shih

    2011-01-01

    Small bowel tumors and Crohn's disease are common causes of small bowel obstruction. Early stage neoplasms can easily be mistaken for Crohn's disease. Therefore, thorough work-ups including imaging studies and endoscopic evaluation with biopsies are critical for accurate diagnosis. Here we report a case of an otherwise healthy female with progressive onset of multiple, recurrent obstructive symptoms secondary to terminal ileal narrowing who was referred for management of steroid-dependent Crohn's disease. After thorough evaluation, the diagnosis was revised to myeloid granulocytic sarcoma involving the terminal ileum. In this case, a delay in diagnosis can be detrimental for prognosis, as myeloid granulocytic sarcoma is highly predictive of underlying acute myeloid leukemia and needs urgent referral for chemotherapy and/or resection.

  7. Visceral larval migrans masquerading as metastatic disease in a toddler with Wilms tumor

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Andrew; Fordham, Lynn Ansley; Bula, Melania L. [University of North Carolina School of Medicine, Department of Radiology, Chapel Hill, NC (United States); Blatt, Julie [University of North Carolina School of Medicine, Department of Pediatrics, Chapel Hill, NC (United States)

    2006-03-15

    A 22-month-old girl with a renal mass had multiple small pulmonary nodules on CT at her initial presentation. After biopsy and neoadjuvant chemotherapy, a Wilms tumor was resected and the pulmonary nodules were shown to have regressed on CT. Follow-up imaging 4 months after initial diagnosis demonstrated multiple new liver lesions and new pulmonary nodules with peripheral eosinophilia. Lung biopsy revealed granuloma formation with prominent eosinophils. The serum antibody titers for Toxocara canis were elevated. This case illustrates that toxocariasis should be considered as a rare differential diagnostic possibility for multiple liver lesions and multifocal peripheral pulmonary opacities in young children with Wilms tumor. (orig.)

  8. Pupillary anomaly masquerading as a glaucomatous visual field defect: a case report

    Directory of Open Access Journals (Sweden)

    Tey Adrian

    2004-06-01

    Full Text Available Abstract Background Patients are often referred to ophthalmologists with focal visual field defects on routine testing, possibly related to a potential diagnosis of glaucoma. However, examination of the individual patient's ocular characteristics as well as facial characteristics may often reveal a cause of the visual field defect. Case presentation We describe a patient who was found to have a superior visual field defect on routine testing by the optician. Repeat perimetry with pharmacological dilatation of the pupil revealed that the cause of the field defect was related to an eccentric inferiorly displaced pupil, secondary to trauma some years previously. Discussion Individual patient characteristics, including both ocular, as well as facial, need to be considered, when interpreting any visual field defect.

  9. Primary squamous cell carcinoma of the fallopian tube masquerading inflammatory mass

    Directory of Open Access Journals (Sweden)

    Indu Chawla

    2016-10-01

    Full Text Available Ovarian pregnancy is rare and a conspicuous variant of ectopic pregnancy and an accurate preoperative diagnosis is very challenging various advances in diagnostic modalities like Transvaginal ultrasonography has evolved in identifying an ovarian pregnancy. We report here one such case of 30 years old with severe lower abdominal pain and bleeding per vaginum following six weeks of amenorrhea confirmed as ovarian ectopic pregnancy consistent with Speigelberg's criteria on ultrasonography. This case highlights the significance of 3D ultrasonography in the diagnosis. Histopathological report concluded it to be an ovarian ectopic pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3609-3612

  10. MAIN-SEQUENCE STARS MASQUERADING AS YOUNG STELLAR OBJECTS IN THE CENTRAL MOLECULAR ZONE

    Energy Technology Data Exchange (ETDEWEB)

    Koepferl, Christine M.; Robitaille, Thomas P.; Morales, Esteban F. E.; Johnston, Katharine G., E-mail: koepferl@mpia.de [Max Planck Institute for Astronomy, Königstuhl 17, D-69117 Heidelberg (Germany)

    2015-01-20

    In contrast to most other galaxies, star formation rates in the Milky Way can be estimated directly from young stellar objects (YSOs). In the central molecular zone the star formation rate calculated from the number of YSOs with 24 μm emission is up to an order of magnitude higher than the value estimated from methods based on diffuse emission (such as free-free emission). Whether this effect is real or whether it indicates problems with either or both star formation rate measures is not currently known. In this paper, we investigate whether estimates based on YSOs could be heavily contaminated by more evolved objects such as main-sequence stars. We present radiative transfer models of YSOs and of main-sequence stars in a constant ambient medium which show that the main-sequence objects can indeed mimic YSOs at 24 μm. However, we show that in some cases the main-sequence models can be marginally resolved at 24 μm, whereas the YSO models are always unresolved. Based on the fraction of resolved MIPS 24 μm sources in the sample of YSOs previously used to compute the star formation rate, we estimate the fraction of misclassified ''YSOs'' to be at least 63%, which suggests that the star formation rate previously determined from YSOs is likely to be at least a factor of three too high.

  11. Main-sequence stars masquerading as Young Stellar Objects in the central molecular zone

    CERN Document Server

    Koepferl, Christine M; Morales, Esteban F E; Johnston, Katharine G

    2014-01-01

    In contrast to most other galaxies, star-formation rates in the Milky Way can be estimated directly from Young Stellar Objects (YSOs). In the Central Molecular Zone (CMZ) the star-formation rate calculated from the number of YSOs with 24 microns emission is up to order of magnitude higher than the value estimated from methods based on diffuse emission (such as free-free emission). Whether this effect is real or whether it indicates problems with either or both star formation rate measures is not currently known. In this paper, we investigate whether estimates based on YSOs could be heavily contaminated by more evolved objects such as main-sequence stars. We present radiative transfer models of YSOs and of main-sequence stars in a constant ambient medium which show that the main-sequence objects can indeed mimic YSOs at 24 microns. However, we show that in some cases the main-sequence models can be marginally resolved at 24 microns, whereas the YSO models are always unresolved. Based on the fraction of resolve...

  12. Mirror or Masquerade? On Representational Ethics in Cultural Heritage Museology And Tourism

    Directory of Open Access Journals (Sweden)

    Campbell Râna

    2014-01-01

    Full Text Available Icelandic cultural heritage museology is embedded in a complex of social, political, and economic matters, at both the national and continental levels, that look to tourism as an opportunity for development in rural regions. The present paper draws on master’s research that examined the relationships of Westfjords communities with two maritime heritage museums in the region. Two qualitative case studies based on in-depth, semi-structured interviews with heritage producers connected to each site were supplemented with additional qualitative data from a focus group comprised of five Westfjords residents. Open and closed coding schemes based on the condensation of transcripts into thematic units were used to analyze the data, thus producing descriptions of the representational ethos of each museum, and findings were subjected to ethical analysis. Both museums were found to reflect contemporary issues that are subject to debates about cultural identity, heritage, and representational style and ideology, while analysis revealed that there is a persistent danger of oversimplifying or distorting cultural representations, particularly where each museum has stakes in tourism. This was judged a potential disservice to the nuanced identities of local communities, and a recommendation was put forth for museums to engage conscientiously with questions of identity and cultural representation.

  13. Mirror or Masquerade? On Representational Ethics in Cultural Heritage Museology And Tourism

    OpenAIRE

    Campbell Râna

    2014-01-01

    Icelandic cultural heritage museology is embedded in a complex of social, political, and economic matters, at both the national and continental levels, that look to tourism as an opportunity for development in rural regions. The present paper draws on master’s research that examined the relationships of Westfjords communities with two maritime heritage museums in the region. Two qualitative case studies based on in-depth, semi-structured interviews with heritage producers connected to each si...

  14. Takayasu arteritis masquerading as stable angina in a 29-year-old man.

    Science.gov (United States)

    Wang, Lei; Ma, Teng; Zhao, Yun-Tao

    2017-04-01

    Takayasu arteritis is a form of vasculitis that involves the aorta, its major branches, and the pulmonary arteries. Coronary artery involvement is not uncommon, and most frequently includes the ostia and proximal segments. Early diagnosis of Takayasu arteritis is difficult since it is a rare disease and is accompanied by various nonspecific clinical symptoms. However, recent advances in imaging modalities-including magnetic resonance angiography, computed tomography (CT), sonography, and fluoro-deoxyglucose positron emission tomography (FDG-PET)/CT Isobe (2013) [2]-have facilitated earlier and more accurate diagnoses of this condition. Here we report a case in which imaging revealed stenosis in the ostia of the coronary artery.

  15. Chediak Higashi Syndrome masquerading as acute leukemia / storage disorder - A rare case report

    Directory of Open Access Journals (Sweden)

    Mirza Asif Baig

    2015-07-01

    CHS is characterised by partial oculocutaneous albinism, frequent fatal bacterial infections, bleeding diathesis and peripheral + Cranial nerve palsies. This disorder further culminates into accelerated phase (Lymphoproliferative Syndrome progressing into pancytopenia. CHS is due to single gene mutation in LYST (CHS gene localized to 1q chromosome. The diagnostic hallmark of CHS is presence of giant purple to blue violet inclusions in leucocytes. In this study granules are more prominent in Bone marrow than in PBS correlating well with previous studies. Approximately 85% of the cases, of CHS culminates into Accelerated phase showing Lymphohistiocytic infiltration progressing to pancytopenia and death due to infection. The very rare nature of this disease and its grave prognosis merits its reporting. [Int J Res Med Sci 2015; 3(7.000: 1785-1787

  16. Stellar Activity Masquerading as Planets in the Habitable Zone of the M dwarf Gliese 581

    CERN Document Server

    Robertson, Paul; Endl, Michael; Roy, Arpita

    2014-01-01

    The M dwarf Gliese 581 is believed to host four planets, including one (GJ 581d) near the habitable zone that could possibly support liquid water on its surface if it is a rocky planet. The detection of another habitable-zone planet--GJ 581g--is disputed, as its significance depends on the eccentricity assumed for d. Analyzing stellar activity using the H-alpha line, we measure a stellar rotation period of 130+/-2 days and a correlation for H-alpha modulation with radial velocity. Correcting for activity greatly diminishes the signal of GJ 581d (to 1.5 sigma), while significantly boosting the signals of the other known super-Earth planets. GJ 581d does not exist, but is an artifact of stellar activity which, when incompletely corrected, causes the false detection of planet g.

  17. Cladophialophora bantiana brain abscess masquerading cerebral tuberculoma in an immunocompetent host

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2014-03-01

    Full Text Available Phaeohyphomycosis is a term that collectively describes fungal infections caused by moulds and yeasts that have brown-pigmented cell walls (due to the presence of melanin. We report a case of 45 year female who had multiple coalescing lesions in the right basal ganglionic and thalamic region. Based on the imaging and investigation findings a diagnosis of cerebral tuberculoma was suspected. Histopathology of the excised specimen showed brown colored fungal hyphae surrounded by neutrophilic infiltrate. A diagnosis of phaeohyphomycosis caused by Cladophialophora bantiana was made and accordingly antifungal treatment was started. Brain abscess caused by Cladophialophora bantiana in an immunocompetent host is relatively uncommon and usually associated with overall high mortality. The best outcomes have been reported in patients who receive both surgical excision of the abscess followed by systemic antifungal therapy. In view of its rarity of these lesions preoperative diagnosis is difficult particularly in an immunocompetent host and absence of other risk factors.

  18. Creutzfeldt-Jakob disease: A great masquerade in neurology, a rare case report from South India

    Directory of Open Access Journals (Sweden)

    Sivaprakash Varadan

    2015-01-01

    Full Text Available Creutzfeldt-Jakob disease (CJD is a rare, fatal neurodegenerative disease caused by an infectious protein called prion and is characterized by spongiform changes, neuronal loss, reactive astrocytic proliferation, and accumulation of pathologic cellular protein. Clinical presentation of CJD is characterized by rapidly progressive dementia, neurologic symptoms and visual impairment, and the development of akinetic mutism, which can mimic many neurological conditions. The diagnosis is based on clinical presentation, electroencephalogram, and typical cerebrospinal fluid and magnetic resonance imaging (MRI findings. Literature on the incidence and prevalence of CJD is lacking in South India. We report the case of a 57-year-old woman with progressive dementia and typical neurologic symptoms, myoclonic jerks, and MRI findings of CJD. This case highlights the need for a high index of suspicion to diagnose CJD.

  19. Guillain-Barre syndrome masquerading as acute respiratory failure in an infant.

    Science.gov (United States)

    Kishore, Praveen; Sharma, Pradeep Kumar; Saikia, Bhaskar; Khilnani, Praveen

    2015-01-01

    Guillain-Barré syndrome (GBS) is a rare entity in infants. We report a case of GBS in a 5-month-old girl. The child presented with cough, loose stools, breathing difficulty, and listlessness. The child was treated as pneumonia with respiratory failure. Due to difficulty in weaning from ventilation with areflexia, marked hypotonia, and reduced power in all four limbs; possibilities of spinal muscular atrophy, poliomyelitis, and myopathies were kept. Nerve conduction velocity study was suggestive of mixed sensory-motor, severe axonal, and demyelinating polyradiculoneuropathy. Cerebrospinal fluid study revealed albuminocytological dissociation. Child was diagnosed as GBS and treated with intravenous immunoglobulin. Child recovered completely on follow-up. GBS should be considered as a differential diagnosis in acute onset respiratory failure with neuromuscular weakness in infants.

