Lipodystrophy of Abdominal Pannus: A Severe Complication of Phosphatidyl Choline Injections

“Injection lipolysis” or “mesotherapy” is done for introducing various substances into deeper layers of the skin with the aim to dissolve subcutaneous fat. However, the safety profile of these chemicals is poorly regulated. Therefore, they may cause side effects or long-term sequelae that can be disastrous for the patient. We present such a case that required surgical management to salvage it and to give an aesthetically acceptable result.     

Acute recurrence of orbital cavernous hemangioma in a young man: a case report

A 29-year-old man presented with a history of prominent left eye of 6 months' duration. He also reported fluctuating blurred vision since 15 days ago. On examination, proptosis of 3 mm was noted in the left eye. Computed tomography (CT scan) of the orbits showed a well-circumscribed, hyperdense, intraconal mass lesion in left orbit, located in the inferotemporal quadrant. Orbitotomy was performed, and the tumor was delivered with an intact capsule. The clinical diagnosis of cavernous hemangioma was confirmed on histopathologic examination. The presence of intact capsule was confirmed grossly and with histopathology. The patient returned 6 weeks after surgery with recurrent proptosis. Repeated CT scan showed a recurrent intraconal mass of similar characteristics as in the primary presentation. A repeated orbitotomy was done, and the tumor was removed intact. Histopathology of the recurrent tumor confirmed the diagnosis of cavernous hemangioma. We report a rare case of orbital cavernous hemangioma with short-term recurrence (6 weeks).     

Recurrent orbital paraganglioma: a clinicopathological correlation of an extremely rare tumor

Orbital paraganglioma is an extremely rare clinical entity with fewer than 40 cases reported in the literature. A well-documented case of a recurrent orbital paraganglioma is reported and its clinical, radiologic, histopathologic, and immunohistochemical features are discussed.     

Role of cyclooxygenase-2 in the angiogenesis of colorectal cancer

BACKGROUND: Cyclooxygenase (COX) is the rate-limiting enzyme in the synthesis of prostaglandins. It exists in two isoforms: COX-1 which is constitutively expressed and COX-2 which is an inducible form activated by a variety of cytokines during inflammation. DISCUSSION: Interest in this enzyme arose in the early 1990s when, following epidemiological studies, aspirin (which is a COX inhibitor) was found to reduce the risk of colorectal cancer. Since then various studies to decipher the mechanisms by which COX reduces the development of colorectal cancer have been undertaken. One of the mechanisms being studied is its role in the angiogenesis of colorectal cancer. Angiogenesis of its own has been well established as a key factor in the development of tumours. Agents that specifically inhibit COX-2 are now in clinical development and have been licensed to be used in patients with familial adenomatosis polyposis. CONCLUSION: What needs to be determined is whether the antiangiogenic effects of COX-2 inhibitors can be used in the prevention and/or treatment of colorectal cancer and its metastases.     

Left Ventricular Longitudinal Strain in Characterization and Outcome Assessment of Mixed Aortic Valve Disease Phenotypes

ObjectivesThe aims of this study were to characterize the interplay between mixed aortic valve disease (MAVD) phenotypes (defined by concomitant severities of aortic stenosis and aortic regurgitation) and left ventricular global longitudinal strain (LV-GLS), and to assess the prognostic utility of LV-GLS in MAVD.BackgroundLittle is known about the way LV-GLS separates MAVD phenotypes and if it is associated with their outcomes.MethodsThis observational cohort study evaluated 783 consecutive adult patients with left ventricular ejection fraction ≥50% and MAVD, which was defined as coexisting with at least moderate aortic stenosis and at least moderate aortic regurgitation. We measured the conventional echocardiographic variables and average LV-GLS from apical long, 2- and 4-chamber views. The primary endpoint was all-cause mortality.ResultsMean age of patients was 69 ± 15 years, and 58% were male. Mean LV-GLS was –14.7 ± 2.9%. In total, 458 patients (59%) underwent aortic valve replacement at a median period of 50 days (25th to 75th percentile range: 6 to 560 days). During a median follow-up period of 5.6 years (25th to 75th percentile range: 1.8 to 9.4 years), 391 patients (50%) died. When stratified patients into tertiles according to LV-GLS values, patients with worse LV-GLS had worse outcomes (p < 0.001). LV-GLS was independently associated with mortality (hazard ratio: 1.09; 95% confidential intervals: 1.04 to 1.14; p < 0.001), with the relationship between LV-GLS and mortality being linear.ConclusionsLV-GLS is associated with all-cause mortality. LV-GLS may be useful for risk stratification in patients with MAVD.