Facial Nerve Palsy

It is agreed that some cases of facial nerve palsy are surgical emergencies. Other cases are controversial. The best available electrodiagnostic test is 48 to 72 hours late in noting changes. An early test for axonotmesis is unavailable. Immediate consultation with a specialist qualified to deal with the problem is urged.     

Effect of Pollution History on Immunological Responses and Organ Histology in the Marine Mussel Mytilus edulis Exposed to Cadmium

The effect of previous toxicant exposure (i.e., exposure history) on an organism’s response to re-exposure to the toxicant is of considerable interest. The marine mussel Mytilus edulis was collected from reference and polluted sites in southwest England, and groups of mussels from each site were exposed to 20 μg/L CdCl₂ for 0, 1, 4, and 8 days and compared with unexposed controls. End points evaluated were tissue metal and electrolyte concentrations, haemolymph chemistry, haemocyte characteristics [counts, neutral red uptake (NRU), and phagocytosis], histology, and expression of metallothionein gene (mt10) expression in digestive glands. Field-collected animals differed by collection site for some end points at time zero, at which time tissue Fe and Pb concentrations were greater and NRU and condition index lower in mussels from the polluted site. Subsequent exposure to cadmium (Cd) in the laboratory caused Cd accumulation mainly in digestive gland, but there were no site-specific effects on tissue trace-metal concentrations. NRU, phagocytosis, and haemolymph Na⁺ and K⁺ concentrations differed among sites and Cd treatment, but there were no clear trends. Exposure to Cd resulted in lower Ca²⁺ concentrations in gill, digestive gland, and haemolymph in animals from the polluted site compared with controls (Kruskal–Wallis, p ≤ 0.05). Lesions, including necrosis, inflammation, and neoplasia, were observed in animals from the polluted site, but the frequency of these lesions appeared to decrease unexpectedly after Cd exposure. Expression of mt10 increased 3-fold in Cd-exposed animals from the polluted site compared with all other groups (Kruskal–Wallis, p = 0.01). We conclude that Cd exposure affected some immune responses in M. edulis, but pre-exposure history influenced toxicological outcomes of Cd exposure in the laboratory.     

Blood vessel segmentation and width estimation in ultra-wide field scanning laser ophthalmoscopy

Features of the retinal vasculature, such as vessel widths, are considered biomarkers for systemic disease. The aim of this work is to present a supervised approach to vessel segmentation in ultra-wide field of view scanning laser ophthalmoscope (UWFoV SLO) images and to evaluate its performance in terms of segmentation and vessel width estimation accuracy. The results of the proposed method are compared with ground truth measurements from human observers and with existing state-of-the-art techniques developed for fundus camera images that we optimized for UWFoV SLO images. Our algorithm is based on multi-scale matched filters, a neural network classifier and hysteresis thresholding. After spline-based refinement of the detected vessel contours, the vessel widths are estimated from the binary maps. Such analysis is performed on SLO images for the first time. The proposed method achieves the best results, both in vessel segmentation and in width estimation, in comparison to other automatic techniques.OCIS codes: (100.2960) Image analysis, (100.3008) Image recognition, algorithms and filters, (100.4996) Pattern recognition, neural networks, (170.4470) Ophthalmology     

Immunopathological studies on the cutaneous lesions in sarcoidosis

We examined the immunohistology of the cutaneous granulomas in sarcoidosis. By direct immunofluorescence immunoglobulin deposits were found in the skin lesions of 5 to 8 patients. These consisted of IgM within blood vessel wall (5 patients), IgM at the epidermal-dermal junction (2 patients) and IgG within and around the granuloma (2 patients). A fibrin network was present within the granulomas. Biopsy of a Kveim test site but not of uninvolved skin or of an erythema nodosum lesion showed similar immunofluorescence findings. Sheep erythrocytes sensitized with IgG antibody adhered to epithelioid cells within the granuloma indicating the presence of surface Fc receptors. At the periphery of the granulomas were B-lymphocytes. These findings are similar to those described in nodal and pulmonary sarcoid granulomas, and suggest that humoral antibodies may be important in the pathogenesis of the sarcoid granuloma.     

Variably Acid-fast Bacteria in a Rare Case of Coexistent Malignant Lymphoma and Cutaneous Sarcoid-like Granulomas

ABSTRACT: A 74-year-old woman presented clinical, laboratory, and histologic evidence of coexistent cutaneous sarcoid-like granulomas, malignant lymphocytic lymphoma, and multiple basal cell carcinomas, all occurring within slightly more than a one-year period. Variably acid-fast coccoid forms were observed in the histologic sections of the cutaneous, non-caseating granulomas: and similar, variably acid-fast, extra and intracelluar coccoid forms and granular bodies were seen in the lymph nodes showing lymphoma. The possible relationship between sarcoid-like granulomas, sarcoidosis, and malignancy is discussed, as well as the possible role of cell wall deficient forms (L-forms) of mycobacteria in the pathogenesis of these diseases.