  20. Lodged oesophageal button battery masquerading as a coin: an unusual cause of bilateral vocal cord paralysis.

    Science.gov (United States)

    Bernstein, Jonathan Michael; Burrows, Stuart A; Saunders, Michael W

    2007-03-01

    An 11-month-old girl with an oesophageal foreign body was presented: from the radiographic appearance it was presumed to be a coin. Microlaryngoscopy 5 h after ingestion revealed a button battery impacted in the hypopharynx with severe damage to the oesophageal mucosa. The patient was intubated for 6 days in the intensive care unit because of stridor and respiratory distress. Repeat microlaryngoscopy demonstrated bilateral vocal cord palsy, which was presumed to be secondary to the involvement of the recurrent laryngeal nerves in the injury. We recommend that in the absence of a history of observed ingestion, it should be assumed that coin-like foreign bodies are button batteries until proven otherwise.

  1. Probable hepatic tuberculosis masquerading as Klatskin tumour in an immunocompetent patient.

    Science.gov (United States)

    Hanafiah, Mohammad; Alhabshi, Sharifah Majedah Idrus; Bag, Tribeni; Low, Soo Fin

    2013-12-16

    A 55-year-old immunocompetent woman was presented with features of obstructive jaundice and a clinicoradiological picture suggestive of a hilar cholangiocarcinoma (Klatskin tumour). However, caseating granulomatous lesion associated with miliary nodules were revealed intraoperatively. The lesion responded to standard antituberculous therapy. This unusual presentation highlights the considerable diagnostic challenge in such case.

  2. Ischemic colitis masquerading as colonic tumor, Case report with review of literature

    Institute of Scientific and Technical Information of China (English)

    Parakkal Deepak; Radha Devi

    2011-01-01

    Ischemic colitis can mimic a carcinoma on computed tomographic (CT) imaging or endoscopic examination. A coexisting colonic carcinoma or another potentially obstructing lesion has also been described in 20% of the cases of ischemic colitis. CT scan can differentiate it from colon cancer in 75% of cases. However, colonoscopy is the preferred method for diagnosing ischemic colitis as it allows for direct visualization with tissue sampling. Varied presentations of ischemic colitis have been described as an ulcerated or submucosal mass or as a narrowed segment of colon with ulcerated mucosa on colonoscopy. Awareness and early recognition of such varied presentations of a common condition is necessary to differentiate from a colonic carcinoma, and to avoid unnecessary surgery and related complications.

  3. Charcot-Marie-Tooth disease masquerading as acute demyelinating encephalomyelitis-like illness.

    Science.gov (United States)

    Kim, Gun-Ha; Kim, Kyoung Min; Suh, Sang-Il; Ki, Chang-Seok; Eun, Baik-Lin

    2014-07-01

    X-linked Charcot-Marie-Tooth disease (CMTX1) is a clinically heterogeneous hereditary motor and sensory neuropathy with X-linked transmission. Common clinical manifestations of CMTX1 disease, as in other forms of Charcot-Marie-Tooth (CMT) disease, are distal muscle wasting and weakness, hyporeflexia, distal sensory disturbance, and foot deformities. Mutations in the connexin-32 gene (gap junction protein β1 [GJB1]) are responsible for CMTX1 disease. In this report, we describe a patient with CMTX1 disease presenting with recurrent attacks of transient and episodic acute demyelinating encephalomyelitis (ADEM)-like symptoms without previous signs of lower extremity weakness or foot deformities; the patient, as well as his asymptomatic mother, exhibited a novel GJB1 mutation (p.Met1Ile). Differential diagnosis of recurrent and transient ADEM-like illness, if unexplained, should include the possibility of CMTX1 disease. Copyright © 2014 by the American Academy of Pediatrics.

  4. Laparoscopic management of fallopian tube prolapse masquerading as adenocarcinoma of the vagina in a hysterectomized woman

    Directory of Open Access Journals (Sweden)

    Kucuk Mustafa

    2002-01-01

    Full Text Available Abstract Background Fallopian tube prolapse as a complication of abdominal hysterectomy is a rare occurrence. A case with fallopian tube prolapse was managed by a combined vaginal and laparoscopic approach and description of the operative technique is presented. Case presentation A 39-year-old woman with vaginal prolapse of the fallopian tube after total abdominal hysterectomy presented with an incorrect diagnosis of adenocarcinoma of the vaginal apex. The prolapsed tube and cystic ovary were removed by vaginal and laparoscopic approach. The postoperative course went well. Conclusions Early or late fallopian tube prolapse can occur after total abdominal hysterectomy and vaginal hysterectomy. Symptoms consist of persistent blood loss or leukorrhea, dyspareunia and chronic pelvic pain. Vaginal removal of prolapsed tube with laparoscopic surgery may be a suitable treatment. The abdominal or vaginal approach used in surgical correction of prolapsed tubes must be decided in each case according to the patient's individual characteristics.

  5. Classical Hodgkin lymphoma masquerading as chronic recurrent multifocal osteomyelitis: a case report.

    Science.gov (United States)

    Pham, Michael; Ressler, Steven; Rosenthal, Allison; Kelemen, Katalin

    2017-02-18

    Hodgkin lymphoma is a hematologic malignancy usually confined to lymphatic structures and commonly associated with constitutional symptoms. Bony involvement and musculoskeletal symptoms are uncommon and typically seen in advanced disease. In this case, we report an unusual presentation of classical Hodgkin lymphoma and highlight diagnostic challenges leading to the misdiagnosis and treatment as chronic recurrent multifocal osteomyelitis. A 38-year-old white man presented with lower extremity musculoskeletal pain. Imaging studies revealed multifocal lytic and sclerotic osseous axial lesions. Multiple core needle bone marrow and excisional lymph node biopsies were non-diagnostic. Having met the criteria, a tentative diagnosis of chronic recurrent multifocal osteomyelitis was given. He was treated with non-steroidal anti-inflammatory medications with partial clinical response but had persistent symptoms. A second medical opinion was pursued. An open bone marrow biopsy was performed and yielded a diagnosis of classical Hodgkin lymphoma after 13 months of diagnostic uncertainty. A chemotherapy regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine was instituted with complete symptomatic and radiologic response. This case illustrates diagnostic difficulties of a musculoskeletal presentation of Hodgkin lymphoma, challenges of non-diagnostic bone marrow and lymph node biopsies, and resultant diagnostic delays in delivering a potentially curative therapy. Had the additional open bone marrow biopsy not been performed, the diagnosis and treatment of Hodgkin lymphoma would have been missed.

  6. Pulmonary toxocariasis masquerading as metastatic tumor nodules in a child with osteosarcoma.

    Science.gov (United States)

    Lim, Yeon-Jung; Kim, Ji-Hye; Oh, Sung Hee; Jeon, Seok Chul; Koh, Hyun Chul; Lee, Young-Ho

    2009-12-15

    A 14-year-old male, who completed chemotherapy following limb salvage surgery for osteosarcoma approximately 2 years ago, was seen for routine follow-up. A CT scan revealed new scattered multifocal nodular lesions. An ultrasonography-guided percutaneous needle biopsy was done to confirm pulmonary metastasis of the underlying osteosarcoma. The lung biopsy showed findings of eosinophilic pneumonia with no evidence of malignancy. Peripheral eosinophilia was also noted. When a more thorough history revealed frequent intake of raw cow liver, we diagnosed pulmonary toxocariasis by ELISA for specific serum IgG antibody. (c) 2009 Wiley-Liss, Inc.

  7. Raised cardiac enzymes in sepsis with renal failure: An encompassing umbrella or a masquerader?

    Directory of Open Access Journals (Sweden)

    Dilip Gude

    2014-01-01

    Full Text Available Elevation of cardiac enzymes and troponins particularly in settings of sepsis and renal failure may cloud the diagnostic picture of acute coronary syndrome in many cases. Interpretation of such elevated enzymes thus warrants caution. It necessitates adequate awareness amongst clinicians, of conditions with such elevation in the absence of myocardial ischemia/infarction as well as those that harbinger false positives. We discuss one such case that posed a diagnostic dilemma and review the pertinent literature.

  8. Out of Many, One People? Representations of Female Masqueraders in the Jamaica Carnival on Facebook

    Directory of Open Access Journals (Sweden)

    KAI BARRATT

    2017-01-01

    Full Text Available Al igual que muchos carnavales de estilo caribeño, el desfile de carnaval jamaicano está dominado por mujeres y sus representaciones en los medios de comunicación son controladas por los fotógrafos que dictan cómo se presentan en plataformas de medios sociales como Facebook. Utilizando un marco sobre representación y poder en los medios de comunicación, el documento postula que los fotógrafos defienden las ideas hegemónicas sobre el cuerpo de las mujeres cuando deciden quién aparece en sus álbumes de fotos de Facebook. Un análisis de contenido examinó imágenes del desfile de carnaval de 2015 de tres álbumes de Facebook y encontró que los fotógrafos prefirieron a las mujeres delgadas, de piel clara, vestidas con los trajes más lisos y comprometidas con una pose de pie. Estos hallazgos contradicen el lema nacional de Jamaica “Out of Many, One People”, que promueve la idea de una sociedad con todo incluido, pero ignora las estratificaciones sociales que están arraigadas en la antigua sociedad de plantación. Estas divisiones a lo largo de las líneas de la etnicidad y la clase se traducen en última instancia a los espacios de rendimiento donde el carnaval, una importación cultural, se posiciona frente dancehall, que es el principal producto cultural de Jamaica.

  9. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient.

    Science.gov (United States)

    Forster, Michael-J; Akoh, Jacob-A

    2008-03-21

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen.

  10. Gastrointestinal stromal tumor masquerading as a lung neoplasm. A case presentation and literature review

    Directory of Open Access Journals (Sweden)

    Papagiannopoulos K

    2008-05-01

    Full Text Available Abstract Gastrointestinal stromal tumors (GISTs are rare neoplasms of the gastrointestinal tract. Their incidence in the esophagus is 1%–3%. Never has a GIST been documented to directly invade the lung. We report a primary esophageal GIST with direct invasion into the lung parenchyma, presenting predominantly with respiratory symptoms. We include a retrospective literature review. Although the principle 'common things are common' usually guides our everyday clinical practice, this case emphasizes that rare entities can mimic common pathologies and underlines the importance of having a clearly defined differential diagnostic list which should be meticulously scrutinized.

  11. Nuclear protein of the testis midline carcinoma masquerading as a primary mediastinal seminoma

    Directory of Open Access Journals (Sweden)

    Maria S. Sayapina

    2016-06-01

    Full Text Available Nuclear protein of the testis (NUT midline carcinomas are rare aggressive carcinomas characterized by chromosomal rearrangements that involve the gene encoding the NUT. This article reviews the clinicopathologic features and the differential diagnosis of these malignancies.

  12. Ovarian Teratoma Masquerading as a CSF Pseudocyst in a Female with a Ventriculoperitoneal Shunt

    Directory of Open Access Journals (Sweden)

    John M. K. Mislow

    2009-01-01

    Full Text Available Background. In today's fast-paced and high-acuity emergency departments, clinicians are often compelled to triage cases so rapidly that a differential diagnosis consistent with the history and physical examination is not comprehensive. Case Report. This case report describes the unexpected finding of a cystic ovarian neoplasm in a young female with an abdominal mass and a ventriculoperitoneal shunt, initially diagnosed as a cerebrospinal fluid pseudocyst. We use this case to illustrate that the astute clinician must always synthesize a diagnosis from all data sources and not to rely on initial radiographic evaluations. Conclusions. This remarkable case demonstrates that all differential diagnoses must be entertained in order to rapidly and accurately diagnose a patient with a cystic abdominal mass.

  13. External iliac artery thrombus masquerading as sciatic nerve palsy in anterior column fracture of the acetabulum

    Directory of Open Access Journals (Sweden)

    Narender Kumar Magu

    2015-01-01

    Full Text Available We report a case of ischemic neuropathy of the sciatic nerve in a patient with an anterior column fracture of the acetabulum operated by ilioinguinal approach. It resulted from occlusion of the blood supply to the sciatic nerve. There were no signs of a vascular insult until ischemic changes ensued on the 6 th postoperative day on the lateral part of great toe. The patient underwent crossover femoro-femoral bypass grafting and there was a complete reversal of the ischemic changes at 6 months. The sciatic nerve palsy continued to recover until the end of 1 year; by which time the only deficit was a Grade 4 power in the extensor hallucis longus (EHL and the extensor digitorum longus (EDL. There was no further recovery at 2 years followup.

  14. Isolated Bilateral Renal Mucormycosis Masquerading as Renal Abscess in an Immunocompetent Individual: A Lesson Learnt

    Directory of Open Access Journals (Sweden)

    Somorendro Paonam

    2014-01-01

    Full Text Available Isolated renal mucormycosis is a rare entity in immunocompetent subjects. It is usually a rapidly progressive disease with poor prognosis but it can mimic renal abscess with a protracted course.

  15. Mucormycosis in a surgical defect masquerading as osteomyelitis: a case report and review of literature.

    Science.gov (United States)

    Mengji, Ashwini Kumar; Yaga, Uday Shankar; Gollamudi, Nishanth; Prakash, Bhanu; Rajashekar, Edunuri

    2016-01-01

    Mucormycosis is a rare, highly lethal opportunistic fungal disease affecting immune compromised and diabetic patients. Mucormycosis is considered as the 3(rd) most common invasive mycosis after candidiasis and aspergillosis in debilitating patients. It is caused by the filamentous fungi of the class zygomycetes. The infection usually begins in the nose due to inhalation of fungal spores. This fatal fungal disease needs a prompt and early definitive diagnosis, aggressive surgical therapy and high dose anti-fungal therapy. Here, we present a case report of Mucormycosis in a 64 year elderly diabetic male patient who was previously operated for myiasis and also the extensive review of the literature of the mucormycosis.

