Abstract
Trichophyton mentagrophytes is a fungus that causes skin disease in humans and other animals worldwide. Studies on molecular biology and fluorescent labeling of the fungus are limited. Here, we applied mCherry for the first time in T. mentagrophytes to label the fungus and its organelles. We constructed four expression vectors of mCherry or mCherry fusions containing a variety of resistance markers and promoters, which were then integrated, together with two previous mCherry expression vectors, in T. mentagrophytes via Agrobacterium tumefaciens-mediated transformation (AtMT). The resulting transformants emitted bright red fluorescence. We used the histone protein H2B and the peroxisome targeting signal 1 (PTS1) peptide to target the nucleus and peroxisomes, respectively, in T. mentagrophytes. In the transformants expressing mCherry-fused H2B, the fluorescence was distinctly localized to the nuclei in hyphae, spores and the fungal cells in infected animal tissue. In the T. mentagrophytes transformants where the peroxisome was targeted, the mCherry was present as small dots (0.2–1 μm diameter) throughout the spores and the hyphae. We also constructed a T. mentagrophytes AtMT library containing more than 1,000 hygromycin-resistant transformants that were genetically stable. Our results provide useful tools for further investigations on molecular pathogenesis of T. mentagrophytes.Πέμπτη 22 Φεβρουαρίου 2018
Variations in the relative abundance of Wolbachia in the gut of Nasutitermes arborum across life stages and castes
Abstract
There are multiple forms of interactions between termites and bacteria. In addition to their gut microbiota, which has been intensively studied, termites host intracellular symbionts such as Wolbachia. These distinct symbioses have been so far approached independently and mostly in adult termites. We addressed the dynamics of Wolbachia and the microbiota of the eggs and gut for various life stages and castes of the wood-feeding termite, Nasutitermes arborum, using deep-sequencing of the 16S rRNA gene. Wolbachia was dominant in eggs as expected. Unexpectedly, it persisted in the gut of nearly all stages and castes, indicating a wide somatic distribution in termites. Wolbachia-related sequences clustered into few OTUs, but these were within the same genotype, acquired maternally. Wolbachia was largely dominant in DNA extracts from the guts of larvae and pre-soldiers (59.1% to 99.1% of reads) where gut-resident lineages were less represented and less diverse. The reverse was true for the adult castes. This is the first study reporting the age-dependency of the relative abundance of Wolbachia in the termite gut and its negative correlation with the diversity of the microbiota. The possible mechanisms underlying this negative interaction are discussed.A subset of patients with pemphigoid (herpes) gestationis has serological evidence of celiac disease
Abstract
Background
Pemphigoid (herpes) gestationis (PG) is an uncommon, self-limited disease with other autoimmune associations; however, celiac disease (CD) is not recognized as one.
Methods
From 71 patients' sera submitted for herpes gestationis factor (HGF) testing over a 5-year period, 12 were consistent with PG demonstrating HGF and increased IgG BP180 antibody levels; these sera were tested for IgA and IgG endomysial antibodies (EMA), epithelial basement membrane zone and cell surface antibodies by indirect immunofluorescence, and for IgA and IgG tissue transglutaminase (transglutaminase 2 or TG2) antibodies, IgA epidermal transglutaminase (transglutaminase 3 or TG3) antibodies, IgG BP230, and IgG desmoglein 1 and desmoglein 3 antibodies by enzyme-linked immunosorbent assays (ELISAs).
Results
Three of 12 patients' sera with PG (25%) had CD antibodies with positive IgA EMA and increased IgA TG2 antibody levels; two of these had positive IgG EMA, and one other had an increased IgA TG3 antibody level.
Conclusions
A subset of patients with serological findings of PG also has serological evidence of CD, which may have implications in the etiopathogenesis of PG and which reveals important information about the mother's, and possibly her infant's, health.
Adsorption and desorption of potentially toxic metals on modified biosorbents through new green grafting process
Abstract
Six lignocellulosic waste-derived biosorbents [cantaloupe peel (CAN), pine cone (PC), litchi fruit peel (LP), annona squamosal (AS), bamboo shoot (BS), and sugarcane bagasse (SB)] were selected as low-cost and renewable materials to prepare chemically modified biosorbent. The modified biosorbent was prepared through a newer carboxyl groups-grafting process onto the biosorbent's surface using acrylic acid. The results showed that the cation exchange capacity (CEC) of biosorbents increased by approximately 66.3–104% after modified. The modified biosorbent exhibited significantly higher adsorption capacity of Pb2+, Cu2+, and Cd2+ ions than the pristine biosorbent. The maximum Langmuir adsorption capacity (Qomax) of both pristine and modified biosorbents toward three metal ions (Pb2+, Cu2+, and Cd2+) followed the decreasing order: CAN > PC > LP > AS > BS > SB. The preference ranking of three metal ions on the pristine and modified biosorbents (mmol/kg) was generally in the order: Pb2+ > Cu2+ > Cd2+. Among these biosorbents, cantaloupe peel exhibited an excellent adsorption affinity to metal cations compared to the five others. The Qomax values of modified and pristine cantaloupe peels were ordered as follows: 143.2 and 81.1 mg/g for Pb2+ adsorption, > 45.4 and 30.4 mg/g for Cd2+ adsorption, > 33.1 and 23.5 mg/g for Cu2+ adsorption. After five adsorption–desorption cycles, the removal efficiency of Pb2+ by modified CAN was maintained at around 70%. The ion exchange played a determining role in adsorption mechanism. It can be concluded that modified cantaloupe peel can serve as a newer and promising biosorbent with a high adsorption capacity to various potentially toxic metals.
Performance of sorghum cultivars for biomass quality and biomethane yield grown in semi-arid area of Pakistan
Abstract
Biomass is a promising renewable energy source and its significance is escalating in the context of climate change and depletion of fossil foils. This study was conducted for two consecutive years 2016 and 2017, using five sorghum cultivars, i.e., JS-263, Jawar-2011, Hagari, JS-2002, and YS-2016, in order to determine the best cultivars in terms of dry matter yield, chemical composition, and biomethane yield grown under semi-arid conditions in Pakistan. The results revealed that sorghum cultivars responded differently in terms of growth, biomass yield, chemical composition, and methane yield. Cultivars Jawar-2011 produced maximum leaf area index, leaf area duration, crop growth rate, plant height, and leaves per plant, however, they were comparable with Sorghum-2016, whereas cultivar JS-2002 performed poorly among the tested cultivars. Similarly, cultivar Jawar-2011 produced maximum dry matter yield (16.37 t ha−1) similar to that of YS-2016, further cultivar JS-2002 performed poorly and gave lower dry matter yield (12.87 t ha−1). The maximum protein concentration (10.95), neutral detergent fibers (61.20), and lignin contents (5.55) found in Jawar-2011 were comparable with those in YS-2016, while the lowest neutral detergent fiber and lignin contents were found in JS-2002. Although JS-2002 produced the highest specific methane yield per kilogram of volatile solids, it was overcompensated by Jawar-2011 owing to higher dry matter yield per hectare. These results suggested that cultivar Jawar-2011 can be grown successfully in semi-arid conditions of Pakistan in order to get good biomass yield along with higher methane yield.
