Cannonball appearance,a tricky yet underrated imaging manifestation of COVID-19

Emergency Radiology - Spreading swiftly across the borders and over the seas, severe acute respiratory syndrome–related coronavirus-2 (SARS-COV-2), as causative pathogen of coronavirus...     

Correlation between serum YKL-40 and carotid intima media thickness in type 1 diabetics

It has been suggested that elevated serum level of YKL-40 could be a risk factor as well as early marker of both type 2 and type 1 diabetes mellitus (T1D) and their complications. We investigated the correlation between serum level of YKL-40 and carotid intima media thickness (cIMT) as well as urinary albumin/creatinine ratio (UACR) in type 1 diabetic patients. A total of 49 patients with T1D and 43 healthy controls underwent the assessment of serum level of YKL-40 (by ELISA) and cIMT measurement (by Doppler ultrasonography). Fasting blood and urine samples were also taken to measure the levels of hemoglobin A1C, lipid profile, CBC, serum and urine creatinine, and urine albumin. Serum levels of YKL-40, cIMT, and UACR were significantly higher in diabetic patients compared to those in healthy people (P < 0.001). Serum levels of YKL-40 had a significant correlation with cIMT, and duration of diabetes. We report that YKL-40 may be a good prognostic as well as diagnostic marker of early macrovascular complications in T1D.

     

Orthopantomographic assessment of the width of attached gingiva

By revealing the mucogingival junction with Schiller's iodine solution and marking it separately at each tooth with a short piece of metal wire, attached to the tooth and gingiva with a strip of Squibb's Orahesive Dental Bandage, the location of the borderline between the attached gingiva and the free alveolar mucosa was made visible in the orthopantomogram. The orthopantomographic width of the attached gingiva was measured to the nearest millimeter by determination of the distance between the mucogingival and cementoenamel junctions along the long axis of each tooth. When the orthopantomograms of ten dentulous adults were measured twice with a one week interval, the reading error was ± 0,5 mm. When the mucogingival junctions of five dentulous adults were marked again after two months and the orthopantomographic width of the attached gingiva remeasured to the nearest millimeter, the difference between the results was ± 0,6 mm. The total deviation (± 0,7 mm) being less than the one millimeter unit of measurement, the method was judged reliable for orthopantomographic studies on gingival anatomy.     

Lipoid proteinosis: phenotypic heterogeneity in Iranian families with c.507delT mutation in ECM1

Lipoid proteinosis (LP) is a rare autosomal recessive genodermatosis caused by loss‐of‐function mutations in the ECM1 gene, and previous studies have noted phenotypic variability. In this study, we examined 12 patients representing three Iranian families for clinical manifestations and genotyped them for mutations in ECM1. LP was diagnosed with characteristic mucocutaneous and neurologic manifestations. Five patients were also subjected to magnetic resonance imaging (MRI)/computed tomography (CT) scan of the central nervous system. DNA was isolated from peripheral blood from patients and their clinically unaffected relatives, and mutations in ECM1 were sought by PCR‐based amplification of all exons and flanking intronic sequences, followed by bidirectional Sanger sequencing. Significant phenotypic variability in this multisystem disorder, including presence of convulsions and epilepsy in about half of the patients was noted. In most cases, this was associated with calcifications in the brain detected by MRI/CT scans. Genotyping of the affected individuals in three families from the central region of Iran revealed presence of homozygous c.507delT mutation in ECM1, reflecting the observed consanguinity in these families. This large cohort revealed extensive phenotypic variability in individuals with the same mutation in ECM1. This observation suggests a role for genetic and epigenetic as well as environmental modulation of the phenotype. Identification of mutations allows screening of unaffected individuals for presence or absence of this mutation in extended LP families, with implications for genetic counseling.     

Altered tryptophan metabolism in human meningioma

Meningiomas are the neoplasms that arise from the arachnoid cells of the meninges. It was reported that cancer cells escape from immune system through the metabolism of an aromatic essential amino acid tryptophan (TRP) via Kynurenine (KYN) pathway. However, the role of TRP metabolites such as, 5-Hydroxy tryptophan (5-HTP), 5-Hydroxy tryptamine (5-HT), N-acetyl serotonin (NAS), Melatonin (MEL), KYN, N-acetyl tryptamine, 5-Hydroxy indole acetic acid (5-HIAA) and 5-Methoxy indole acetic acid is not yet evaluated in human meningioma. Therefore, in the current study we have evaluated the levels of TRP and its metabolites in the progression of human meningioma using tumor biopsy samples and autopsy control meninges with Reverse Phase-HPLC. We here report that TRP metabolism favors towards KYN pathway in human meningioma and it could be due to increased indoleamine 2,3-dioxygenase 2 levels as we found its m-RNA levels to be up regulated in human meningioma. We observed significant increase in KYN and 5HIAA levels and significant decrease in TRP, 5-HTP, 5-HT, NAS and MEL levels in meningioma compared to control meninges. Since TRP metabolites regulate inducible nitric oxide synthase (INOS) gene expression and thereby nitric oxide (NO) production, we have also evaluated the INOS and NO levels. The INOS and NO levels were up regulated in human meningioma. The present data corroborates with existing data on TRP metabolism in tumor progression and may serve to target TRP metabolism as a therapeutic intervention.