  16. Unresponsive eczematous dermatitis: a case of pancreatic cancer masquerading as cutaneous T cell lymphoma.

    Science.gov (United States)

    Levin, J; Camisa, C

    1999-08-01

    Skin diseases may be the presenting sign of malignancy, but strict criteria are required to make the diagnosis of a paraneoplastic syndrome. Common dermatoses may also herald an underlying malignancy without meeting these criteria. We report the case of an elderly man with an unresponsive eczematous dermatitis whose evaluation eventually revealed a pancreatic carcinoma. This case is presented to alert the clinician that a common dermatosis may be the first sign of an occult malignancy, especially if it behaves in an atypical or aggressive manner or is recalcitrant to standard therapies.

  17. Unusual brachial plexus lesion: Hematoma masquerading as a peripheral nerve sheath tumor

    Directory of Open Access Journals (Sweden)

    Khaled M Krisht

    2016-01-01

    Full Text Available Background: Malignant peripheral nerve sheath tumors (MPNSTs of the brachial plexus have unique radiographic and clinical findings. Patients often present with progressive upper extremity paresthesias, weakness, and pain. On magnetic resonance (MR imaging, lesions are isointense on T1-weighted and hyperintense on T2-weighted sequences, while also demonstrating marked enhancement on MR studies with gadolinium diethylenetriamine pentaacetic acid. On the basis of their characteristic MR imaging features and rapid clinical progression, two brachial plexus lesions proved to be organizing hematomas rather than MPNST. Methods: A 51-year-old male and a 31-year-old female were both assessed for persistent and worsened left-sided upper extremity pain, paresthesias, and weakness. In both cases, the MR imaging of the brachial plexus demonstrated an extraspinal enhancing lesion located within the left C7-T1 neuroforamina. Results: Although the clinical and radiographic MR features for these 2 patients were consistent with MPNSTs, both lesions proved to be benign organizing hematomas. Conclusions: These two case studies emphasize that brachial plexus hematomas may mimic MPNSTs on MR studies. Accurate diagnosis of these lesions is critical for determining the appropriate management options and treatment plans. Delaying the treatment of a highly aggressive nerve sheath tumor can have devastating consequences, whereas many hematomas resolve without surgery. Therefore, if the patient has stable findings on neurological examination and a history of trauma, surgical intervention may be delayed in favor of repeat MR imaging in 2-3 months to re-evaluate the size of the mass.

  18. Focal cemento-osseous dysplasia masquerading as benign cementoblastoma: A diagnostic dilemma.

    Science.gov (United States)

    Rao, Gayathri S; Kamalapur, Muralidhar G; Acharya, Swetha

    2014-01-01

    Focal cemento-osseous dysplasia (FCOD) is a fibro-osseous lesion that is a nonneoplastic reactive lesion. A case of 47-year-old female patient presenting with a diagnostic dilemma to the clinician is reported. Methods to achieve definitive diagnosis are discussed. FCOD can present with features of periapical pathology or other osseous lesions. Hence, to arrive at a definitive diagnosis biopsy and histopathologic examination is imperative.

  19. Depression masquerading as chest pain in a patient with Wolff Parkinson White syndrome

    Science.gov (United States)

    Madabushi, Rajashree; Agarwal, Anil; Gautam, Sujeet K S; Khuba, Sandeep

    2016-01-01

    Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire–9 (PHQ–9) criteria. After ruling out sinister causes, she was treated for depression using oral Duloxetine and counselling. This led to resolution of symptoms, and improved her mood and functional capability. This case highlights the use of psychological screening tools and diligent examination in scenarios as confusing as the one presented here. Addressing the psychological aspects of pain and adopting a holistic approach are as important as treatment of the primary pathology. PMID:27738505

  20. Cutaneous Metastasis of Medullary Carcinoma Thyroid Masquerading as Subcutaneous Nodules Anterior Chest and Mandibular Region

    Directory of Open Access Journals (Sweden)

    Rahul Mannan

    2014-01-01

    Full Text Available Cutaneous metastasis of underlying primary malignancies can present to dermatologist with chief complaints of cutaneous lesions. The underlying malignancy is generally diagnosed much later after a complete assessment of the concerned case. Medullary carcinoma thyroid (MCT is a relatively uncommon primary neoplasia of the thyroid. Very few cases presenting as cutaneous metastases of MCT have been reported in the literature. Most of the cases which have been reported are of the papillary and the follicular types. We here report a case of a patient who presented in the dermatology clinic with the primary complaint of multiple subcutaneous nodules in anterior chest wall and left side of body of mandible. By systematic application of clinical and diagnostic skills these nodules were diagnosed as cutaneous metastasis of MCT bringing to the forefront a history of previously operated thyroid neoplasm. So clinically, the investigation of a flesh coloured subcutaneous nodule, presenting with a short duration, particularly in scalp, jaw, or anterior chest wall should include possibility of metastastic deposits. A dermatologist should keep a possibility of an internal organ malignancy in patients while investigating a case of flesh coloured subcutaneous nodules, presenting with short duration. A systematic application of clinical and diagnostic skills will eventually lead to such a diagnosis even when not suspected clinically at its primary presentation. A prompt and an emphatic diagnosis and treatment will have its bearing on the eventual outcome in all these patients.

  1. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient

    Institute of Scientific and Technical Information of China (English)

    Michael J Forster; Jacob A Akoh

    2008-01-01

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen.

  2. Xp11 Translocation Renal Cell Carcinoma: Unusual Variant Masquerading as Upper Tract Urothelial Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Arash Akhavein

    2014-05-01

    Full Text Available Xp11 translocation renal cell carcinoma (TRCC is a rare subtype of renal cell carcinoma characterized by chromosomal translocations involving the TFE3 gene located at the Xp11.2 locus. Initial cases were more common in children, but cases in older adults have begun to accrue and suggest a relatively more aggressive course. We report a case of Xp11 TRCC in a 63-year-old female patient with initial presentation mimicking upper urinary tract urothelial cell carcinoma, with biopsy proving TRCC. She underwent a radical nephrectomy and paracaval lymph node dissection and is followed up with the intent to initiate vascular endothelial growth factor–targeted therapy in case of recurrence.

  3. Epilepsy due to 20q13.33 subtelomere deletion masquerading as pyridoxine-dependent epilepsy.

    Science.gov (United States)

    Mefford, Heather C; Cook, Joseph; Gospe, Sidney M

    2012-12-01

    A cause of antiepileptic medication resistant seizures presenting in neonates and young infants is pyridoxine-dependent epilepsy (PDE), an organic aciduria, which is due to recessive mutations in the ALDH7A1 gene, resulting in deficiency of antiquitin. Since the discovery of molecular basis of this disorder, a few patients have been reported with a similar clinical phenotype but without evidence of antiqutin dysfunction. We report on a patient who had carried a clinical diagnosis of PDE for 7 years, but who was than shown to have normal ALDH7A1 sequencing and the absence of biomarkers characteristic of this familial epilepsy. Array comparative genomic hybridization (CGH) demonstrated a 1.5-Mb terminal deletion of the long arm of chromosome 20, which included deletion of the KCNQ2 and CHRNA4 genes, both of which have been associated with specific epilepsy syndromes. We suggest that this boy's neonatal epilepsy and neurodevelopmental disabilities are secondary to this deletion and that his clinical response to pyridoxine was coincidental. This patient's history emphasizes the utility of array CGH in the evaluation of children with epilepsy of unknown etiology.

  4. IgG4-related intraocular inflammation masquerading as ciliary body melanoma in a young girl

    Directory of Open Access Journals (Sweden)

    Dipankar Das

    2016-01-01

    Full Text Available Immunoglobulin G4 (IgG4-related diseases affects various tissues and organs of the human body. Orbital, adnexal, and scleral inflammations were already reported in the medical literature. To the best of our knowledge, we report the first case of intraocular IgG4-associated inflammatory mass in the ciliary body mimicking as a melanoma in a 23-year-old female from Northeast India. Characteristic histopathology, immunohistochemistry in the tissue, protein chemistry, and raised serum IgG4 were supportive for the diagnosis. As this newly diagnosed disease has multi-organ affection and little is known about its pathogenesis particularly in eye and adnexa, the present case will open many challenges in clinico-pathological diagnosis and research in the future.

  5. Electromagnetic cascade masquerade: a way to mimic $\\gamma$--ALP mixing effects in blazar spectra

    CERN Document Server

    Dzhatdoev, T A; Kircheva, A P; Lyukshin, A A

    2016-01-01

    Most of the studies on extragalactic {\\gamma}-ray propagation performed up to now only accounted for primary gamma-ray absorption and adiabatic losses (absorption-only model). However, there is growing evidence that this model is oversimplified and must be modified in some way. (...) There are many hints that a secondary component from electromagnetic cascades initiated by primary $\\gamma$-rays or nuclei may be observed in the spectra of some blazars. We study the impact of electromagnetic cascades from primary $\\gamma$-rays or protons on the physical interpretation of blazar spectra obtained with imaging Cherenkov telescopes. We use the publicly-available code ELMAG to compute observable spectra of electromagnetic cascades from primary $\\gamma$-rays. For the case of primary proton, we develop a simple, fast, and reasonably accurate hybrid method to calculate the observable spectrum. (...) Electromagnetic cascades show at least two very distinct regimes labeled by the energy of the primary $\\gamma$-ray ($E_{0...

  6. Neoplastic leptomeningeal disease masquerading as central serous retinopathy. A case report.

    Science.gov (United States)

    Elaraoud, Ibrahim; Suleman, Hanif J; Cikatricis, Peter; Palmer, Helen

    2016-01-01

    A 69-year-old man became aware of people's speech being out of synch with their lip movements alongside persistent headaches, both of which progressively worsened. A few weeks later, he developed progressive and painless visual loss in one eye. Initial neurological evaluation, inflammatory markers and head computed tomography scan were normal. Ophthalmological examination and OCT scan revealed right macular subretinal fluid with choroidal indentation, which prompted urgent further investigations including head MRI revealing extensive leptomeningeal disease. The patient continued to deteriorate and deceased shortly afterwards. This is the first reported case of neoplastic leptomeningeal disease presenting with loss of vision due to choroidal metastasis with localised exudative retinal detachment. Diagnosing neoplastic leptomeningeal disease requires a high index of suspicion from the treating physician. Symptoms may be nonspecific and/or subtle. Combining cerebrospinal fluid cytology from lumbar puncture with contrast-enhanced magnetic resonance imaging of the brain is considered the optimal diagnostic approach.

  7. Docetaxel-Induced Systemic Sclerosis with Internal Organ Involvement Masquerading as Congestive Heart Failure

    Science.gov (United States)

    Vemulapalli, Raghavendra C.; Gupta, Amit; Shreve, Maria E.; Rees, Della A.

    2017-01-01

    Systemic sclerosis, or scleroderma, is a complex medical disorder characterized by limited or diffuse skin thickening with frequent involvement of internal organs such as lungs, gastrointestinal tract, or kidneys. Docetaxel is a chemotherapeutic agent which has been associated with cutaneous side effects. An uncommon cutaneous side effect of docetaxel is scleroderma-like skin changes that extend from limited to diffuse cutaneous systemic sclerosis. Several case reports have been published regarding the association of docetaxel and systemic sclerosis. However, those reports demonstrated the association between docetaxel and scleroderma-like skin changes without internal organ involvement. Here, we report a case of systemic sclerosis with pulmonary arterial hypertension and a microangiopathic kidney involvement induced by docetaxel chemotherapy. After an exhaustive literature review, this could be the first case of docetaxel-induced systemic sclerosis involving internal organs.

  8. Oral histoplasmosis masquerading as oral cancer in HIV-infected patient: A case report

    OpenAIRE

    Mohammed, Shafiulla; Sinha, Mahua; Chavan, Purushottam; Premalata, CS; Shivaprakash,; Chakrabarti, Arunaloke; Jayshree, Rudrapatna S

    2012-01-01

    Histoplasmosis is an endemic mycoses caused by Histoplasma capsulatum with endemicity around midwestern United States and central America. The endemicity of histoplasmosis in India is not clearly known. Histoplasmosis, especially oral histoplasmosis, is now increasingly being reported from India. We report here a culture-confirmed and sequence confirmed, oral histoplasmosis in a HIV seropositive individual who was referred to our regional cancer centre with a suspicion of oral cancer.