Antioxidant action and protective and reparative effects of lentinan on oxidative damage in HaCaT cells
Summary
Background
Lentinus edodes is one of the largest edible fungi. Lentinan, extracted from its fruiting body has clinically significant anticancer, antibacterial, antiviral, and anticoagulant effects; however, its preventive effects on skin oxidative damage are unclear.
Aims
We aimed to evaluate the in vitro antioxidation capability of lentinan and its protective and reparative effects on a model of cell oxidative damage.
Methods
We evaluated the in vitro antioxidant potential of lentinan by assessing its free-radical quenching ability using DPPH and ABTS and superoxide anions. Using the HaCaT cell line as the experimental system, we tested the protective and reparative effects of lentinan on a model of H2O2-induced cellular oxidative damage through assessment of cell survival rate, malondialdehyde (MDA) content, and superoxide dismutase (SOD) activity.
Results
Lentinan displayed high antioxidant potential: DDPH and ABTS quenching rates were above 60%; superoxide anions, approximately 18%. Furthermore, lentinan could dose-dependently prevent the reduction of activity in HaCaT cells by H2O2, reduce MDA formation, and increase SOD activity. Moreover, lentinan showed not only a protective effect against oxidative damage but also reparative effects to a certain extent, in HaCaT cells.
Conclusions
Our findings demonstrated the ability of lentinan to enhance cellular tolerance to oxidative damage, stress resistance, and to have protective and reparative effects on damaged cells. Therefore, with L. edodes as a source for antiaging substances, cosmetics with homology to foods have great potential clinical applications.
Seven novel COL7A1 mutations identified in patients with recessive dystrophic epidermolysis bullosa from Mexico
Summary
Recessive dystrophic epidermolysis bullosa (RDEB; OMIM #226600) is one of the most devastating subtypes of epidermolysis bullosa, a group of skin and mucous membrane blistering disorders often associated with extracutaneous manifestations. RDEB is caused by mutations in COL7A1, the gene encoding type VII collagen (C7), and to date over 700 different mutations in the 8835 nucleotides constituting the open reading frame or adjacent exon–intron boundaries of COL7A1 have been described. We used targeted next-generation sequencing to identify seven previously unreported mutations in a cohort of 17 Mexican patients who were diagnosed with RDEB based on clinical presentation and immunoepitope mapping. Our study expands the spectrum of mutations identified in this cohort, including those suitable for emerging therapies reliant on precise genotyping.
CD30-positive primary cutaneous anaplastic large cell lymphoma with coexistent pseudocarcinomatous hyperplasia
Summary
CD30-positive primary cutaneous anaplastic large cell lymphoma (C-ALCL) is an indolent type of cutaneous lymphoma with favourable clinical prognosis. Pseudocarcinomatous hyperplasia (PCH) is a rare benign epithelial condition that can resemble invasive squamous cell carcinoma both clinically and histopathologically. PCH predominantly occurs in CD30-positive lymphoproliferative disorders. We report a 75-year-old woman with PCH in a multifocal C-ALCL located on the scalp and right retroauricular area, which rapidly responded to treatment with psoralen ultraviolet A photochemotherapy. Comprehensive virological analyses for potential oncogenic viruses, including Epstein–Barr virus, human herpesvirus-8, human papillomaviruses, the recently discovered cutavirus and nine different human polyomaviruses, were negative.
Family environmental and dietary implications for low-level prenatal lead exposure in Wujiang City, China
Abstract
To explore the potential environmental and dietary factors during pregnancy affecting low-level prenatal lead exposure, we conducted a longitudinal study in Wujiang City, China. A total of 1976 mother-infant pairs were included from 2009 to 2010. An interviewed questionnaire was conducted and cord blood samples were collected. The geometric means of cord blood lead level was 30.3 μg/L (95% CI, 29.8–30.8) with 99.24% below 100 μg/L. Maternal age, passive smoking, and living in the countryside were significantly associated with cord blood lead concentrations. Multiple logistic models showed that some family environmental factors including using firewood and electricity as kitchen fuel were positively correlated with increased cord blood lead levels. Among dietary sources recorded in this study, meat consumption (> 3 times/week), fish consumption (1–3 times/week), vegetables consumption (> 1 times/day), and fruit intake (> 1 times/day) had inverse relationship with cord blood lead levels. In general, our findings may have important implications for family environmental and dietary direction during pregnancy to decrease prenatal lead exposure.
Effects of soil pyrene contamination on growth and phenolics in Norway spruce ( Picea abies ) are modified by elevated temperature and CO 2
Abstract
With the constant accumulation of polycyclic aromatic hydrocarbons (PAHs) in soil and increasing temperature and CO2 levels, plants will inevitably be exposed to combined stress. Studies on the effects of such combined stresses are needed to develop mitigation and adaptation measures. Here, we investigated the effects of soil pyrene contamination (50 mg kg−1) on growth and phenolics of 1-year-old Norway spruce seedlings from five different origins in Finland at elevated temperature (+ 2 °C) and CO2 (+ 360 ppm). Pyrene significantly decreased spruce height growth (0–48%), needle biomass (0–44%), stem biomass (0–43%), and total phenolic concentrations in needles (2–13%) and stems (1–19%) compared to control plants. Elevated temperature alone did not affect growth but led to lower concentrations of total phenolics in needles (5–29%) and stems (5–18%) in both soil treatments. By contrast, elevated CO2 led to higher needle biomass (0–39%) in pyrene-spiked soils and higher concentrations of stem phenolics (0–18%) in pyrene-spiked and control soils compared to ambient treatments. The decrease in height growth and phenolic concentrations caused by pyrene was greater at elevated temperature, while elevated CO2 only marginally modified the response. Seedlings from different origins showed different responses to the combined environmental stressors. The changes in growth and in the quantity and quality of phenolics in this study suggest that future climate changes will aggravate the negative influence of soil pyrene pollution on northern conifer forest ecosystems.
Revenue Increase following 2017 Multiple Procedures Payment Reduction Modification: Differential Impact on Neuroradiology--Report from an Academic Medical Center [PRACTICE PERSPECTIVES]
BACKGROUND AND PURPOSE:
The Centers for Medicare and Medicaid Services imposed a 25% professional component multiple procedure payment reduction for the professional component of advanced diagnostic imaging modalities in January 2012. In 2017, the Centers for Medicare and Medicaid Services rolled back the multiple procedure payment reduction to 5% for subsequent imaging. To evaluate the effect of this change, we analyzed 5 months of Centers for Medicare and Medicaid Services procedures at Johns Hopkins Medical Institution.
