Prolapsed intraocular aspergilloma masquerading as malignant melanoma

We describe an aspergilloma that masqueraded as an intraocular malignant melanoma in an elderly male patient.     

Prognostic significance of biomarkers in squamous cell carcinoma of the tongue: multivariate analysis

BACKGROUND AND OBJECTIVES: Expression of a panel of biomarkers, such as p53, Bcl-2, Cyclin D1, c-myc, p21ras, c-erb B2, cytokeratin-19 (CK-19), and factor VIII-related antigen (FVIII-RA), was studied together in anterior tongue tumors from the oral cavity and in posterior tongue tumors from the oropharynx of patients with early- and locally advanced-stage disease, to evaluate their prognostic value. METHODS: The expression of the above-mentioned biomarkers was studied by immunohistochemical localization. RESULTS: In this study, 18%, 26%, 62%, 75%, 73%, 50%, and 29% of the tumors exhibited p53, Bcl-2, Cyclin D1, c-myc, p21ras, c-erb B2, and CK-19 expression, respectively. Twenty percent of the tumors had a microvessel count of >0.0. The expression of these biomarkers was also correlated with clinicopathologic parameters. In early-stage patients with a tobacco habit, who showed borderline significance for relapse-free survival by Kaplan-Meier survival analysis, this turned out to be significant, with the general linear model univariate survival analysis. In the total group, disease stage emerged as the most significant prognostic factor, followed by c-myc, when Cox forward stepwise regression and general linear model multivariate survival analysis were performed. However, Cyclin D1, which was significant by Cox forward stepwise regression analysis, lost its significance by general linear model multivariate analysis. In patients with early-stage disease, MVC, which was a significant predictor of disease relapse by Cox forward stepwise regression analysis, lost its significance by general linear model analysis because of small number of patients. In patients with locally advanced tongue cancer, multivariate survival analysis of individual biomarkers by both Cox forward stepwise regression and general linear model analysis indicated c-myc expression to be strongly indicative of poor prognosis. However, multivariate analysis of individual markers along with a combination of markers showed that only by Cox forward stepwise regression analysis did the combined expression of markers c-myc, Cyclin D1, and p21ras emerge as a significant independent prognosticator. CONCLUSIONS: Overall stage emerged as the most significant prognostic indicator of disease outcome. Tobacco habit also affected relapse-free survival in patients with early-stage disease. However, immunostaining of c-myc in the tumors of locally advanced-stage tongue cancer patients might be a potential adjunct to clinical stage in the pathologic evaluation of tongue specimens.     

BRCA1 expression in leukoplakia and carcinoma of the tongue

BACKGROUND AND OBJECTIVES: Expression of BRCA1 was examined in patients with leukoplakia and carcinoma of the tongue. Its prognostic value was evaluated in patients with tongue cancer. METHODS: Expression of BRCA1 was studied by immunohistochemical localization. Cytoplasmic staining of BRCA1 was observed in both leukoplakia and carcinoma of the tongue. RESULTS: In leukoplakia, 61% and 39% of the patients expressed BRCA1 expression with a staining intensity of 1+ and 2+, respectively. In patients with hyperplasia (67%), BRCA1 expression with a staining intensity of 1+ was 67%; BRCA1 expression with a staining intensity of 2+ was 33%. In patients with dysplasia (33%; mild and moderate), BRCA1 expression with a staining intensity of 1+ and 2+ was 50% each. In carcinoma of the tongue, only 34% of the patients showed BRCA1 expression. In this group, 33% of the tumors exhibited 1+ staining, and only 1% of the tumors expressed 2+ staining. Moreover, BRCA1 expression with a staining intensity of 2+ was significantly higher in patients with dysplasia (50%) than in those with hyperplasia (33%), followed by patients with squamous cell carcinoma of the tongue (1%). The percentage positivity of BRCA1 expression in tongue cancer patients was significantly lower (34%), as compared with patients with leukoplakia (100%; P = 0.000001). A significant positive correlation was noted between BRCA1 and c-myc (P = 0.012). Univariate survival analysis by log-rank test and multivariate survival analysis by Cox regression showed that BRCA1 expression was the most significant prognostic factor predicting relapse-free survival of early-stage patients. CONCLUSIONS: Subcellular localization of the BRCA1 gene product provided evidence of its involvement in the pathogenesis of tongue tumors.     