  9. Congenital pseudoaneurysm of mitral-aortic intervalvular fibrosa masquerading as left atrial mass in fetal life

    Science.gov (United States)

    Chidambarathanu, Shanthi; Raja, Vijayalakshmi; Suresh, Indrani

    2017-01-01

    A 28-week-old fetus was detected to have a single left atrial mass in prenatal ultrasound. Postnatal echocardiography showed an aneurysm between the anterior mitral leaflet and aortic valve, to the left of atrioventricular junction and communicating with the left ventricle through a narrow mouth. It probably originated from the mitral-aortic intervalvular fibrous tissue and an inherent weakness at this site might be the cause. Reported cases of pseudoaneurysm of mitral-aortic intervalvular fibrosa and subvalvular ventricular aneurysms seen following infective endocarditis, surgery, or trauma seem to have a similar anatomical background. This case explains the possibility of congenital aneurysm in this location which needs to be considered a differential diagnosis in similar cases. PMID:28163433

  10. Iatrogenic aortic pseudoaneurysm following anterior thoracic spine surgery masquerading as chronic infection

    Directory of Open Access Journals (Sweden)

    Goni Vijay

    2013-12-01

    Full Text Available 【Abstract】Late vascular complications involving aorta are rare but devastating adversities following anterior thoracic spine operations are present. The current article describes our experience with one such patient who had an iatrogenic pseudoaneurysm of the thoracic aorta, mimick- ing infection. The patient was treated successfully follow- ing concomitant efforts by multidisciplinary experts with shunting. We wish to highlight upon the significance of recognizing the possible sinister consequences of a dan- gerously prominent spinal implant and the role of a suspi- cious surgeon in identifying these menacing complications at the right time. Key words: Fractures, bone; Aorta, thoracic; Aneurysm, false; Iatrogenic disease

  11. Central nervous system infections masquerading as cerebrovascular accidents: Case series and review of literature

    Directory of Open Access Journals (Sweden)

    Lisa Hayes

    2014-01-01

    Conclusion: The cases described demonstrate that CNS infections need to be considered in the differential diagnosis of CVAs presenting with fevers. The signs and symptoms of non-CNS infections associated with CVAs may be clinically indistinguishable from those of CNS infections. The outcomes of untreated CNS infections are extremely poor. It is thus imperative to have a high index of suspicion for CNS infection when evaluating CVAs with fevers or other signs of infection.

  12. Early recognition is important when multiple magnets masquerade as a single chain after foreign body ingestion

    Directory of Open Access Journals (Sweden)

    Auriel August

    2016-10-01

    Full Text Available Ingestions of multiple magnets can lead to serious damage to the gastrointestinal tract. Moreover, these foreign bodies can take deceptive shapes such as single chains which may mislead clinicians. We report the case of a ten-year-old boy who swallowed 33 magnets, the most yet reported, which took on the appearance of a single loop in the stomach, while actually being located in the stomach, small bowel, and colon. Early recognition and prompt intervention are necessary to avoid complications of this foreign body misadventure.

  13. Rare Presentation of Genitourinary Tuberculosis Masquerading as Renal Cell Carcinoma: A Histopathological Surprise

    Directory of Open Access Journals (Sweden)

    Santosh Kumar

    2014-01-01

    Full Text Available Genitourinary tuberculosis (GUTB is a rare extrapulmonary manifestation of tuberculosis (TB. Various forms of presentation are described and in most cases the disease results in calcification, atrophy, or necrosis of the renal parenchyma. The kidney is not generally palpable except in cases of hydronephrosis due to an upper ureteric stricture. We present a case of GUTB presenting as inflammatory pseudotumor. This case was initially diagnosed as renal malignancy and managed accordingly. Histopathology confirmed the diagnosis of pseudotumoral renal TB.

  14. Ruptured abdominal aortic aneurysm masquerading as isolated hip pain: an unusual presentation.

    Science.gov (United States)

    Vaidyanathan, Sriram; Wadhawan, Himanshu; Welch, Pedro; El-Salamani, Murad

    2008-05-01

    The rupture of an abdominal aortic aneurysm (AAA) is a catastrophic event. Misdiagnosis by first-contact emergency physicians remains a serious concern. Varied and frequently nonspecific presentations lead to erroneous diagnostic impressions and cause significant delays in definitive intervention. We report the case of a 73-year-old man with a ruptured AAA presenting with isolated acute right hip pain without any classical features such as truncal pain or hypotension. Despite major advances in imaging and definitive treatment, a heightened awareness among emergency physicians remains the only effective means of improving detection and thereby survival.

  15. Posterior reversible encephalopathy syndrome masquerading as progressive multifocal leukoencephalopathy in rituximab treated neuromyelitis optica.

    Science.gov (United States)

    Berger, Joseph R; Neltner, Janna; Smith, Charles; Cambi, Franca

    2014-11-01

    Both progressive multifocal leukoencephalopathy (PML) and posterior reversible encephalopathy syndrome (PRES) have been reported as complications of rituximab therapy. These disorders may appear indistinguishable on magnetic resonance imaging (MRI). We report on a 42 year old woman with neuromyelitis optica (NMO) of 10 years duration who developed extensive white matter disease affecting chiefly both parietal lobes 6 months after her first and only dose of rituximab. The MRI findings suggested the diagnosis of PML, but her history was more consistent with PRES. Ultimately, a brain biopsy was performed which was consistent with the diagnosis of PRES. PRES and PML may have overlapping symptomatology and be indistinguishable on MRI. An approach to distinguishing between these two disorders is addressed.

  16. Asteroid Hyalosis Masquerading as Vitreous Hemorrhage on Point-of-Care Sonography.

    Science.gov (United States)

    Lema, Penelope C; Mantuani, Daniel; Nagdev, Arun; Adhikari, Srikar

    2017-07-17

    Point-of-care ocular sonography is frequently used in the emergency department to evaluate patients with vision disorders. We describe a case series of 3 patients who ultimately had a diagnosis of asteroid hyalosis, a lesser-known condition that on point-of-care sonography may be mistaken for vitreous hemorrhage. Asteroid hyalosis is considered a benign degenerative condition. In contrast, vitreous hemorrhage may be an ocular emergency that warrants an urgent ophthalmologic consultation if there is an underlying retinal tear or detachment. Although similar in appearance on sonography, recognition of the subtle pathognomonic sonographic features along with their clinical presentations can differentiate these diseases, with vastly different management strategies and dispositions. © 2017 by the American Institute of Ultrasound in Medicine.

  17. Coccidioidomycosis masquerading as skeletal tuberculosis: an imported case and review of coccidioidomycosis in India.

    Science.gov (United States)

    Capoor, Malini R; Sen, Bishwaroop; Varshney, Parul; Verghese, Mathew; Shivaprakash, M R; Chakrabarti, Arunaloke

    2014-01-01

    We describe a possible imported case of osteo-articular coccidioidomycosis in India. Culture of the computed tomography-guided aspirate revealed the growth of Coccidioides spp., which was identified as Coccidioides posadasii by sequencing of the internal transcribed spacer (ITS) region of rDNA. He was successfully treated with amphotericin B followed by itraconazole. All the previous published reports of coccidioidomycosis cases diagnosed in India are also reviewed in order to increase the awareness of this disease in non-endemic areas.

  18. Amnesia in Frontotemporal Dementia with Amyotrophic Lateral Sclerosis, Masquerading Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    A. Yamanami-Irioka

    2011-10-01

    Full Text Available A 68-year-old man with a clinical diagnosis of Alzheimer’s disease (AD later developed amyotrophic lateral sclerosis (ALS, which was confirmed at autopsy at age 72 years. Because neuronal loss and AD-type pathologies (Braak stage II for neurofibrillary tangles were scant, TDP-43-positive intracytoplasmic inclusions in hippocampal dentate granular cells and in neurons in the subiculum and amygdala, even though small in amount, may represent the earliest lesions of ALS-related dementia and could be the cause of dementia in this patient. Although the persistent elevation of creatine kinase from the onset could be a pointer to the presence of motor involvement, more accurate characterization of dementia, which may differentiate ALS-related dementia and AD, is necessary.

  19. Severe liver dysfunction in an infant with cystic fibrosis masquerading as metabolic liver disease

    Directory of Open Access Journals (Sweden)

    K P Srikanth

    2016-01-01

    Full Text Available We present a rare presentation of cystic fibrosis with neonatal cholestasis. Histological features of mucoviscidosis were present in liver involving the biliary tract, intestinal mucosa, pancreas, and lung. Besides, there was a rare association with autosomal dominant type of polycystic renal disease.

  20. C1 Inhibitor Deficiency and Angioedema of the Small Intestine Masquerading as Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Kelly W Burak

    2000-01-01

    Full Text Available A case of C1 inhibitor deficiency presenting as localized edema of the small intestine is described. A 16-year-old, previously healthy woman presented with recurrent attacks of abdominal pain and vomiting following minor abdominal trauma. Investigations including computed tomography scan and barium studies confirmed localized edema of the jejunum. At laparoscopy, Crohn’s disease was suspected; however, a subsequent enteroscopy was normal. Complement levels revealed a low C4 level, and C1 inhibitor deficiency was later confirmed. Attacks of abdominal pain began after starting oral contraceptives and have not returned since stopping the birth control pill. This rare cause of abdominal pain is examined, and C1 inhibitor deficiency and angioedema are reviewed.

  1. Retroperitoneal Necrotizing Fasciitis Masquerading as Perianal Abscess – Rare and Perilous

    Science.gov (United States)

    Amaranathan, Anandhi; Barathi, Deepak; Shankar, Gomathi; Sistla, Sarath Chandra

    2017-01-01

    Necrotizing fasciitis is one of the uncommon presentations of a rapidly spreading subcutaneous tissue infection. Although the actual cause is unclear in many cases, most of them are due to the rapid proliferation of microorganisms. Retroperitoneal necrotizing fasciitis is extremely rare. It is a potentially lethal infection that requires immediate and aggressive surgical care. Early diagnosis is the key to a better prognosis. The possibility of retroperitoneal necrotizing fasciitis should be suspected in patients with symptoms of sepsis that are disproportionate to clinical findings. The rapid deterioration of the patient also gives a clue towards the diagnosis. We report a 35-year-old male with perianal abscess who had been progressed to retroperitoneal necrotizing fasciitis. The patient was managed successfully with aggressive debridement and drainage after laparotomy. Appropriate antibiotics were used to combat the sepsis. The patient recovered well at follow up, three months after discharge. Another patient, a 45-year-old male with a retroperitoneal abscess, progressed to retroperitoneal necrotizing fasciitis, and extra peritoneal drainage and debridement was done. Antibiotics depending upon the culture and sensitivity were used to control sepsis. But the patient succumbed to death 45 days after surgery due to uncontrolled sepsis. Necrotizing fasciitis of any anatomical site needs aggressive surgical care with early intervention. But retroperitoneal necrotizing fasciitis needs an extra effort for diagnosis. After diagnosis, it needs timely surgical intervention and appropriate antibiotic therapy for the recovery of the patients. PMID:28229030

  2. Lichen Simplex Chronicus as an Essential Part of the Dermatologic Masquerade

    Science.gov (United States)

    Voicu, Cristiana; Tebeica, Tiberiu; Zanardelli, Matteo; Mangarov, Hristo; Lotti, Torello; Wollina, Uwe; Lotti, Jacopo; França, Katlein; Batashki, Atanas; Tchernev, Georgi

    2017-01-01

    A 48 years old female patient had been suffering from the lesions presented for four years. They have started as small, pruritic patches which had been mechanically irritated and grew up in time. The patient had no associated comorbidities or allergies, and she was not under any medication. On physical examination, she presented one erythematous, exudative plaque, with dimensions of 2.5/4 cm, located on the proximal phalanx and interphalangeal articulation of the left thumb. All histopathological features were consistent with the diagnosis of lichen simplex chronicus. Some lesions of lichen simplex chronicus exhibit signs of pseudocarcinomatous, infundibular and sometimes eccrine ductal proliferation of keratinocytes. Although the pseudoinfiltrative aspect of the epithelial proliferation and its pronounced degree might mimic a well-differentiated lesion of squamous cell carcinoma, a lack of cellular atypia and atypical mitotic figures are features that do not support this diagnosis. On the other hand, long lasting lesions of lichen simplex chronicus may lead to alterations in the processes of keratinocyte proliferation and differentiation and eventually give rise to malignant transformation. The best treatment management is a psychodermatological approach, a combination of skin care with psychotherapy, in order to prevent relapses. PMID:28785363

  3. Kikuchi-fujimoto disease, the masquerading menace: A rare case report

    Directory of Open Access Journals (Sweden)

    Rohit Kataria

    2016-01-01

    Full Text Available Kikuchi-Fujimoto disease (KFD or histiocytic necrotizing lymphadenitis is a rare, benign, self-limiting disease with unknown etiology characterized by regional lymphadenopathy. A 30-year-old female presented with fever, weakness, multiple joint pain, oral ulcers, erythematous facial rashes, hemorrhagic crusting on both lips, and cervical lymphadenopathy of 2-month duration. Clinically, the disease was mimicking systemic lupus erythematosus, but immunofluorescence was negative for it. Lymph node biopsy suggested a diagnosis of KFD.

  4. Cervical tuberculosis masquerading as cancer cervix: a report of three cases.

    Science.gov (United States)

    Sachan, Rekha; Gupta, Pooja; Patel, M L; Verma, Ajay; Maurya, Malti

    2013-01-01

    Tuberculosis is still frequently observed in third world countries like Africa and Asia. Here we report three cases of genital tuberculosis with variable presentations. First case was a lady of reproductive age group who presented with polymenorrhea and post-coital bleeding with unhealthy cervix. Histopathology of cervical tissue revealed tubercular cervicitis. Second and third cases presented with different complaints like discharge per vaginum, post-coital bleeding and pain in lower abdomen with growth over the cervix. Cervical biopsy was inconclusive of tuberculosis but endometrial tissue sampling for TB PCR was positive. This shows that newer diagnostic marker test can help us to detect secondary genital tuberculosis.