MATERIALS AND METHODS:We analyzed the procedure codes and reimbursement rate for studies performed between January 1 and May 31, 2017. Patients with Medicare insurance who had multiple diagnostic procedures in a day were selected. Per the Centers for Medicare and Medicaid Services guidelines, procedures with the highest price were considered fully reimbursed and subsequent studies were marked for differences between 25% (2013–2016) and 5% reduction (2017).
RESULTS:We included 8787 patients with 22,236 procedures (mean, 2.53 studies/day). CT, MR imaging, and ultrasound scans composed 75.9%, 21.5%, and 2.6% of all studies, with 61.2%, 54.9%, and 85.4% of the procedures of each technique subject to multiple procedure payment reduction, respectively. The projected reimbursement for these studies was $1,666,437, which translated to a $179,782 (12.1%) increase in revenue comparing 25%-versus-5% multiple procedure payment reduction rates for 5 months: $128,542 for CT, $47,802 for MR imaging, and $3439 for ultrasound. The annual overall prorated increase in revenue would be $431,476. The impact was maximal for neuroradiology.
CONCLUSIONS:With the recent favorable adjustment in multiple procedure payment reduction regulations, CT-heavy subspecialties like neuroradiology benefit the most with revenue increases. Different practice settings might experience revenue increases to a different extent, depending on the procedure and payer mix.
HARMless: Transient Cortical and Sulcal Hyperintensity on Gadolinium-Enhanced FLAIR after Elective Endovascular Coiling of Intracranial Aneurysms [INTERVENTIONAL]
BACKGROUND AND PURPOSE:
Cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR has been increasingly recognized after iodinated contrast medium exposure during angiographic procedures. The goal of this study was to assess the relationship of cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR against various variables in patients following elective endovascular treatment of intracranial aneurysms.
MATERIALS AND METHODS:We performed a retrospective review of 58 patients with 62 MR imaging studies performed within 72 hours following endovascular treatment of intracranial aneurysms. Patient demographics, aneurysm location, and vascular territory distribution of cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR were documented. Analysis of cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR with iodinated contrast medium volume, procedural duration, number of angiographic runs, and DWI lesions was performed.
RESULTS:Cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR was found in 32/62 (51.61%) post-endovascular treatment MR imaging studies, with complete resolution of findings in all patients on the available follow-up studies (27/27). Angiographic iodinated contrast medium injection and arterial anatomy matched the vascular distribution of cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR. No significant association was found between cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR with iodinated contrast medium volume (P = .56 value) and the presence of DWI lesions (P = .68). However, a significant association was found with procedural time (P = .001) and the number of angiographic runs (P = .019). No adverse clinical outcomes were documented.
CONCLUSIONS:Cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR is a transient observation in the arterial territory exposed to iodinated contrast medium during endovascular treatment of intracranial aneurysms. Cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR is significantly associated with procedural time, and the frequency of angiographic runs suggesting a potential technical influence on the breakdown of the BBB, but no reported adverse clinical outcome or association with both iodinated contrast medium volume and DWI lesions was found. Recognition of cortical and sulcal hyperintensity on gadolinium-enhanced FLAIR as a benign incidental finding is vital to avoid unnecessary investigation.
Quantification of Intracranial Aneurysm Volume Pulsation with 7T MRI [INTERVENTIONAL]
BACKGROUND AND PURPOSE:
Aneurysm volume pulsation is a potential predictor of intracranial aneurysm rupture. We evaluated whether 7T MR imaging can quantify aneurysm volume pulsation.
MATERIALS AND METHODS:In Stage I of the study, 10 unruptured aneurysms in 9 patients were studied using a high-resolution (0.6-mm, isotropic) 3D gradient-echo sequence with cardiac gating. Semiautomatic segmentation was used to measure aneurysm volume (in cubic millimeters) per cardiac phase. Aneurysm pulsation was defined as the relative increase in volume between the phase with the smallest volume and the phase with the largest volume. The accuracy and precision of the measured volume pulsations were addressed by digital phantom simulations and a repeat image analysis. In Stage II, the imaging protocol was optimized and 9 patients with 9 aneurysms were studied with and without administration of a contrast agent.
RESULTS:The mean aneurysm pulsation in Stage I was 8% ± 7% (range, 2%–27%), with a mean volume change of 15 ± 14 mm3 (range, 3–51 mm3). The mean difference in volume change for the repeat image analysis was 2 ± 6 mm3. The artifactual volume pulsations measured with the digital phantom simulations were of the same magnitude as the volume pulsations observed in the patient data, even after protocol optimization in Stage II.
CONCLUSIONS:Volume pulsation quantification with the current imaging protocol on 7T MR imaging is not accurate due to multiple imaging artifacts. Future studies should always include aneurysm-specific accuracy analysis.
An Automated Statistical Technique for Counting Distinct Multiple Sclerosis Lesions [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Lesion load is a common biomarker in multiple sclerosis, yet it has historically shown modest association with clinical outcome. Lesion count, which encapsulates the natural history of lesion formation and is thought to provide complementary information, is difficult to assess in patients with confluent (ie, spatially overlapping) lesions. We introduce a statistical technique for cross-sectionally counting pathologically distinct lesions.
MATERIALS AND METHODS:MR imaging was used to assess the probability of a lesion at each location. The texture of this map was quantified using a novel technique, and clusters resembling the center of a lesion were counted. Validity compared with a criterion standard count was demonstrated in 60 subjects observed longitudinally, and reliability was determined using 14 scans of a clinically stable subject acquired at 7 sites.
RESULTS:The proposed count and the criterion standard count were highly correlated (r = 0.97, P < .001) and not significantly different (t59 = –.83, P = .41), and the variability of the proposed count across repeat scans was equivalent to that of lesion load. After accounting for lesion load and age, lesion count was negatively associated (t58 = –2.73, P < .01) with the Expanded Disability Status Scale. Average lesion size had a higher association with the Expanded Disability Status Scale (r = 0.35, P < .01) than lesion load (r = 0.10, P = .44) or lesion count (r = –.12, P = .36) alone.
CONCLUSIONS:This study introduces a novel technique for counting pathologically distinct lesions using cross-sectional data and demonstrates its ability to recover obscured longitudinal information. The proposed count allows more accurate estimation of lesion size, which correlated more closely with disability scores than either lesion load or lesion count alone.
Sonographic Development of the Pericallosal Vascularization in the First and Early Second Trimester of Pregnancy [PEDIATRICS]
BACKGROUND AND PURPOSE:
Anomalies of the corpus callosum are rare. Routine scanning in midtrimester of the pregnancy often fails to identify defective development. The purpose of the study was to identify the pericallosal artery and all its main branching arteries during early gestation from the first trimester onward, to measure the length of the pericallosal artery during its development, and to establish a normal vascular map for each week of development.
