Nasosinusal sarcoidosis: 2 cases. A report of 2 cases

INTRODUCTION: Nasosinusal sarcoidosis is a rare non caseating granulomatous disease. It may be inaugural, isolated or associated with multisystemic sarcoidosis. MATERIAL [corrected] AND METHODS: We report two cases of nasosinusal sarcoidosis associated to multisystemic sarcoidosis. Both patients were females aged over 43 years. In one case, the primary symptom was a nasal obstruction. Tomodensitometric and guided biopsy findings provided the main diagnostic criteria. Anti-malaric treatment was prescibed in both cases. Stabilisation of the lesions was noted. DISCUSSION: we tried to reveal through this study the diagnostic an therapeutic difficulties of nasosinusal sarcoidosis.     

Flt-1 intraceptors inhibit hypoxia-induced VEGF expression in vitro and corneal neovascularization in vivo

PURPOSE: To determine whether subunits of VEGF receptor-1 coupled with an endoplasmic reticulum retention signal can block hypoxia-induced upregulation of VEGF secretion in corneal epithelial cells and block murine corneal angiogenesis induced by corneal injury. METHODS: Human corneal epithelial cells, transfected with plasmids encoding Flt23K or Flt24K (the VEGF-binding domains of the Flt-1 receptor coupled with the endoplasmic reticulum retention peptide KDEL), were subjected 2 days after transfection to 5% hypoxia for 24 hours. Supernatant was sampled at 24 hours and assayed for VEGF by ELISA. For in vivo models, mouse corneas underwent intrastromal injections of plasmids encoding Flt23K or Flt24K, and 2 days later, sustained injury induced by topical NaOH and mechanical scraping. Corneas were assessed 2 days later for VEGF ELISA and leukocyte counting or 1 week later for quantification of neovascularization. RESULTS: Hypoxia induced VEGF by human corneal epithelial cells was sequestered by both Flt23K and Flt24K; Flt-1 23K suppressed VEGF secretion as well. Intrastromal delivery of plasmid Flt23K suppressed VEGF by 40.4% (P = 0.009), leukocytes by 49.4% (P < 0.001), and neovascularization by 66.8% (P = 0.001). Flt24K suppressed VEGF expression by 30.8% (P = 0.042), leukocytes by 25.8% (P < 0.001), and neovascularization by 49.5% (P = 0.015). CONCLUSIONS: Flt-1 intraceptors, which are endoplasmic reticulum retention signal-coupled VEGF receptors, significantly suppress hypoxia-induced VEGF secretion by corneal epithelial cells in vitro. In vivo, delivery of naked plasmids expressing these intraceptors inhibits injury-induced upregulation of VEGF, leukocyte infiltration, and corneal neovascularization.     

Chronic ocular surface disease after allogeneic bone marrow transplantation

Graft-versus-host disease (GVHD) is a common complication of allogeneic bone marrow transplantation (allo-BMT). Ocular surface disease (OSD) is one of the most common manifestations of chronic ocular GVHD, yet little is known about it. In this article, we review the available literature on this condition and present results from our study of the manifestations of OSD in the chronic phase (>3 months duration) post allo-BMT. Our study consisted of a retrospective chart review of 62 allo-BMT patients with chronic OSD evaluated at our center between 1995 and 2002. The clinical features, systemic associations, treatment, and status of OSD at the last follow-up are presented and discussed in the context of other reports of OSD in GVHD.     

Auricular angiolymphoid hyperplasia with eosinophilia

Angiolymphoid hyperplasia with eosinophilia is an uncommon, benign, angioproliferative cutaneous disorder. Previously, angiolymphoid hyperplasia with eosinophilia and Kimura's disease were regarded as identical conditions, however, recent work identifies them as separate entities. It is clinically manifested by solitary or multiple, red to brown firm papules and nodules, occurring in the head and neck region with a predilection for the peri-auricular area. It usually occurs during the early and mid-adult life. It is more common in Caucasians with equal gender involvement. We report this condition in a 32 years old adult Pakistani male having red-brown papules in left ear.     

Compound palmar ganglion with carpal tunnel syndrome

Compound palmer ganglion is an uncommon condition characterized by a swelling in the distal part of volar aspect of wrist and communicating with another swelling over palm across the flexor retinaculum. It commonly results from tuberculous tenosynovitis. It may lead to carpal tunnel syndrome and need surgical excision with division of flexor retinaculum.     

Bladder polyp complicated with cystitis glandularis cystica

A one year old boy presented with dribbling of urine since birth. Ultrasonography showed bilateral hydronephrosis and hydroureter suggestive of posterior urethral valves. Micturating cystourethrogram and cystoscopy was not possible due to obstruction at bladder neck. Vesicostomy was initially performed to relieve the obstruction. Child presented again at the age of 3 years whence MCUG suggested a filling defect in the bladder, confirmed as a mass on cystoscopy. Exploration revealed a 3 x 4 cm polypoidal mass arising from the bladder neck near verumontanum. Excision of the mass was easy due to narrow pedicle. Histology suggested it to be a large fibroepithelial polyp complicated by cystitis glandularis cystica. Child had uneventful recovery and is symptoms-free 6 months after surgery.     

Microemulsion and poloxamer microemulsion-based gel for sustained transdermal delivery of diclofenac epolamine using in-skin drug depot: In vitro/in vivo evaluation

Microemulsion (ME) and poloxamer microemulsion-based gel (PMBG) were developed and optimized to enhance transport of diclofenac epolamine (DE) into the skin forming in-skin drug depot for sustained transdermal delivery of drug. D-optimal mixture experimental design was applied to optimize ME that contains maximum amount of oil, minimum globule size and optimum drug solubility. Three formulation variables; the oil phase X₁ (Capryol^®), Smix X₂ (a mixture of Labrasol^®/Transcutol^®, 1:2 w/w) and water X₃ were included in the design. The systems were assessed for drug solubility, globule size and light absorbance. Following optimization, the values of formulation components (X₁, X₂, and X₃) were 30%, 50% and 20%, respectively. The optimized ME and PMBG were assessed for pH, drug content, skin irritation, stability studies and ex vivo transport in rat skin. Contrary to PMBG and Flector^® gel, the optimized ME showed the highest cumulative amount of DE permeated after 8 h and the in vivo anti-inflammatory efficacy in rat paw edema was sustained to 12 h after removal of ME applied to the skin confirming the formation of in-skin drug depot. Our results proposed that topical ME formulation, containing higher fraction of oil solubilized drug, could be promising for sustained transdermal delivery of drug.