  5. latrogenic aortic pseudoaneurysm following anterior thoracic spine surgery masquerading as chronic infection

    Institute of Scientific and Technical Information of China (English)

    Vijay Goni; Ajay Bahl; Nirmal Raj Gopinathan; Vibhu Krishnan; Rajesh Kumar

    2013-01-01

    Late vascular complications involving aorta are rare but devastating adversities following anterior thoracic spine operations are present.The current article describes our experience with one such patient who had an iatrogenic pseudoaneurysm of the thoracic aorta,mimicking infection.The patient was treated successfully following concomitant efforts by multidisciplinary experts with shunting.We wish to highlight upon the significance of recognizing the possible sinister consequences of a dangerously prominent spinal implant and the role of a suspicious surgeon in identifying these menacing complications at the right time.

  6. Guillain-Barre syndrome masquerading as acute respiratory failure in an infant

    Directory of Open Access Journals (Sweden)

    Praveen Kishore

    2015-01-01

    Full Text Available Guillain-Barré syndrome (GBS is a rare entity in infants. We report a case of GBS in a 5-month-old girl. The child presented with cough, loose stools, breathing difficulty, and listlessness. The child was treated as pneumonia with respiratory failure. Due to difficulty in weaning from ventilation with areflexia, marked hypotonia, and reduced power in all four limbs; possibilities of spinal muscular atrophy, poliomyelitis, and myopathies were kept. Nerve conduction velocity study was suggestive of mixed sensory-motor, severe axonal, and demyelinating polyradiculoneuropathy. Cerebrospinal fluid study revealed albuminocytological dissociation. Child was diagnosed as GBS and treated with intravenous immunoglobulin. Child recovered completely on follow-up. GBS should be considered as a differential diagnosis in acute onset respiratory failure with neuromuscular weakness in infants.

  7. Prominent subcutaneous oedema as a masquerading symptom of an underlying inflammatory myopathy.

    Science.gov (United States)

    Anantharajah, Anthea; Vucic, Steve; Tarafdar, Surjit; Vongsuvanh, Roslyn; Wilcken, Nicholas; Swaminathan, Sanjay

    2017-02-01

    The inflammatory myopathies are a group of immune-mediated inflammatory muscle disorders that typically present with marked proximal muscle weakness. We report four cases of inflammatory myopathies with marked subcutaneous oedema as their main complaint. Three of the four patients had normal or low levels of creatine kinase, an enzyme often markedly elevated in these disorders. Magnetic resonance imaging of the muscles, followed by a muscle biopsy were used to make a definitive diagnosis.

  8. Diffuse lipofibromatosis of the lower extremity masquerading as a vascular anomaly.

    Science.gov (United States)

    Greene, Arin K; Karnes, Julie; Padua, Horacio M; Schmidt, Birgitta A; Kasser, James R; Labow, Brian I

    2009-06-01

    Lipofibromatosis is a slow-growing, childhood soft-tissue neoplasm that is often confused with other conditions. We report a patient with lipofibromatosis causing extremity enlargement at birth. The lesion initially was thought to be a vascular anomaly or lipedema on clinical and MRI examination. When involving the lower extremity, diffuse lipofibromatosis must be differentiated from more common causes of lower limb enlargement in children: lymphatic malformation, lymphedema, or lipedema. Compared with these more frequent conditions, lipofibromatosis usually causes less morbidity. Management of the tumor includes observation or excision. Because complete extirpation of the lesion is difficult, the recurrence rate is high.

  9. Acute lymphoblastic leukemia masquerading as juvenile rheumatoid arthritis: diagnostic pitfall and association with survival.

    Science.gov (United States)

    Marwaha, Ram Kumar; Kulkarni, Ketan Prasad; Bansal, Deepak; Trehan, Amita

    2010-03-01

    Acute lymphoblastic leukemia (ALL) often presents with osteoarthritic manifestations which may lead to misdiagnosis with juvenile rheumatoid arthritis (JRA). This study was designed to identify ALL patients with initial diagnosis of JRA, compare their clinicolaboratory characteristics and outcome with other ALL patients treated at our center. Case records of 762 patients with ALL were analyzed. Information regarding the clinical-demographic profile, therapy and outcome were recorded. Of the children, 49 (6.4%) had initial presentation mimicking JRA. Asymmetric oligoarthritis was the most common pattern of joint involvement. Majority presented with fever, pallor, arthritis, night pain, and bone pain. None of the routine prognostic factors including age, gender, lymphadenopathy, hepatosplenomegaly, total leukocytes count (TLC), and platelet count were significantly associated with relapse/death. The mean symptom-presentation interval (SPI), hemoglobin was significantly higher whilst the TLC was significantly lower in these patients compared to other ALL patients. The 5 year overall-survival was better than other patients with ALL (p = 0.06, by logrank test). Significantly longer SPI in these patients underscores the need for prompt and early investigations to rule out ALL in patients of JRA with atypical features and pointers of ALL. Children with ALL-mimicking JRA may belong to a subgroup of ALL with a better prognosis.

  10. A farmer's occupational airborne contact dermatitis masqueraded by coexisting rosacea: delayed diagnosis and legal acknowledgement.

    NARCIS (Netherlands)

    Spiewak, R.W.; Dutkiewicz, J

    2004-01-01

    A rare case of coexistence of occupational airborne dermatitis with rosacea is presented in a 41-year-old female farmer. Her first dermatitis symptoms appeared at the age of 10 when she started helping her parents on the farm. Uncovered skin areas of the face, neck, decollete, forearms and the hands

  11. Papillary thyroid carcinoma metastasis to the lumbar spine masquerading as a schmorl's node

    Energy Technology Data Exchange (ETDEWEB)

    Daignault, Cory P.; Palmer, Edwin L.; Scott, James A.; Swan, John S. [Dept. of Radiology, Massachusetts General Hospital, Boston (United States); Daniels, Gilbert H. [Dept. of Radiology, Division of Nuclear Medicine, UMass Memorial Medical Center, Worcester (United States)

    2015-09-15

    A Schmorl's node is a common incidental finding encountered during radiologic imaging. Despite the vertebral body being a common site of metastatic disease, a lytic lesion adjacent to an endplate with typical imaging features can often confidently be called a Schmorl's node. This is a case report of a patient with a single well-defined FDG-avid papillary thyroid carcinoma metastasis to the spine that had imaging findings characteristic of a Schmorl's node on CT and MRI. This case is important to consider as it demonstrates that the imaging characteristics of metastatic disease and Schmorl's nodes can overlap.

  12. A gastrointestinal stromal tumor of the duodenum masquerading as a pancreatic head tumor

    Institute of Scientific and Technical Information of China (English)

    Sung Ho Kwon; Jung Woo Shin; Neung Hwa Park; Do Ha Kim; Hee Jeong Cha; Seok Won Jung; Byung Chul Kim; Jae Serk Park; In Du Jeong; Jong Hwa Lee; Yang Won Nah; Sung Jo Bang

    2007-01-01

    Gastrointestinal stromal tumor (GIST) represents the most common kind of mesenchymal tumor that arises from the alimentary tract. GIST is currently defined as a gastrointestinal tract mesenchymal tumor showing CD117 (c-kit protein) positivity at immunohistochemistry.Throughout the whole length of the gastrointestinal tract, GIST arises most commonly from the stomach followed by the small intestine, the colorectum, and the esophagus. Only 3%-5% of GISTs occur in the duodenum, and especially, if GIST arises from the C loop of the duodenum, it can be difficult to differentiate from the pancreas head mass because of its anatomical proximity. Here, we report a case of duodenal GIST,which was assessed as a pancreatic head tumor preoperatively.

  13. A farmer's occupational airborne contact dermatitis masqueraded by coexisting rosacea: delayed diagnosis and legal acknowledgement.

    NARCIS (Netherlands)

    Spiewak, R.W.; Dutkiewicz, J

    2004-01-01

    A rare case of coexistence of occupational airborne dermatitis with rosacea is presented in a 41-year-old female farmer. Her first dermatitis symptoms appeared at the age of 10 when she started helping her parents on the farm. Uncovered skin areas of the face, neck, decollete, forearms and the hands

  14. Masquerading Machismo: La India and the Staging of Chusmerfa on the Salsa Scene

    DEFF Research Database (Denmark)

    Derno, Maiken Tandgård

    2002-01-01

    Genre, gender, performance, boundaries, feminism, salsa machismo, music industri, Latina identity......Genre, gender, performance, boundaries, feminism, salsa machismo, music industri, Latina identity...

  15. Diffuse intestinal submucosal lipomatosis with incidental epidermal inclusion cyst of caecum clinically masquerading as carcinoma caecum.

    Science.gov (United States)

    Thakur, Brijesh; Kishore, Sanjeev; Bhardwaj, Aparna; Kudesia, Sandip

    2014-07-30

    Symptomatic diffuse submucosal intestinal lipomatosis is a rare entity. Also few cases of epidermal inclusion cyst of caecum have been reported in literature. Here, we are presenting a rare case of intestinal submucosal lipomatosis with coincidence of epidermal inclusion cyst of caecum and presumptively diagnosed as carcinoma of ileocaecal region during surgery in a 55 years old male. Both are rare entity considering the location even they should be kept as a differential diagnosis in unusual cases of intestinal perforations with inconclusive radiological findings or clinical uncertainity.

  16. Diffuse intestinal submucosal lipomatosis with incidental epidermal inclusion cyst of caecum clinically masquerading as carcinoma caecum

    Directory of Open Access Journals (Sweden)

    Brijesh Thakur

    2014-08-01

    Full Text Available Symptomatic diffuse submucosal intestinal lipomatosis is a rare entity. Also few cases of epidermal inclusion cyst of caecum have been reported in literature. Here, we are presenting a rare case of intestinal submucosal lipomatosis with coincidence of epidermal inclusion cyst of caecum and presumptively diagnosed as carcinoma of ileocaecal region during surgery in a 55 years old male. Both are rare entity considering the location even they should be kept as a differential diagnosis in unusual cases of intestinal perforations with inconclusive radiological findings or clinical uncertainity.

  17. Uncommon Presentation of Isolated Jejunal Lymphoma Masquerading as Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Swati Sattavan

    2016-01-01

    Full Text Available Primary gastrointestinal lymphoma is a rare entity, commonly involving stomach, small bowel, and colorectum. The usual location for small bowel B cell lymphoma is distal ileum due to abundant lymphoid tissue. We are reporting the case of a 53-year-old lady presumptively diagnosed as Crohn’s disease on clinical and radiological grounds but histopathologically proven to be an unusual variant of isolated primary non-Hodgkin’s lymphoma.

  18. CHROMOBLASTOMYCOSIS MASQUERADING AS DERMATOPHYTOSIS, WITH THE DESCRIPTION OF A NEW OPPORTUNISTIC SPECIES.

    Science.gov (United States)

    Kampirapap, Kowit; Reangchainam, Sutthirat; Ornpaew, Pornpit; Tresukosol, Poohglin

    2015-01-01

    An unusual case of chromoblastomycosis is reported, it resembled dermatophytosis, tinea faciei due to the presence of a well-demarcated scaly ery- thematous patch on the face. The patient was a 63-year-old farmer from central Thailand, who had the skin lesion for 10 years. Mycological and histopathologi- cal investigations of scales and skin biopsy specimen revealed a granulomatous infiltrate with sclerotic bodies, the hallmark of chromoblastomycosis. The infec- tion showed only localized superficial expansion with a scaly patch suggesting a new clinical type of the disease. The causative organism was identified by DNA sequencing as Rhinocladiella phaeophora. R.phaeophora originally was a saprophytic dematiaceous fungus recovered from maize field soil from Colombia. The case was unusual in its clinical presentation and this is the first case of chromoblastomycosis reported to be caused by a new opportunistic species of the genus Rhinocladiella. The disease was not responsive to itraconazole, but was later treated successfully with terbinafine.

  19. Pyoderma Gangrenosum Masquerading as Necrotizing Fasciitis: Stepping Away from Cognitive Shortcuts

    Directory of Open Access Journals (Sweden)

    Rachael Hilton

    2017-07-01

    Full Text Available A patient with post-Cesarean wound complication was treated for necrotizing fasciitis (NF with sharp debridement and broad-spectrum antibiotics. Several operations and three weeks later, her abdominal skin, subcutaneous fat, right-sided rectus abdominus, and underlying fascia had been removed without any improvement in granulation tissue. Original pathology samples demonstrated sheets of necrosis consistent with NF, but were re-reviewed by a dermatopathologist who diagnosed the patient with pyoderma gangrenosum (PG. She was started on high-dose steroids and dapsone, and her wound quickly showed signs of improvement. Anchor bias delayed the initiation of steroids and diagnosis of PG as the surgical, medical, and consulting teams were hesitant to stray from the diagnosis of NF.

  20. Squamous cell carcinoma of the finger masquerading as an abscess. Case report.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    A 43-year-old man presented with an abscess on his left ring finger, which recurred despite multiple drainage procedures. Histological examination of the lesion was unhelpful; it was only on histopathological examination of the finger after ray amputation that the diagnosis of cutaneous squamous cell carcinoma was established. This case illustrates the need to consider malignancy when dealing with chronic finger infections.

  1. Clinical Presentation of Inadvertent Intrathecal Vincristine Masquerading Guillain-Barre Syndrome.

    Science.gov (United States)

    Saha, Agni Sekhar; Islam, Md Fekarul; Bhattacharya, Sukanta; Giri, Prabhas Prasun

    2016-06-01

    Vincristine, a potent chemotherapeutic agent, is highly neurotoxic. If given intrathecally by accident it is almost always fatal. We are reporting a 6 year old girl with acute lymphoblastic leukaemia in complete remission, who was given inadvertent intrathecal Vincristine instead of Methotrexate. She developed gradually progressive quadriplegia and respiratory paralysis requiring prolonged mechanical ventilation, initially mimicking Guillain-Barre Syndrome, both clinically and electro-physiologically. She also developed progressive encephalopathy. The clinical deterioration subsequently plateaued without any significant improvement and after more than 5 months, she finally expired.