MATERIALS AND METHODS:We performed a single-center prospective, longitudinal clinical study in 15 patients between 11 and 22 weeks of gestation. The origin and course of the different blood vessels were identified.
RESULTS:There was a linear association among gestational age, the biparietal diameter, and the length of the pericallosal artery. The curvature of the developing pericallosal artery increases linearly with the gestational age and biparietal diameter, and 4 variations of branching of the callosomarginal artery were observed.
CONCLUSIONS:The pericallosal artery and its branches can be identified and measured from 11 weeks on, and the pericallosal artery takes its characteristic course. A defective course or an abnormal biometry of the pericallosal artery could be an early sonographic marker of abnormal development of the corpus callosum.
Evaluation of the Sensitivity of Inhomogeneous Magnetization Transfer (ihMT) MRI for Multiple Sclerosis [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Inhomogeneous magnetization transfer is a new endogenous MR imaging contrast mechanism that has demonstrated high specificity for myelin. Here, we tested the hypothesis that inhomogeneous magnetization transfer is sensitive to pathology in a population of patients with relapsing-remitting MS in a way that both differs from and complements conventional magnetization transfer.
MATERIALS AND METHODS:Twenty-five patients with relapsing-remitting MS and 20 healthy volunteers were enrolled in a prospective MR imaging research study, whose protocol included anatomic imaging, standard magnetization transfer, and inhomogeneous magnetization transfer imaging. Magnetization transfer and inhomogeneous magnetization transfer ratios measured in normal-appearing brain tissue and in MS lesions of patients were compared with values measured in control subjects. The potential association of inhomogeneous magnetization transfer ratio variations with the clinical scores (Expanded Disability Status Scale) of patients was further evaluated.
RESULTS:The magnetization transfer ratio and inhomogeneous magnetization transfer ratio measured in the thalami and frontal, occipital, and temporal WM of patients with MS were lower compared with those of controls (P < .05). The mean inhomogeneous magnetization transfer ratio measured in lesions was lower than that in normal-appearing WM (P < .05). Significant (P < .05) negative correlations were found between the clinical scores and inhomogeneous magnetization transfer ratio measured in normal-appearing WM structures. Weaker nonsignificant correlation trends were found for the magnetization transfer ratio.
CONCLUSIONS:The sensitivity of the inhomogeneous magnetization transfer technique for MS was highlighted by the reduction in the inhomogeneous magnetization transfer ratio in MS lesions and in normal-appearing WM of patients compared with controls. Stronger correlations with the Expanded Disability Status Scale score were obtained with the inhomogeneous magnetization transfer ratio compared with the standard magnetization transfer ratio, which may be explained by the higher specificity of inhomogeneous magnetization transfer for myelin.
Brain Injury Lesion Imaging Using Preconditioned Quantitative Susceptibility Mapping without Skull Stripping [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Identifying cerebral microhemorrhage burden can aid in the diagnosis and management of traumatic brain injury, stroke, hypertension, and cerebral amyloid angiopathy. MR imaging susceptibility-based methods are more sensitive than CT for detecting cerebral microhemorrhage, but methods other than quantitative susceptibility mapping provide results that vary with field strength and TE, require additional phase maps to distinguish blood from calcification, and depict cerebral microhemorrhages as bloom artifacts. Quantitative susceptibility mapping provides universal quantification of tissue magnetic property without these constraints but traditionally requires a mask generated by skull-stripping, which can pose challenges at tissue interphases. We evaluated the preconditioned quantitative susceptibility mapping MR imaging method, which does not require skull-stripping, for improved depiction of brain parenchyma and pathology.
MATERIALS AND METHODS:Fifty-six subjects underwent brain MR imaging with a 3D multiecho gradient recalled echo acquisition. Mask-based quantitative susceptibility mapping images were created using a commonly used mask-based quantitative susceptibility mapping method, and preconditioned quantitative susceptibility images were made using precondition-based total field inversion. All images were reviewed by a neuroradiologist and a radiology resident.
RESULTS:Ten subjects (18%), all with traumatic brain injury, demonstrated blood products on 3D gradient recalled echo imaging. All lesions were visible on preconditioned quantitative susceptibility mapping, while 6 were not visible on mask-based quantitative susceptibility mapping. Thirty-one subjects (55%) demonstrated brain parenchyma and/or lesions that were visible on preconditioned quantitative susceptibility mapping but not on mask-based quantitative susceptibility mapping. Six subjects (11%) demonstrated pons artifacts on preconditioned quantitative susceptibility mapping and mask-based quantitative susceptibility mapping; they were worse on preconditioned quantitative susceptibility mapping.
CONCLUSIONS:Preconditioned quantitative susceptibility mapping MR imaging can bring the benefits of quantitative susceptibility mapping imaging to clinical practice without the limitations of mask-based quantitative susceptibility mapping, especially for evaluating cerebral microhemorrhage–associated pathologies, such as traumatic brain injury.
Intraoperative Conebeam CT for Assessment of Intracochlear Positioning of Electrode Arrays in Adult Recipients of Cochlear Implants [HEAD & NECK]
BACKGROUND AND PURPOSE:
Intraoperative conebeam CT has been introduced into the operating room and provides quick radiologic feedback. This study aimed to investigate its utility in the assessment of the positioning of the electrode array after cochlear implantation.
MATERIALS AND METHODS:This was a retrospective study of 51 patients (65 ears) with intraoperative imaging by conebeam CT (O-arm) after cochlear implantation between 2013 and 2017. Correct placement into the cochlea was immediately identified. Positioning assessments were later analyzed with OsiriX software.
RESULTS:Intraoperative imaging was quickly performed in all cases. No misplacement into the vestibule or semicircular canals was found. A foldover of the implanted array was identified in 1 patient. Secondary analysis by 2 raters showed excellent agreement on insertion depth angle (intraclass correlation = 0.96, P < .001) and length of insertion of the electrode array (intraclass correlation coefficient = 0.93, P = .04) measurements. The evaluation of the number of extracochlear electrodes was identical between the 2 raters in 78% of cases (Cohen = 0.55, P < .001). The scalar position was inconsistent between raters. When we compared O-arm and high-resolution CT images in 14 cases, the agreement was excellent for insertion depth angle (intraclass correlation coefficient = 0.97, P < .001) and insertion length (intraclass correlation coefficient = 0.98, P < .001), good for the number of extracochlear electrodes (Cohen = 0.63, P = .01), but moderate for the scalar position (Cohen = 0.59, P = .02).
CONCLUSIONS:Intraoperative conebeam CT using the O-arm is a safe, rapid, easy, and reliable procedure to immediately identify a misplacement or foldover of an electrode array. The insertion depth angle, insertion length, and number of electrodes inserted can be accurately assessed.