Mid latency and slow vertex responses during pregnancy

Central auditory pathways picked up electro-physiologically as mid latency responses (MLRs) and slow vertex responses (SVRs) have been studied least in women during their critical periods of life although auditory brainstem responses (ABRs) have been studied by many researchers. In the present study MLRs and SVRs were recorded in 20 pregnant women of age group 18-28 years. Their period of gestation ranged between 26-40 weeks and pregnancy had been uneventful and normal. MLRs and SVRs were recorded from Cz-A1 and Cz-A2 positions with alternating 90 dB sound pressure click stimuli delivered at 5 Hz and 0.5 Hz respectively. 256 stimuli for mid-latency and 64 stimuli for slow vertex responses were averaged and analyzed. Different waves of these auditory evoked responses were compared with 20 age matched non-pregnant females. The data obtained was analyzed for each variable by using unpaired student's T test. Present study did not reveal any difference in MLR waves during pregnancy when compared with the non-pregnant females whereas all the SVR waves were found to be significantly delayed in pregnant females. As SVR generators are found in different cortical areas, it can be said that auditory information processing at the higher centers is slow during pregnancy which in turn could be due to elevated levels of sex hormones specially estrogen and progesterone during pregnancy.     

Use of polymerase chain reaction in the diagnosis of fungal endophthalmitis

OBJECTIVE: To evaluate the usefulness of polymerase chain reaction (PCR) compared with the conventional mycologic methods in the diagnosis of fungal endophthalmitis. DESIGN: Prospective comparative validation of diagnostic testing-case-control study. PARTICIPANTS AND CONTROLS: Thirty subjects in whom fungal endophthalmitis was suspected and 20 controls with noninfections. INTERVENTION TESTING: Collection of intraocular specimens and testing for the presence of fungus by PCR and conventional methods. MAIN OUTCOME MEASURES: Detection of fungus by microscopy, growth by culture, and fungal DNA by PCR for definitive and rapid diagnosis of fungal endophthalmitis. RESULTS: None of the controls was positive by microscopy, culture, or PCR. Among the 43 intraocular specimens from 30 subjects, 24 were positive by conventional mycologic methods and 32 were positive by PCR. PCR increased the sensitivity of detection by 18.6%, which was statistically significant (McNemar test: P = 0.039). CONCLUSIONS: PCR was a more sensitive and rapid diagnostic tool compared with the conventional mycologic methods in the diagnosis of fungal endophthalmitis.     

Primary Amenorrhoea in a Triple X Female

The incidence of trisomy X in the newborn population is estimated to be 1 in 1,000 liveborn females. Most of them have normal physical appearance and puberty. Therefore, the reported number of triple X females in the literature is low. We herein report one patient with triple X chromosomes, primary amenorrhoea and normal intelligence. Steroid hormonal levels, clinical and ultrasound findings were suggestive of ovarian failure/gonadal dysgenesis. This case emphasizes the need for chromosomal analysis in women presenting with premature ovarian failure leading to primary or secondary amenorrhoea.     

A Direct Comparison of the Anticancer Activities of Digitoxin MeON-Neoglycosides and O-Glycosides: Oligosaccharide Chain Length-Dependent Induction of Caspase-9-Mediated Apoptosis

Digitoxin is a cardiac glycoside currently being investigated for potential use in oncology. While a number of structure-activity relationship studies have been conducted, an investigation of anticancer activity as a function of oligosaccharide chain length has not yet been performed. We generated mono-, di-, and tri-O-digitoxoside derivatives of digitoxin and compared their activity to the corresponding MeON-neoglycosides. Both classes of cardenolide derivatives display comparable oligosaccharide chain length-dependent cytotoxicity toward human cancer cell lines. Further investigation revealed that both classes of compounds induce caspase-9-mediated apoptosis in non-small cell lung cancer cells (NCI-H460). Since O-glycosides and MeON-neoglycosides share a similar mode of action, the convenience of MeON-neoglycosylation could be exploited in future SAR work to rapidly survey large numbers of carbohydrates to prioritize selected O-glycoside candidates for traditional synthesis.     

Spondylodiscitis Complicated by the Ingestion of a Button Battery: a Case Report

A one-and-a-half year old boy who presented with a cough, irritability, and refusal of food was found to have an impacted foreign body in his upper esophagus. We present the radiologic findings of the foreign body (a button battery) impacted in the upper esophagus and its complications; namely, mediastinitis and spondylodiscitis after endoscopic removal. Further, plain radiograph and MR imaging findings are discussed along with literature review.