  2. GIANT SPLENIC ARTERY PSEUDO ANEURYSM MASQUERADING AS BLEEDING PER RECTUM - A RARE CASE

    Directory of Open Access Journals (Sweden)

    Bhupesh

    2013-10-01

    Full Text Available ABSTRACT: Splenic artery aneurysm are rare entity, we report a c ase of 40 year old male presenting with hypovolemic shock and massive bleeding per rectum secondary to spleenic artery aneurysm rupture into the colon. Patient underwent exploratory laparotomy and definitive procedure was done KEY WORDS: Splenic artery an eurysm 1: shock 2 : bleeding per rectum 3: chronic pancreatitis;

  3. Schwannoma of the vagus nerve masquerading as a carotid body tumor.

    Science.gov (United States)

    Schupp, Daniela J; Mukherjee, Dipankar; Sharma, Gopesh K

    2009-01-01

    A 45-year-old male presented with increasing hoarseness and swelling of his right neck over 5 months. He was noted to have right vocal cord paralysis and hemiatrophy of his tongue. He was found to have a schwannoma of the vagus nerve with compression of the right hypoglossal nerve. One month after his surgery, the patient's tongue mobility was improving, he was not aspirating, his voice was better and his right vocal cord remained abducted. A discussion of this case is followed by a review of the literature surrounding this rare disease and this unique presentation.

  4. Myoglobinuria masquerading as acute rejection in a renal allograft recipient with recurrent post transplant diabetic nephropathy.

    Science.gov (United States)

    Gupta, Pallav; Sharma, Amit; Khullar, Dinesh

    2014-08-01

    Rhabdomyolysis contributes to 7-10% of total AKI cases. Myoglobinuria as a cause of acute renal allograft dysfunction is extremely uncommon. Renal allograft recipient on cyclosporine or tacrolimus can develop myoglobinuria in presence of other precipitating factors. Present case describes an interesting report of myoglobinuria in a patient with post transplant diabetic nephropathy mimicking acute graft rejection. Clinically myoglobinuria presenting as renal allograft dysfunction is diagnosis of exclusion and renal biopsy is extremely important in making a correct diagnosis and planning optimal management in such cases.

  5. Pediatric Interstitial Lung Disease Masquerading as Difficult Asthma: Management Dilemmas for Rare Lung Disease in Children

    Directory of Open Access Journals (Sweden)

    EY Chan

    2005-01-01

    Full Text Available Idiopathic nontransplant-related childhood bronchiolitis obliterans is an uncommon disease. Most patients present with chronic recurrent dyspnea, cough and wheezing, which are also features of asthma, by far a much more common condition. The present case study reports on a six-year-old girl who presented to a tertiary care centre with recurrent episodes of respiratory distress on a background of baseline tachypnea, chronic hypoxemia and exertional dyspnea. Her past medical history revealed significant lung disease in infancy, including respiratory syncytial virus bronchiolitis and repaired gastroesophageal reflux. She was treated for 'asthma exacerbations' throughout her early childhood years. Bronchiolitis obliterans was subsequently diagnosed with an open lung biopsy. She did not have sustained improvement with systemic corticosteroids, hydroxychloroquine or clarithromycin. Cardiac catheterization confirmed the presence of secondary pulmonary hypertension. Treatment options remain a dilemma for this patient because there is no known effective treatment for this condition, and the natural history is not well understood. The present case demonstrates the need for careful workup in 'atypical asthma', and the urgent need for further research into the rare lung diseases of childhood.

  6. Subarachnoid hemorrhage with transient ischemic attack: Another masquerader in cerebral venous thrombosis

    Directory of Open Access Journals (Sweden)

    Bhawna Sharma

    2010-01-01

    Full Text Available Cerebral venous thrombosis has a wide spectrum of clinical manifestations that may mimic many other neurological disorders and lead to frequent misdiagnoses or delay in diagnosis. The most frequent symptoms and signs are headache, seizures, focal deficits, and papilledema. A number of rare atypical manifestations have been described. Cerebral venous thrombosis may present with an isolated intracranial hypertension type picture, thunderclap headache, attacks of migraine with aura, isolated psychiatric disturbances, pulsatile tinnitus, isolated or multiple cranial nerve involvement, and occasionally as subarachnoid hemorrhage (SAH or transient ischemic attack. Our patient presented with thunderclap headache and transient ischemic attack like episode with obvious SAH on CT scan. Acute SAH suggests the presence of a vascular lesion, such as ruptured aneurysm, and CVT is not generally considered in the diagnostic workup of SAH. The case emphasizes the importance of cerebral venous study in nonaneurysmal cases of SAH. It is important to have a high index of suspicion in such atypical cases to avoid delay in diagnosis.

  7. Optopharmacological control of TRPC channels by coumarin-caged lipids is associated with a phototoxic membrane effect.

    Science.gov (United States)

    Tiapko, Oleksandra; Bacsa, Bernadett; de la Cruz, Gema Guedes; Glasnov, Toma; Groschner, Klaus

    2016-08-01

    Photouncaging of second messengers has been successfully employed to gain mechanistic insight of cellular signaling pathways. One of the most enigmatic processes of ion channel regulation is lipid recognition and lipid-gating of TRPC channels, which represents pivotal mechanisms of cellular Ca(2+) homeostasis. Recently, optopharmacological tools including caged lipid mediators became available, enabling an unprecedented level of temporal and spatial control of the activating lipid species within a cellular environment. Here we tested a commonly used caged ligand approach for suitability to investigate TRPC signaling at the level of membrane conductance and cellular Ca(2+) handling. We report a specific photouncaging artifact that is triggered by the cage structure coumarin at UV illumination. Electrophysiological characterization identified a light-dependent membrane effect of coumarin. UV light (340 nm) as used for photouncaging, initiated a membrane conductance specifically in the presence of coumarin as low as 30 μmol L(-1) concentrations. This conductance masked the TRPC3 conductance evoked by photouncaging, while TRPC-mediated cellular Ca(2+) responses were largely preserved. The observed light-induced membrane effects of the released caging moiety may well interfere with certain cellular functions, and prompt caution in using coumarin-caged second messengers in cellular studies.

  8. Integrated dataset of impact of dissolved organic matter on particle behavior and phototoxicity of titanium dioxide nanoparticles

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset is generated to both qualitatively and quantitatively examine the interactions between nano-TiO2 and natural organic matter (NOM). This integrated...

  9. Mitigating phototoxicity during multiphoton microscopy of live Drosophila embryos in the 1.0-1.2 µm wavelength range.

    Directory of Open Access Journals (Sweden)

    Delphine Débarre

    Full Text Available Light-induced toxicity is a fundamental bottleneck in microscopic imaging of live embryos. In this article, after a review of photodamage mechanisms in cells and tissues, we assess photo-perturbation under illumination conditions relevant for point-scanning multiphoton imaging of live Drosophila embryos. We use third-harmonic generation (THG imaging of developmental processes in embryos excited by pulsed near-infrared light in the 1.0-1.2 µm range. We study the influence of imaging rate, wavelength, and pulse duration on the short-term and long-term perturbation of development and define criteria for safe imaging. We show that under illumination conditions typical for multiphoton imaging, photodamage in this system arises through 2- and/or 3-photon absorption processes and in a cumulative manner. Based on this analysis, we derive general guidelines for improving the signal-to-damage ratio in two-photon (2PEF/SHG or THG imaging by adjusting the pulse duration and/or the imaging rate. Finally, we report label-free time-lapse 3D THG imaging of gastrulating Drosophila embryos with sampling appropriate for the visualisation of morphogenetic movements in wild-type and mutant embryos, and long-term multiharmonic (THG-SHG imaging of development until hatching.

  10. Environmental aging alters AI(OH)3 coating of TiO2 nanoparticles enhancing their photocatalytic and phototoxicity activities

    Science.gov (United States)

    It is important to evaluate the potential effects of engineered nanomaterials (ENM) across the lifecycle of nanomaterial-enabled products including transformations in the environment that mayeither gain or lose functional properties. For example, uncoated titanium dioxide (Ti02)...

  11. Decreased Phototoxic Effects of TiO₂ Nanoparticles in Consortium of Bacterial Isolates from Domestic Waste Water

    Science.gov (United States)

    Mathur, Ankita; Kumari, Jyoti; Parashar, Abhinav; T., Lavanya; Chandrasekaran, N.; Mukherjee, Amitava

    2015-01-01

    This study is aimed to explore the toxicity of TiO2 nanoparticles at low concentrations (0.25, 0.50 & 1.00 μg/ml); on five bacterial isolates and their consortium in waste water medium both in dark and UVA conditions. To critically examine the toxic effects of nanoparticles and the response mechanism(s) offered by microbes, several aspects were monitored viz. cell viability, ROS generation, SOD activity, membrane permeability, EPS release and biofilm formation. A dose and time dependent loss in viability was observed for treated isolates and the consortium. At the highest dose, after 24h, oxidative stress was examined which conclusively showed more ROS generation & cell permeability and less SOD activity in single isolates as compared to the consortium. As a defense mechanism, EPS release was enhanced in case of the consortium against the single isolates, and was observed to be dose dependent. Similar results were noticed for biofilm formation, which substantially increased at highest dose of nanoparticle exposure. Concluding, the consortium showed more resistance against the toxic effects of the TiO2 nanoparticles compared to the individual isolates. PMID:26496250

  12. Environmental aging alters AI(OH)3 coating of TiO2 nanoparticles enhancing their photocatalytic and phototoxicity activities

    Science.gov (United States)

    It is important to evaluate the potential effects of engineered nanomaterials (ENM) across the lifecycle of nanomaterial-enabled products including transformations in the environment that mayeither gain or lose functional properties. For example, uncoated titanium dioxide (Ti02)...

  13. Potential phototoxicity of aged Al(OH)3-coated Ti02 nanoparticles in retinal pigment epithelial cells

    Science.gov (United States)

    Titanium dioxide (TiO2) nanoparticles (NPs) exposed to UVA radiation generate reactive oxygen species (ROS). As a component of sunscreen formulations, TiO2 NPs may be coated with Al(OH)3 to prevent ROS from causing oxidative damage to tissues. Simulated swimming pool water (SSPW)...

  14. An Evaluation of the Potential Phototoxicity of CeO2 Nanoparticles in Retinal Pigment Epithelial Cells in-vitro

    Science.gov (United States)

    Cerium dioxide (CeO2) engineered nanoparticles (NP) are used as fuel-borne catalysts in off-road diesel engines, which can lead to exhaust emissions of respirable CeO2 NP. Other metal oxides may act as photo-catalysts which induce the generation of free radicals upon exposure to ...

  15. Phototoxic effects of free phthalocyanine and phthalocyanine conjugated to gold nanoparticles for targeted photodynamic therapy of melanoma cancer

    Science.gov (United States)

    Manoto, Sello L.; Oluwole, David O.; Malabi, Rudzani; Maphanga, Charles; Ombinda-Lemboumba, Saturnin; Nyokong, Tebello; Mthunzi-Kufa, Patience

    2017-02-01

    Photodynamic therapy (PDT) has emerged as an effective treatment modality for various malignant neoplasia and diseases. In PDT, the photochemical interaction of photosensitizer (PS), light and molecular oxygen produces singlet oxygen which can lead to tumour cell apoptosis, necrosis or autophagy. The success of PDT is limited by the hydrophobic characteristic of the PS which hinders treatment administration and efficiency. To circumvent this limitation, PS can be incorporated in nanostructured drug delivery systems such as gold nanoparticles (AuNPs). In this study, we investigated the effectiveness of free zinc monocarboxyphenoxy phthalocyanine (ZnMCPPc) and ZnMCPPc conjugated to AuNPs. Commercially purchased melanoma cancer cells cultured as cell monolayers were used in this study. Changes in cellular response were evaluated using cellular morphology, viability, proliferation and cytotoxicity. Untreated cells showed no changes in cellular morphology, proliferation and cytotoxicity. However, photoactivated free ZnMCPPc and ZnMCPPc conjugated to AuNPs showed changes in cellular morphology and a dose dependent decrease in cellular viability and proliferation as well as an increase in cell membrane. ZnMCPPc conjugated to AuNPs showed an improved efficiency in PDT as compared to free ZnMCPPc, which might be as a result of the vehicle effect of AuNPs. Both PSs used in this study were effective in inducing cell death with ZnMCPPc conjugated to AuNPs showing great potential as an effective PS for PDT.

  16. Phototoxicity of TiO2 Nanoparticles under Solar Radiation to Two Aquatic Species: Daphnia magna and Japanese Medaka

    Science.gov (United States)

    One target of development and application of TiO2 nanoparticles (nano-TiO2) is photochemical degredation of contaminants and photo-killing of microbes and fouling organisms. However, few ecotoxicological studies have focused on this aspect of nano-TiO2, specifically whether this ...

  17. Phototoxicity of TiO2 Nanoparticles under Solar Radiation to Two Aquatic Species: Daphnia magna and Japanese Medaka

    Science.gov (United States)

    One target of development and application of TiO2 nanoparticles (nano-TiO2) is photochemical degredation of contaminants and photo-killing of microbes and fouling organisms. However, few ecotoxicological studies have focused on this aspect of nano-TiO2, specifically whether this ...