Clinical significance of neutrophil gelatinase-associated lipocalin and galectin-7 in tape-stripped stratum corneum of acne vulgaris
Abstract
The usefulness of stratum corneum neutrophil gelatinase-associated lipocalin and stratum corneum galectin-7 as biomarkers of acne vulgaris was studied. A comparison of neutrophil gelatinase-associated lipocalin levels on the cheeks of patients with acne vulgaris at the start of the study and at the time of symptom improvement showed a significant decrease. On the other hand, the galectin-7 levels at the time of symptom improvement were significantly higher than those at the start of the study. Therefore, because the inflammation in the epidermis and hair follicles was reduced after therapy, as a result of the solution of the inflammatory eruptions caused by acne vulgaris, the neutrophil gelatinase-associated lipocalin level also showed a significant decrease after therapy. These results suggest that stratum corneum neutrophil gelatinase-associated lipocalin may be useful as an objective biomarker of changes in acne vulgaris symptoms.
Primary cutaneous aspergillosis caused by Aspergillus tamarii in a premature infant with extremely low birthweight: A case report with short review
Abstract
Primary cutaneous aspergillosis is a rare, life-threatening fungal infection in premature infants. We report a case of primary cutaneous aspergillosis caused by Aspergillus tamarii in an extremely low birthweight infant. The infant was delivered by cesarean section with complications from an intrauterine infection, brain intraventricular hemorrhage, tension pneumothorax and cardiac tamponade. On the 12th day of life, he developed erythematous maceration with erosion on his back. Septate hyphae were detected on two occasions from specimens of the skin lesion. The manifestations of the colony and slide culture showed the characteristics of A. tamarii. The nucleotide sequences of internal transcribed spacer regions of the ribosomal RNA gene, partial sequences of β-tubulin and calmodulin gene were compatible with those of A. tamarii. Of the known Aspergillus species, Aspergillus fumigatus and Aspergillus flavus have been reported in previous studies as the major causative agents in primary cutaneous aspergillosis, whereas human infection by A. tamarii is rare. We consider that A. tamarii is important as an unusual opportunistic human pathogen among premature infants.
Investigating the scavenging of reactive oxygen species by antioxidants via theoretical and experimental methods
Publication date: March 2018
Source:Journal of Photochemistry and Photobiology B: Biology, Volume 180
Author(s): Hifza Jabeen, Samia Saleemi, Humaira Razzaq, Azra Yaqub, Saira Shakoor, Rumana Qureshi
Reactive oxygen (hydroxyl OH, hydroperoxyl OOH) species are highly unstable to be studied experimentally under normal conditions. The present study reports the antioxidant potential of the vitamins namely ascorbic acid, riboflavin and nicotinic acid against these reactive oxygen species (ROS) using the predictive power of Density Functional Theory (DFT) (B3LYP with 6311G basis set) calculations. The order of reactivity of aforementioned vitamins was assessed by determining the bond dissociation enthalpy (BDE) of the OH bond, which is the controlling factor, if hydrogen atom transfer (HAT) mechanism is considered. Transition state calculations were also carried out to determine the reaction barrier for the radical scavenging reaction of vitamins by calculating the forward and the backward activation energies using the same level of theory as mentioned above.The theoretical methodology was first validated by taking a model stable free radical, 2, 2-diphenyl-1, picrylhydrazyl radical (DPPH) and applying the proposed approach followed by the experimental studies using UV–visible spectroscopy and cyclic voltammetry. The close agreement between the theoretical prediction and experimental observations proved the authenticity of theoretical approach.
Graphical abstract
Assessing associations between indoor environment and health symptoms in Romanian school children: an analysis of data from the SINPHONIE project
Abstract
School environment may have an impact on children's health, but few studies have focused on indoor comfort factors such as temperature, humidity, and noise in relation with potential effects on children's health. Our cross-sectional study used data from the European Schools Indoor Pollution and Health Observatory Network in Europe (SINPHONIE) project to assess children's allergy, asthma-like symptoms, and flu-like symptoms in relation with classroom comfort and environmental factors. The study used self-reported data from three questionnaires to identify classroom conditions and student health outcomes for 280 students. We used backwards variable selection and unconditional logistic regression to assess the outcome-environment relationship while controlling for demographics, family history of allergy, and home exposures. We found increased risks for allergy and flu-like symptoms associated with hot classrooms in the heating season, increased risks for asthma-like symptoms associated with noisy classrooms, and a protective effect for allergy associated with good outdoor air quality. Romanian classrooms rely on natural ventilation, which may contribute to increased temperature and humidity in the heating season. Further research warrants the use of SINPHONIE's measurement data to validate our findings.
A prospective randomised comparison of fixation methods in Tamai's zone I amputation
The treatment of choice for fingertip amputation is replantation to restore function and aesthetics. The purpose of this study was to compare the success rates and salvage periods between patients with Tamai's zone I amputation injuries treated with bony fixation and suture fixation.
Neo-adjuvant radiotherapy (NART) in breast reconstruction – the future for autologous reconstruction in locally advanced disease?
Several studies have shown the advantage of immediate autologous breast reconstruction (IBR) over delayed reconstruction with better quality of life, psychological wellbeing and aesthetic outcomes1. Oncological safety of IBR has been confirmed with several studies showing that IBR does not adversely affect disease-free or overall survival and does not significantly delay the diagnosis of recurrent disease
Foot reconstruction using a free proximal peroneal artery perforator flap: anatomical study and clinical application
When a small, thin and durable flap is required for coverage of the foot, the proximal peroneal artery perforator (PPAP) free flap may be novel option. However, few clinical results and anatomical studies on the PPAP flap have been published.
Pregnancy Outcomes in Patients with Vitiligo: A Nationwide Population-based Cohort Study from Korea
Vitiligo is a chronic autoimmune skin disorder affecting 1% of populations worldwide. Few large-scale studies have explored adverse pregnancy outcomes in patients with vitiligo.
Interleukin-17, Inflammation, and Cardiovascular Risk in Patients With Psoriasis
In addition to being recognized as a chronic inflammatory disease that manifests in the skin, psoriasis is increasingly understood to be a systemic disease that causes immune dysregulation throughout the body. The systemic nature of psoriasis is evidenced by the higher burden of comorbidities and shorter life expectancies of patients with psoriasis, particularly those with early onset and severe disease. Notably, psoriasis is associated with an increased risk for cardiovascular disease, which is the most common cause of morbidity and mortality in patients with psoriasis.
A Spectrum Including Features of Psoriasis and Pityriasis Rubra Pilaris
Heterozygous mutations in CARD14 have been shown to be associated with psoriasis and familial pityriasis rubra pilaris (PRP). Many patients with CARD14 mutations display features of both disorders, which can result in diagnostic uncertainty. In addition, these eruptions are often recalcitrant to conventional psoriasis therapies such as methotrexate, oral retinoids and TNF-α inhibitors.
Cosmetic Augmentation of the Nasal Tip and Nasal Dorsum With ePTFE
This randomized clinical trial investigates whether attaching the conchal cartilage as shield grafts at the distal end of the graft can prevent extrusion and whether the use of ePTFE in the nasal tip can achieve a stable aesthetic outcome.
Nasal Tip Rotation Outcome With the New Domes Technique in Rhinoplasty
This analytic cohort study assesses whether the definitive outcome of the rotation angle of the nasal tip in patients undergoing primary rhinoplasty can be determined with the new domes technique.
Study on transport and transformation of contaminant through layered soil with large deformation
Abstract
Based on large-deformation consolidation theory and the advection-dispersion equation of contaminant in saturated porous media, a one-dimensional theoretical model for coupled large-deformation and solute transport through layered finite soil is presented. This model comprehensively takes the effect of soil weight, sorption, and biodegradation into account. Model validation and applications are achieved through case studies of double-layered finite soil, with the transport and transformation process of contaminant being reproduced numerically. It is found that the breakthrough time of contaminant obtained from the linear adsorption solution is greater than the case of the non-linear adsorption solution, which can provide a reference for the design of landfill liner. Simulation results also indicate that relevant factors affect the transport of contaminant in layered soil interdependently; comprehensive study is required to assess the capacity of natural clay barrier for contaminant transportation.
Mitigation measures to avert the impacts of plastics and microplastics in the marine environment (a review)
Abstract
The increasing demand for and reliance on plastics as an everyday item, and rapid rise in their production and subsequent indiscriminate disposal, rise in human population and industrial growth, have made the material an important environmental concern and focus of interest of many research. Historically, plastic production has increased tremendously to over 250 million tonnes by 2009 with an annual increased rate of 9%. In 2015, the global consumption of plastic materials was reported to be > 300 million tonnes and is expected to surge exponentially. Because plastic polymers are ubiquitous, highly resistant to degradation, the influx of these persistent, complex materials is a risk to human and environmental health. Because microplastics are principally generated from the weathering or breakdown of larger plastics (macroplastics), it is noteworthy and expedient to discuss in detail, expatiate, and tackle this main source. Macro- and microplastic pollution has been reported on a global scale from the poles to the equator. The major problem of concern is that they strangulate and are ingested by a number of aquatic biota especially the filter feeders, such as molluscs, mussels, oysters, from where it enters the food chain and consequently could lead to physical and toxicological effects on aquatic organisms and human being as final consumers. To this end, in order to minimise the negative impacts posed by plastic pollution (macro- and microplastics), a plethora of strategies have been developed at various levels to reduce and manage the plastic wastes. The objective of this paper is to review some published literature on management measures of plastic wastes to curb occurrence and incidents of large- and microplastics pollution in the marine environments.
Water planning in a mixed land use Mediterranean area: point-source abstraction and pollution scenarios by a numerical model of varying stream-aquifer regime
Abstract
Integrated hydrodynamic modelling is an efficient approach for making semi-quantitative scenarios reliable enough for groundwater management, provided that the numerical simulations are from a validated model. The model set-up, however, involves many inputs due to the complexity of both the hydrological system and the land use. The case study of a Mediterranean alluvial unconfined aquifer in the lower Var valley (Southern France) is useful to test a method to estimate lacking data on water abstraction by small farms in urban context. With this estimation of the undocumented pumping volumes, and after calibration of the exchange parameters of the stream-aquifer system with the help of a river model, the groundwater flow model shows a high goodness of fit with the measured potentiometric levels. The consistency between simulated results and real behaviour of the system, with regard to the observed effects of lowering weirs and previously published hydrochemistry data, confirms reliability of the groundwater flow model. On the other hand, accuracy of the transport model output may be influenced by many parameters, many of which are not derived from field measurements. In this case study, for which river-aquifer feeding is the main control, the partition coefficient between direct recharge and runoff does not show a significant effect on the transport model output, and therefore, uncertainty of the hydrological terms such as evapotranspiration and runoff is not a first-rank issue to the pollution propagation. The simulation of pollution scenarios with the model returns expected pessimistic outputs, with regard to hazard management. The model is now ready to be used in a decision support system by the local water supply managers.
The effect of skin surface topography and skin colouration cues on perception of male facial age, health, and attractiveness
Abstract
Objective
Previous studies investigating the effects of skin surface topography and colouration cues on perception of female faces reported a differential weighting for perception of skin topography and colour evenness, where topography was a stronger visual cue for perception of age, whereas skin colour evenness was a stronger visual cue for perception of health. We extend these findings in a study of the effect of skin surface topography and colour evenness cues on perceptions of facial age, health, and attractiveness in males.
Methods
Facial images of six men (aged 40 to 70 years), selected for co-expression of lines / wrinkles and discolouration, were manipulated digitally to create eight stimuli, namely, separate removal of these two features (a) on the forehead, (b) in the periorbital area, (c) on the cheeks and (d) across the entire face. Omnibus (within-face) pairwise combinations, including the original (unmodified) face, were presented to a total of 240 male and female judges, who selected the face they considered younger, healthier, and more attractive.
Results
Significant effects were detected for facial image choice, in response to skin feature manipulation. The combined removal of skin surface topography resulted in younger age perception compared with that seen with the removal of skin colouration cues, whereas the opposite pattern was found for health preference. No difference was detected for perception of attractiveness. These perceptual effects were seen particularly on the forehead and cheeks. Removing skin topography cues (but not discolouration) in the periorbital area resulted in higher preferences for all three attributes.
Conclusion
Skin surface topography and colouration cues affect perception of age, health, and attractiveness in men's faces. The combined removal of these features on the forehead, cheeks, and in the periorbital area results in the most positive assessments.
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Method development for determination of migrated phthalate acid esters from polyethylene terephthalate (PET) packaging into traditional Iranian drinking beverage (Doogh) samples: a novel approach of MSPE-GC/MS technique
Abstract
In the current study, a novel magnetic solid phase extraction (MSPE) technique combined with a gas chromatography/mass spectroscopy (GC/MS) was developed to determine the phthalate ester content of bottled Doogh samples. Doogh is a yogurt-based drinking beverage, which is frequently consumed in Middle East and Balkans. It is produced by stirring yogurt in Chern separation machine and consists of substances such as water, yogurt, and salt in addition to aqueous extracts of native herbs. The magnetic multi-walled carbon nanotubes (MWCNT-Fe3O4) were used as adsorbents of phthalate acid esters (PAEs) due to a superior adsorption capability of hydrophobic compounds. In this context, the quantity of the extractable migrated phthalate esters (dibutyl phthalate (DBP), dimethyl phthalate (DMP), butyl benzyl phthalate (BBP), diethyl phthalate (DEP), di-N-octyl phthalate (DNOP), and bis (2-ethylhexyl) phthalate (DEHP)) from polyethylene terephthalate (PET) bottles into Doogh samples was measured. The correlation between the concentration of migrated PAEs and some factors such as the type of Doogh (gaseous and without gas), difference in brand (five brands), volume (1500 and 300 mL), and the storage time also was investigated. The migration level into Doogh samples was increased by incorporating of gas as well as increasing the volume of PET bottles. Also, with elaborating of storage time, the migration of some phthalates such as DEHP (the mean from 2419.85 ng L−1 in the first week to 2716.15 ng L−1 in the second month), DEP, and total phthalate was increased. However, no significant difference in concentrations of migrated phthalate esters among different examined brands was noted. Finally, the concentration of migrated PAEs from bottle into all the examined Doogh samples was below the defined standards by EPA; 6 μg/L for DEHP in drinking water.