  18. Experimental effects of sand-dust storm on tolerance index, percentage phototoxicity and chlorophyll a fluorescence of Vigna radiata L.

    Directory of Open Access Journals (Sweden)

    M. Alavi

    2015-03-01

    Full Text Available In arid and semi-arid parts of the world excessive mineral aerosol carried by air parcels is a common climatic incident with well-known environmental side effects. In this way, we studied the role of sand-dust accumulation on various aspects of productivity of Vigna radiata L. including dry mass (DM, chlorophyll (Chl a, b, Chlorophyll a fluorescence (effective quantum yield of PSII photochemistry (ФPSII, maximal quantum yield of PSII photochemistry (Fv/Fm and electron transport rate (ETR. V. radiata was exposed to a gradient of dust concentrations in a dust chamber (0.5 (T1, 1(T2 and 1.5 g/m3 (T3 simulated by a dust generator for a period of 60 days. Results of this experiment indicate that DM and Chl content of shoot are negatively correlated with the intensity of the dust exposure. Exposure of V. radiata to dust compared with the control was caused 5% (T1, 14% (T2 and 27% (T3 reduction in leaf DM (p≤0.05, ANOVA. Also, exposure to the dust induced a significant (p≤0.05 reduction in the Total Chl content in (T3 25%. Also, we showed that ФPSII, ETR and Fv/Fm were affected by increasing of the dust concentrations. Exposure to the dust resulted in a significant reduction in ETR of 15%, 22%, and 43%.

  19. Photobleaching and phototoxicity of KillerRed in tumor spheroids induced by continuous wave and pulsed laser illumination.

    Science.gov (United States)

    Kuznetsova, Daria S; Shirmanova, Marina V; Dudenkova, Varvara V; Subochev, Pavel V; Turchin, Ilya V; Zagaynova, Elena V; Lukyanov, Sergey A; Shakhov, Boris E; Kamensky, Vladislav A

    2015-11-01

    The purpose of this study was to evaluate photobleaching of the genetically encoded photosensitizer KillerRed in tumor spheroids upon pulsed and continuous wave (CW) laser irradiation and to analyze the mechanisms of cancer cell death after the treatment. We observed the light-dose dependent mechanism of KillerRed photobleaching over a wide range of fluence rates. Loss of fluorescence was limited to 80% at light doses of 150 J/cm(2) and more. Based on the bleaching curves, six PDT regimes were applied for irradiation using CW and pulsed regimes at a power density of 160 mW/cm(2) and light doses of 140 J/cm(2) , 170 J/cm(2) and 200 J/cm(2). Irradiation of KillerRed-expressing spheroids in the pulsed mode (pulse duration 15 ns, pulse repetition rate 10 Hz) induced predominantly apoptotic cell death, while in the case of CW mode the cancer cells underwent necrosis. In general, these results improve our understanding of photobleaching mechanisms in GFP-like proteins and show the importance of appropriate selection of treatment mode for PDT with KillerRed. Representative fluorescence image of two KillerRed-expressing spheroids before and immediately after CW irradiation.

  20. The PARP inhibitor PJ-34 sensitizes cells to UVA-induced phototoxicity by a PARP independent mechanism.

    Science.gov (United States)

    Lakatos, Petra; Hegedűs, Csaba; Salazar Ayestarán, Nerea; Juarranz, Ángeles; Kövér, Katalin E; Szabó, Éva; Virág, László

    2016-08-01

    A combination of a photosensitizer with light of matching wavelength is a common treatment modality in various diseases including psoriasis, atopic dermatitis and tumors. DNA damage and production of reactive oxygen intermediates may impact pathological cellular functions and viability. Here we set out to investigate the role of the nuclear DNA nick sensor enzyme poly(ADP-ribose) polymerase 1 in photochemical treatment (PCT)-induced tumor cell killing. We found that silencing PARP-1 or inhibition of its enzymatic activity with Veliparib had no significant effect on the viability of A431 cells exposed to 8-methoxypsoralen (8-MOP) and UVA (2.5J/cm(2)) indicating that PARP-1 is not likely to be a key player in either cell survival or cell death of PCT-exposed cells. Interestingly, however, another commonly used PARP inhibitor PJ-34 proved to be a photosensitizer with potency equal to 8-MOP. Irradiation of PJ-34 with UVA caused changes both in the UV absorption and in the 1H NMR spectra of the compound with the latter suggesting UVA-induced formation of tautomeric forms of the compound. Characterization of the photosensitizing effect revealed that PJ-34+UVA triggers overproduction of reactive oxygen species, induces DNA damage, activation of caspase 3 and caspase 8 and internucleosomal DNA fragmentation. Cell death in this model could not be prevented by antioxidants (ascorbic acid, trolox, glutathione, gallotannin or cell permeable superoxide dismutase or catalase) but could be suppressed by inhibitors of caspase-3 and -8. In conclusion, PJ-34 is a photosensitizer and PJ-34+UVA causes DNA damage and caspase-mediated cell death independently of PARP-1 inhibition.

  1. Inactivation of bacteria G(+)-S. aureus and G(-)-E. coli by phototoxic polythiophene incorporated in ZSM-5 zeolite.

    Science.gov (United States)

    Cík, Gabriel; Priesolová, Sona; Bujdáková, Helena; Sersen, Frantisek; Potheöová, Timea; Kristín, Jozef

    2006-06-01

    A new heterogeneous photocatalyst was prepared by oxidative polymerization of the thiophene with ferric chloride in the ZSM-5 zeolite type. The synthesized polythiophene absorbs radiation in the visible range of the electromagnetic spectrum and by illumination with visible light generates reactive oxygen species (ROS) in water medium. During illumination reactive hydroxyl radical was detected by the spin trapping EPR method. Efficiency of the photocatalyst was tested on the killing of Gram-positive bacteria Staphylococcus aureus and Gram negative bacteria Escherichia coli.

  2. Peripheral tuberculous lymphadenitis masquerading as metastatic gastric carcinoma on F 18 FDG dual time point PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Kon; Shin, Jeong Eun; Lee, Jai Hyuen [Dankook Univ. College of Medicine, Cheonan (Korea, Republic of)

    2012-12-15

    A 59 year old woman was hospitalized with weight loss, anorexia, and low grade fever for 2 weeks. she had under gone a total gastrectomy followed by adjuvant chemotherapy 10 years prior due to advanced gastric cancer to evaluate recurrence, fluorine 19 fluorodeoxyglucose (FDG) dual time point positron emission tomography/computed tomography (DTPP) was conducted with a gemini GXL 6 PET/CT system (Philips, Hamburg, Germany). FDG DTPP was performed twice, with an early scan 60 min after FDG injection and a delayed scan 150min after FDG injection. The early scan showed that multiple hypermetabolic lesions were located along left supraclavicular, mediastinal (1R, 2R, 3, 4R and 7) and left paraaortic (retroperitoneal) nodal stations. The delayed scan showed that all the above mentioned lesions revealed a more increased maximal standard uptake value (SUVmax) than was detected in the early scan. both scans did not show intrapulmonary lesion. For example, the left supraclavicular lymph node, 2R and retroperitoneal lymph node were observed with early and delayed SUV maxes of 4.5/7.6/3.6 and 6.7/7.7/3.6 and 6.7/10.7/4.4, respectively. Tom confirm diagnosis and establish a treatment plan, a mediastinoscopic biopsy of one of the mediastinal lymph nodes (4R) was subsequently performed and tuberculosis was ultimately diagnosed. Then, the patient started an antituberculosis treatment instead of antichemotherapy. A follow up FDG PET/CT performed 12 months later showed disappeared FDG uptake and significant decreased change of multiple peripheral tuberculous lymphadenitis. Whole body FDG PET/CT has widespread use in diagnosing and staging variable malignancies, and plays an important role in detection of gastric cancer recurrence. However, FDG is not cancer specific and some inflammatory diseases have shown higher FDG uptake on PET imaging. Infection, inflammation, and granulomatosis are also known to cause false positive FDG PET scans because activated inflammatory cells show avidity for FDG. So, for alternative measure differentiating malignancy from benign disease, early standard FDG PET/CT and delayed scan after early scan, namely FDG DTPP, has been introduced and often performed worldwide. FDG DTPP used the phenomenon that with time, FDG uptake in normal or benign tissues decreases. Although FDG DTPP has been not accepted routinely, the retention index inferred from FDG DTPP predicted patient prognosis in lung cancer. We had considered multiple hypermetabolic lymph nodes as metastasis rather than benign lymphadenopathies because of increased FDG uptake on the delayed scan versus the early scan, before pathologic results were confirmed. It is presumed that FDG DTPP could not help differentiate malignancy from benign diseases in cases of active infectious disease such as ongoing tuberculosis. Peripheral tuberculous lymphadenitis (PTL) is a common manifestation of extrapulmonary tuberculosis and remains an important cause of adenopathy globally. It was difficult for those lesions to be directly considered as PTL, because PTL manifestation mainly involves cervical chains and the supraclavicular region.

  3. Exoplanet detection. Comment on "Stellar activity masquerading as planets in the habitable zone of the M dwarf Gliese 581".

    Science.gov (United States)

    Anglada-Escudé, Guillem; Tuomi, Mikko

    2015-03-01

    Robertson et al. (Reports, 25 July 2014, p. 440) claimed that activity-induced variability is responsible for the Doppler signal of the proposed planet candidate GJ 581d. We point out that their analysis using periodograms of residual data is inappropriate and promotes inadequate tools. Because the claim challenges the viability of the method to detect exo-Earths, we encourage reanalysis and a deliberation on what the field-standard methods should be.

  4. Amyand's hernia masquerading inguinal abscess complicated with appendico-cutaeneous fistula in an infant with Hirschsprung's disease

    Directory of Open Access Journals (Sweden)

    Ruzaimie Noor

    2017-06-01

    Full Text Available A normal or diseased vermiform appendix located inside the inguinal hernia is called Amyand's hernia (AH. The incidence of appendicitis in Amyand's hernia is rare. The appendicitis per se is uncommon disease in infancy. We reported an extremely rare case of undiagnosed right Amyand's hernia mimicking inguinal abscess complicated with appendico-cutaneous fistula in total colonic Hirschsprung's Disease.

  5. Squamous cell carcinoma with osteoclast-like giant cells masquerading as pleomorphic sarcoma: A rare case report

    Directory of Open Access Journals (Sweden)

    Khushboo Dewan

    2015-01-01

    Full Text Available Squamous cell carcinoma (SCC with osteoclast-like giant cells (OLGCs is a rare entity known to occur in skin, breast, lung, and pharynx. Only a single case of SCC containing OLGC in larynx has been reported so far. We report a case of a 65-year-old male patient presenting with sudden onset respiratory distress, who was subjected to biopsy, which was reported as undifferentiated sarcoma which was endorsed on laryngectomy specimen, however, sections from cervical lymph nodes revealed deposits of SCC. Extensive resectioning revealed a single focus showing origin of poorly differentiated carcinoma from the overlying squamous epithelium. Hence in undifferentiated pleomorphic sarcoma, a thorough sectioning and careful search for SCC including immunohistochemical markers should be done to exclude the possibility of a poorly differentiated epithelial malignancy.

  6. Fatal Bacillus cereus endocarditis masquerading as an anthrax-like infection in a patient with acute lymphoblastic leukemia: case report.

    Science.gov (United States)

    Cone, Lawrence A; Dreisbach, Luke; Potts, Barbara E; Comess, Barbara E; Burleigh, William A

    2005-01-01

    A 38-year-old male farm worker with relapsing acute lymphoblastic leukemia spontaneously developed an ulcerating ulcer on his anterior thigh which was surrounded by a non-tender area of erythema. Bacillus cereus was isolated from the ulcer and blood, and the patient received intravenous penicillin and vancomycin for one week. When sensitivity studies were returned he was treated with gatifloxacin orally. After two weeks of combined antimicrobial therapy and negative blood cultures, the patient received combination chemotherapy with vincristine, prednisone, doxorubicin and cyclophosphamide. He was hospitalized a day after completing chemotherapy with neutropenic sepsis due to B. cereus. He received similar antimicrobial therapy as previously, but died three days later. At autopsy, the patient was found to have acute mitral valve endocarditis and bilateral brain abscesses. This was the first case of B. cereus endocarditis reported in a patient with acute lymphoblastic leukemia.

  7. Comment on "Stellar activity masquerading as planets in the habitable zone of the M dwarf Gliese 581"

    CERN Document Server

    Anglada-Escudé, Guillem

    2015-01-01

    Robertson et al.(Reports, July 25 2014, p440-444)(1) claimed that activity-induced variability is responsible for the Doppler signal of the proposed planet candidate GJ 581d. We point out that their analysis using periodograms of residual data is incorrect, further promoting inadequate tools. Since the claim challenges the viability of the method to detect exo-Earths, we urge for more appropriate analyses (see appendix).

  8. Chemotherapy versus surgery in primary B-cell lymphoma masquerading as Klatskin tumor-a diagnostic and therapeutic dilemma.

    Science.gov (United States)

    Ghose, Abhimanyu; Sethi, Namrata; Li, Guiyuan; Chaudhary, Rekha

    2011-11-01

    Primary lymphoma in the region of the liver bed mimicking hilar cholangiocarcinoma or Klatskin tumor is very rare. A patient presented with obstructive jaundice along with right upper quadrant pain, weight loss, and decreased appetite. Apart from altered liver function, her lactate dehydrogenase was significantly elevated, and imaging studies showed prominent lesion close to the liver bed with localized lymphadenopathy. The diagnosis ultimately reached at by biopsy and immunohistochemical staining was diffuse large B-cell lymphoma. Such cases are very infrequent, but demand awareness. The sooner the diagnosis can be reached by minimally invasive procedures, the earlier chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone can be initiated and laparotomy can be avoided as chemotherapy is the mainstay of treatment, even in the presence of jaundice.

  9. Cervical sympathetic chain schwannoma masquerading as a carotid body tumour with a postoperative complication of first-bite syndrome.

    LENUS (Irish Health Repository)

    Casserly, Paula

    2012-01-31

    Carotid body tumours (CBT) are the most common tumours at the carotid bifurcation. Widening of the bifurcation is usually demonstrated on conventional angiography. This sign may also be produced by a schwannoma of the cervical sympathetic plexus. A 45-year-old patient presented with a neck mass. Investigations included contrast-enhanced CT, MRI and magnetic resonance arteriography with contrast enhancement. Radiologically, the mass was considered to be a CBT due to vascular enhancement and splaying of the internal and external carotid arteries. Intraoperatively, it was determined to be a cervical sympathetic chain schwannoma (CSCS). The patient had a postoperative complication of first-bite syndrome (FBS).Although rare, CSCS should be considered in the differential diagnosis for tumours at the carotid bifurcation. Damage to the sympathetic innervation to the parotid gland can result in severe postoperative pain characterised by FBS and should be considered in all patients undergoing surgery involving the parapharyngeal space.

  10. Hepatocellular carcinoma masquerading as a bleeding gastric ulcer: A case report and a review of the surgical management

    Institute of Scientific and Technical Information of China (English)

    Johnny CA Ong; Pierce KH Chow; Weng-Hoong Chan; Alex YF Chung; Choon Hua Thng; Wai-Keong Wong

    2007-01-01

    Hepatocellular Carcinoma (HCC) is a common malignancy worldwide. While bleeding from the gastrointestinal tract (BGIT) has a well known association with HCC, such cases are mainly due to gastric and esophageal varices.BGIT as a result of invasion of the gastrointestinal tract by HCC is extremely rare and is reportedly associated with very poor prognosis. We describe a 67-year-old male who presented with BGIT. Endoscopy showed the site of bleeding to be from a gastric ulcer, but endoscopic therapy failed to control the bleeding and emergency surgery was required. At surgery, the ulcer was found to have arisen from direct invasion of the gastrointestinal tract by HCC of the left lobe. Control of the bleeding was achieved by surgical resection of the HCC enbloc with the lesser curve of the stomach. The patient remains alive 33 mo after surgery. Direct invasion of the gastrointestinal tract by HCC giving rise to BGIT is very uncommon. Surgical resection may offer significantly better survival over non-surgical therapy, especially if the patient is a good surgical candidate and has adequate functional liver reserves. Prognosis is not uniformly grave.

  11. Direct sampling of metastatic ovarian carcinoma masquerading as endocervical adenocarcinoma in liquid-based cytology cervical sample

    Science.gov (United States)

    Gupta, Nalini; Bhar, Vikrant; Dey, Pranab; Rajwanshi, Arvind; Suri, Vanita

    2014-01-01

    Cervical sample is routinely taken to identify squamous dysplastic lesions of the cervix. Glandular lesions are far less commonly reported on cervical samples. The most common glandular lesion reported on cervical smear is endocervical adenocarcinoma, followed by endometrial adenocarcinoma. Direct sampling by Cervex brush is possible even in endometrial adenocarcinoma, if the tumor directly involves lower uterine segment/endocervical canal. Metastases to cervix are rare but have occasionally been reported in previous reports. We wish to highlight in this case, metastatic ovarian carcinoma directly sampled in cervical liquid-based cytology (LBC) sample, which mimicked cytomorphologically a well-differentiated endocervical adenocarcinoma. To the best of our knowledge, a similar case has not been previously published in SurePath LBC sample. PMID:25538388

  12. Canal of Nuck cyst masquerading as a testicle in a neonate: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Lelah Grossman

    2016-11-01

    Full Text Available Canal of Nuck cysts/hydroceles are rare occurrences in females of all age groups. We describe a case of a female neonate presenting with a labial mass which sonographically resembled a testicle. Upon surgical exploration, it was found to be a hydrocele of the canal of Nuck. We also review the literature on canal of Nuck cysts/hydroceles in the pediatric age group.

  13. Masquerade, mimicry and crypsis of the polymorphic sea anemone Phyllodiscus semoni and its aggregations in South Sulawesi

    NARCIS (Netherlands)

    Hoeksema, B.; Crowther, A.L.

    2011-01-01

    Phyllodiscus semoni is a morphologically variable sea anemone species from the Indo-Pacific with morphotypes ranging from upright and branched to low-lying and rounded. The apparent camouflage strategies of this sea anemone allow it to resemble other species or objects in its environment, such as st

  14. Electromagnetic cascade masquerade: a way to mimic γ-axion-like particle mixing effects in blazar spectra

    Science.gov (United States)

    Dzhatdoev, T. A.; Khalikov, E. V.; Kircheva, A. P.; Lyukshin, A. A.

    2017-07-01

    Context. Most of the studies on extragalactic γ-ray propagation performed up to now only accounted for primary γ-ray absorption and adiabatic losses, known as the "absorption-only model". However, there is growing evidence that this model is oversimplified and must be modified in some way. In particular, it was found that the intensity extrapolated from the optically-thin energy range of some blazar spectra is insufficient to explain the optically-thick part of these spectra. This effect was interpreted as an indication for γ-axion-like particle (ALP) oscillation. On the other hand, there are many hints that a secondary component from electromagnetic cascades initiated by primary γ-rays or nuclei may be observed in the spectra of some blazars. Aims: We study the impact of electromagnetic cascades from primary γ-rays or protons on the physical interpretation of blazar spectra obtained with imaging Cherenkov telescopes. Methods: We used the publicly-available code ELMAG to compute observable spectra of electromagnetic cascades from primary γ-rays. For the case of primary proton, we developed a simple, fast and reasonably accurate hybrid method to calculate the observable spectrum. We performed the fitting of the observed spectral energy distributions (SEDs) with various physical models: the absorption-only model, the "electromagnetic cascade model" for the case of primary γ-rays, and several versions of the hadronic cascade model for the case of primary protons. We distinguish the following species of hadronic cascade models: 1) the "basic hadronic model", in which it is assumed that the proton beam travels undisturbed by the extragalactic magnetic field and that all observable γ-rays are produced by primary protons through photohadronic processes with subsequent development of electromagnetic cascades; 2) the "intermediate hadronic model", which is the same as the basic hadronic model, but the primary beam is terminated at some redshift zc; and 3) the "modified hadronic model" that includes the contribution from primary, redshifted and partially-absorbed, γ-rays. Results: Electromagnetic cascades show at least two very distinct regimes labelled by the energy of the primary γ-ray (E0): the one-generation regime for the case of E0 universal regime for E0 > 100 TeV and redshift to the source zs > 0.02. Spectral signatures of the observable spectrum for the case of the basic hadronic model, zs = 0.186 and low energy (E 200 GeV the spectrum is much harder for the case of the basic hadronic model. In the framework of the intermediate hadronic model, the observable spectrum depends only slightly on the primary proton energy, but it strongly depends on zc at E > 500 GeV. As a rule, both electromagnetic and hadronic cascade models provide acceptable fits to the observed SEDs. We show that the best-fit model intensity in the multi-TeV region of the spectrum in the framework of the electromagnetic cascade model is typically greater than the one for the case of the absorption-only model. Finally, for the case of blazar 1ES 0229+200 we provide strong constraints on the intermediate hadronic model, assuming models for the blazar emission and the magnetic field around the source.

  15. Advanced Machine Learning Techniques and Meta-Heuristic Optimization for the Detection of Masquerading Attacks in Social Networks

    OpenAIRE

    2015-01-01

    According to the report published by the online protection firm Iovation in 2012, cyber fraud ranged from 1 percent of the Internet transactions in North America Africa to a 7 percent in Africa, most of them involving credit card fraud, identity theft, and account takeover or h¼acking attempts. This kind of crime is still growing due to the advantages offered by a non face-to-face channel where a increasing number of unsuspecting victims divulges sensitive information. Interpol...

  16. Localized Langerhans cell histiocytosis masquerading as Brodie's abscess in a 2-year-old child: a case report

    Science.gov (United States)

    Chang, Wei-Fang; Hsu, Yi-Chih; Wu, Yi-Der; Kuo, Chun-Lang; Huang, Guo-Shu

    2016-01-01

    Langerhans cell histiocytosis (LCH), formerly known as histiocytosis X, refers to a spectrum of diseases characterized by idiopathic proliferation of histiocytes that produce either focal (localized LCH) or systemic manifestations (Hand-Schüller-Christian disease and Letterer-Siwe disease). Localized LCH accounts for approximately 60-70 % of all LCH cases. Osseous involvement is the most common manifestation and typically involves the flat bones, along with lesions of the skull, pelvis, and ribs. Localized LCH in bone shows a wide spectrum of clinical manifestations and radiologic features that may mimic those of infections as well as benign and malignant tumors. The diagnostic imaging findings of localized LCH are also diverse and challenging. The penumbra sign is a common and characteristic magnetic resonance imaging (MRI) feature of Brodie's abscess, but is rarely seen in localized LCH. In this report, we describe a case of localized LCH misdiagnosed as Brodie's abscess in a 2-year-old child based on clinical symptoms, laboratory findings, and pre-diagnostic MRI findings (penumbra sign). Therefore, the penumbra sign is not sufficient to clearly establish the diagnosis of Brodie's abscess, and the differential diagnosis of localized LCH should be considered when a child with an osteolytic lesion presents with a penumbra sign. PMID:27065773

  17. Adrenal tuberculosis masquerading as disseminated malignancy: A pitfall of (18)F-FDG PET/CT Imaging.

    Science.gov (United States)

    Gorla, A K R; Gupta, K; Sood, A; Biswal, C K; Bhansali, A; Mittal, B R

    2016-01-01

    Non-invasive characterization of adrenal lesions is a commonly encountered diagnostic challenge. Characteristic clinical and correlative imaging findings may assist in only arriving at a probable diagnosis. Currently, (18)F-FDG PET/CT is considered to provide the most comprehensive imaging information. We here present a case of bilateral adrenal tuberculosis that highlights the need for caution during the interpretation of (18)F-FDG PET/CT and also the need to suggest histopathological correlation. Copyright © 2016 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  18. Giant cell myocarditis masquerading as orbital myositis with a rapid, fulminant course necessitating mechanical support and heart transplantation.

    Science.gov (United States)

    Garg, Vinisha; Tan, Weiyi; Ardehali, Reza; Shah, Janki; Huynh, Tracy; Aksoy, Olcay

    2017-08-01

    Giant cell myocarditis (GCM), a rapidly progressive inflammation of the myocardium, is associated with fulminant heart failure, refractory ventricular arrhythmias, and conduction system abnormalities. Few case reports have noted orbital myositis as the initial clinical presentation. Our case demonstrates a unique presentation of GCM with only ocular symptoms, which unlike prior studies, rapidly progressed to heart failure, tachyarrhythmias, and conduction disease. Our case necessitated quick recognition and treatment with mechanical support making this the first known case of GCM with successful placement of biventricular assist devices and ultimately with heart transplantation. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

  19. Unusual Clinical Presentation of Cutaneous Angiosarcoma Masquerading as Eczema: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Nhat Q. Trinh

    2013-01-01

    Full Text Available An unusual case of cutaneous angiosarcoma clinically mimicking eczema is described. A 98-year-old Caucasian male presented with a 6-month history of a flesh-colored, subcutaneous nodule on his left forehead with contralateral facial erythema and scaling that had been previously diagnosed as eczema. Despite treatments with topical steroids and moisturizers, the condition did not resolve. At our clinic, excisional biopsy of the forehead lesion and scouting biopsies from the contralateral cheek were performed which revealed cutaneous angiosarcoma. The described case illustrates that dermatitis-like features should be considered as a rare clinical manifestation of cutaneous angiosarcoma. It also demonstrates that these lesions may respond well to radiotherapy as a single modality.

  20. Immunoglobulin-associated creatine kinase masquerading as macro-creatine kinase type 2 in a statin user.

    Science.gov (United States)

    Loh, Tze Ping; Ang, Yan Hoon; Neo, Siew Fong; Yin, Cecilia; Wong, Moh Sim; Leong, Sai Mun; Saw, Sharon; Sethi, Sunil K

    2012-01-01

    Macro-creatine kinase (CK) is a cause of falsely elevated CK. Macro-CK type 1 is immunoglobulin-associated CK; type 2 is polymeric mitochondrial-CK. An elderly asymptomatic lady had an elevated CK level after receiving statin therapy. Her CK gel electrophoresis analysis demonstrated coexisting macro-CK type 1 and type 2 patterns. Further analysis by immunofixation and mixing this patient's serum with CK control material revealed an IgG-associated macro-CK that mimicked the electrophoretic pattern of macro-CK type 2. This highly unusual discovery suggests the possibility of the misinterpretation of macro-CK type 1 as macro-CK type 2. Falsely elevated CK is still common despite modern laboratory instrumentation and should be investigated.