Graphical abstract
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Assessing changes in the toxicity of effluents from intensive marine fish farms over time by using a battery of bioassays
Abstract
Although intensive marine fish farming is often assumed to be eco-friendly, the associated activity can lead to chronic exposure of marine organisms to potentially toxic discharges. Moreover, despite the increasing popularity of integrated multi-trophic aquaculture (IMTA), studies of the effects of fish farm effluents are almost non-existent. In the present study, the changes in the toxic potential of effluents from five land-based marine fish farms in NW Spain subjected for different lengths of time to a biodegradation procedure (for 0, 48, 120, and 240 h) were assessed in a battery of bioassays including organisms from different trophic levels (Vibrio fischeri, Isochrysis galbana, and Paracentrotus lividus). The results of the bioassays at the different times were then considered together with farm water flow in the Potential Ecotoxic Effects Probe (PEEP) index. Despite the high volumes of effluents discharged, the generally low toxicity of the effluents hinders assessment of potentially toxic effects. However, dose–response curves and statistical analysis demonstrated the existence of toxic effects during the first five days of the biodegradation procedure, especially immediately after sampling. The proposed modification of the PEEP index better reflects the changes in toxicity over time.
Graphical abstract
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Spatial variation, source identification, and quality assessment of surface water geochemical composition in the Indus River Basin, Pakistan
Abstract
The Indus River Basin (IRB) with an area of 139,202 km2 is the lifeline river basin of Pakistan. An intensive study was conducted in six subcatchments of the IRB with five in the Upper Indus Basin (UIB) and one of the Lower Indus Basin (LIB; between Tarbela Dam and Panjand), i.e., the Gilgit River Basin (UIB-I), Hunza River Basin (UIB-II), UIB-III, UIB-IV and UIB-V, and LIB. A total of 84 surface water samples were collected from main stream and tributaries from June to August, 2016. The pH, electric conductivity (EC), and total dissolved solids (TDS) were measured in situ, whereas major ions (Ca2+, Mg2+, K+, Na+, Cl−, SO42−, and NO3−) and Si were analyzed in the laboratory. The results exhibited alkaline pH (8.55 ± 0.20) with diverse TDS (114.69 ± 77.65 mg L−1) and ion concentrations that were characterized primarily by the Ca-Mg-HCO3 type in the whole basin. The average TDS in the UIB and LIB were 93.99 ± 39.73 and 181.67 ± 167.82 mg L−1, respectively, under the influence of the arid to semi-arid climatic conditions and relatively higher anthropogenic interference in LIB compared to the UIB. The order of dominant major cations was different in the UIB and LIB, reflecting the diverse nature of geological formation. Gibbs plot, mixing diagrams, and ionic ratios were used to identify the controlling mechanism of river geochemistry in the IRB as carbonate weathering in general with different degrees of silicate weathering and minor contribution by evaporite dissolution. In addition, principal component/factor analysis also indicated that the major sources of dissolved loads in the basin are carbonates followed by silicates. Significant influences of silicate minerals were observed in the LIB, and there was a large contribution of evaporites in the UIB-II, UIB-III, and LIB. The suitability assessment showed that the river water fits the WHO permissible limits for drinking purposes from the perspective of major ions, whereas for irrigation purposes, most of the samples exhibited excellent and good levels except for a couple of permissible and doubtful levels from the Sawan and Deratang tributaries in the LIB, which may deteriorate the quality of soil and degrade the water quality downstream.
The demand for contrastive explanations
Abstract
A "contrastive explanation" explains not only why some event A occurred, but why A occurred as opposed to some alternative event B. Some philosophers argue that agents could only be morally responsible for their choices if those choices have contrastive explanations, since they would otherwise be "luck infested". Assuming that contrastive explanations cannot be offered for causally undetermined events, this requirement entails that no one could be held responsible for a causally undetermined choice. Such arguments challenge incompatibilism, since they entail that causal determinism is a prerequisite for moral responsibility. However, I argue that for a significant class of choices, even if we stipulate that they are determined, we will be unable to provide a relevant contrastive explanation. Hence causal determinism is no remedy for luck infestation, and compatibilists do not fare much better than incompatibilists in the face of this requirement. This should serve to weaken its philosophical appeal.
European Surveillance System on Contact Allergies (ESSCA): polysensitization, 2009–2014
Background
Polysensitization, defined as being allergic to three or more haptens from the European baseline series, is considered to reflect increased susceptibility to developing a contact allergy, and is likely to be associated with an impaired quality of life.
Objectives
To evaluate the prevalences of polysensitization across Europe and to analyse factors associated with polysensitization.
Methods
Patch test data collected by the European Surveillance System on Contact Allergies (ESSCA; www.essca-dc.org) in consecutively patch tested patients from January 2009 to December 2014, comprising 11 countries and 57 departments, were retrospectively analysed.
Results
A total of 86 416 patients were available for analysis, showing a standardized prevalence of polysensitization of 7.02%, ranging from 12.7% (Austria) to 4.6% (Italy). Allergen pairs with the strongest association are reported for the total population, for South Europe, and for North/Central Europe. Overall, polysensitized patients showed a higher percentage of extreme (+++) positive patch test reactions than oligosensitized patients. Female sex, occupational dermatitis and age > 40 years were risk factors for polysensitization.
Conclusions
The varying prevalences of polysensitization across Europe most likely reflect differences in patient characteristics and referral patterns between departments. Known risk factors for polysensitization are confirmed in a European dermatitis population.
Indeterminate cell histiocytosis in a Chinese patient with florid and extensive nodular lesions and mixed intermediate cell and macrophage-monocyte bilineage
Indeterminate cell histiocytosis (ICH) is an extremely rare cutaneous neoplastic disorder. It has the immunophenotypic features of both Langerhans and non-Langerhans cell histiocytosis. We report here a case of a healthy young Chinese woman who presented with disfiguring thick, infiltrated cutaneous nodules on the face, trunk and extremities which appeared progressively over a period of 4 years. No systemic involvement has been detected so far. Results of a skin biopsy showed diffuse dermal infiltration of histiocytoid cells with indented nuclei and positive staining for S100 and CD1a and negativity for CD207 (langerin). Admixed within were some CD68-positive foamy histiocytes and multinucleated giant cells with focal positivity for CD163. Though the clinical presentation is more typical of progressive nodular histiocytosis, the histology and immunoprofile is consistent with ICH. Our report adds to the limited case reports in the current literature of ICH in the Chinese population.
Logical Partisanhood
Abstract
A natural suggestion and increasingly popular account of how to revise our logical beliefs treats revision of logic analogously to the revision of scientific theories (Hjortland, Priest, Russell, Williamson, etc.). I investigate this approach and argue that simple applications of abductive methodology to logic result in revision-cycles, developing a detailed case study of an actual dispute with this property. This is problematic if we take abductive methodology to provide justification for revising our logical framework. I then generalize the case study, pointing to similarities with more recent and popular heterodox logics such as naïve logics of truth. I use this discussion to motivate a constraint—logical partisanhood—on the uses of such methodology: roughly: both the proposed alternative and our actual background logic must be able to agree that moving to the alternative logic is no worse than staying put.
Multiple perineuriomatous melanocytic nevi
Perineuriomatous differentiation in solitary cutaneous melanocytic nevi has been described. We present a possibly unique case of a patient with multiple such perineuriomatous nevi. This presentation raises the possibility of a germline mutation may be responsible for the pathogenesis of these unusual lesions.
Granulomatous and lichenoid Dermatitis after IgG4 anti-PD-1 Monoclonal Antibody Therapy for Advanced Cancer
Nivolumab is a fully human IgG4 monoclonal antibody directed against programmed cell death protein 1 (PD-1). PD-1 inhibition allows T-cell activation and recruitment to destroy cancer cells. Checkpoint inhibitors have shown significant survival advantage and relatively low side effects in comparison with conventional chemotherapy in several types of advanced cancer. Granulomatous cutaneous reactions have been reported showing sarcoidal and panniculitic morphology. Here we present a case of drug-induced lichenoid and granulomatous dermatitis after checkpoint inhibitor therapy observed in a 63-year-old male treated with nivolumab for advanced glioblastoma. This morphology has not been previously reported. We documented a high number of CD8+ T cells within the lesions. Additionally, we review the side effects observed with the use of checkpoint inhibitors with special focus on cutaneous manifestations.
Nerve alterations showing autophagy in two patients with lichen aureus
Lichen aureus is a rare, chronic, persistent purpuric dermatosis clinically characterised by striking yellow- to bronze-colored lesions. Histologically, lichen aureus differs from other pigmented purpuric dermatoses in containing dense, band-like infiltrates closely associated with the epidermis. This report describes two patients with lichen aureus, a 20-year-old woman with a lesion on her right arm and a 51-year-old man with a lesion on the right side of his groin. Skin biopsy specimens revealed almost identical findings in both patients, including dense band-like infiltrates containing lymphocytes, histiocytes with hemosiderin deposits scattered extravasated red blood cells and nerve alterations at the dermo-epidermal interface. The nerves within the lesions were filled with granules, which stained positive with antibody to microtubule-associated protein 1A/1B-light chain 3, suggesting autophagy within the nerves. These altered nerves were present only in areas of band-like dermal lymphocytic infiltration. Electron microscopy of the lesions showed the accumulation of autophagosomes in Schwann cells. To our knowledge, this report is the first to describe nerve alterations showing autophagy in patients with lichen aureus.
An unusual clinical presentation of myxoid dermatofibrosarcoma protuberans with a prominent vasculature: a potential pitfall in the diagnosis of myxoid soft tissue tumors
Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue tumor that arises primarily on the trunk and extremities but seldom on the scalp. Several variants of DFSP have been described, including myxoid DFSP. Although typical DFSP may have focally myxoid areas, myxoid DFSP, in which most of the stroma is myxoid, is rare and can pose diagnostic challenges. Here, we report a case of myxoid DFSP with an unusual clinical presentation that could have been mistaken for a lipoma. Additionally, the myxoid DFSP displayed prominent vasculature in a myxoid stroma, which could have been mistaken for a myxoid liposarcoma.
Dermatology hospitalists: a multicenter survey study characterizing the infrastructure of consultative dermatology in select American hospitals
Abstract
Background
Although considered an outpatient specialty, dermatology plays an important role in inpatient medicine. We characterized the activity and structure of dermatology consultation services in select U.S. hospitals.
Methods
In this cross sectional study, a 31-question survey was distributed in person to 32 board-certified dermatologists at the 2017 Society of Dermatology Hospitalists meeting.
Results
Thirty participants completed the survey (yield 93.8%). Most dermatology hospitalists spend 41–52 weeks on service (50%), with 37% spending between 11 and 30 weeks. Coverage was organized by continuous weeks (68%) or months (21%). While on service, hospitalists staffed an average of 4 outpatient clinics per week. Consultative teams also included internal medicine residents (43%), medical students (47%), pediatric residents (10%), and fellows from other specialties (27%). Consultation services saw approximately 3.7 new inpatients and 4.2 follow-up inpatients per day, with daily rounds lasting approximately 2.6 hours.
Conclusions
The results suggest that hospital dermatologists in the U.S. consider inpatient care their niche and devote a majority of their time staffing consults over clinic. The diverse composition of inpatient teams and the number of academic duties held by these physicians suggests they play an important role in medical education.
Surveillance for azoles resistance in Aspergillus spp. highlights a high number of amphotericin B resistant isolates
Summary
Aspergillus spp. are the most common invasive mold infection and are responsible for high mortality. A. fumigatus is currently of interest because resistance to azole antifungals has emerged. The Campinas University Hospital (HC-UNICAMP) receives high-risk patients susceptible to opportunistic infections but there have been no reports of resistant A. fumigatus. This study aimed to assess the susceptibility profile of Aspergillus isolates, specifically looking for azole resistance. ITS and β-tubulin DNA sequencing was performed on 228 sequential clinical isolates. Broth microdilution susceptibility testing was performed for all isolates. A. fumigatus represented 74% of the isolates followed by A. flavus (12%). Nine A. fumigatus isolates from 9 different patients showed high MIC values to at least one azole, but cyp51A polymorphisms were detected in only 6 isolates and none correlated with known resistance mutations. The most troubling observation was that the minimum inhibitory concentration for amphotericin B was elevated (≥2 mg L−1) in 87% of patients with A. flavus isolates and 43% with A. fumigatus isolates. Given that amphotericin B is used to treat azole resistant infections, these data highlight the need for continuous surveillance in Aspergillus for all antifungal resistance to implement correct treatment strategies for the management of these pathogens.
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Publication date: Available online 25 July 2018 Source: Journal of Photochemistry and Photobiology B: Biology Author(s): Marco Ballestr...
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Editorial AJR Reviewers: Heartfelt Thanks From the Editors and Staff Thomas H. Berquist 1 Share + Affiliation: Citation: American Journal...
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Publication date: Available online 28 September 2017 Source: Actas Dermo-Sifiliográficas Author(s): F.J. Navarro-Triviño
