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Sample records for hydronephrosis mimicking progressive

  1. Renal artery aneurysm mimicking renal calculus with hydronephrosis.

    PubMed

    Chen, Shanwen; Meng, Hongzhou; Cao, Min; Shen, Baihua

    2013-06-01

    A 51-year-old woman was found to have a left renal calculus with hydronephrosis. She underwent unsuccessful extracorporeal shock wave lithotripsy, leading to the recommendation that percutaneous lithotomy was necessary to remove the renal calculus. In view of the unusual shape of the calculus and absence of abnormalities in urine sediment, preoperative computed tomography and renal angiography were performed, which instead showed a calcified left renal artery aneurysm. Subsequent efforts to perform an aneurysmectomy also failed, eventually necessitating left nephrectomy. This case illustrates the pitfalls in the diagnosis of a renal artery aneurysm, which is a relatively common condition that may have unusual presentations. Hence, it is suggested that the possibility of a renal artery aneurysm be considered in the differential diagnosis when one detects a renal calculus with an unusual appearance. In addition, we propose that 3-dimensional reconstruction computed tomography be performed before considering surgical options for such renal calculi to rule out the possibility of a renal artery aneurysm.

  2. Hydronephrosis of one kidney

    MedlinePlus

    ... Acute hydronephrosis; Urinary obstruction; Unilateral hydronephrosis; Nephrolithiasis - hydronephrosis; Kidney stone - hydronephrosis; Renal calculi - hydronephrosis; Ureteral calculi - hydronephrosis; ...

  3. Paraneoplastic syndrome mimicking progressive supranuclear palsy.

    PubMed

    Dash, Deepa; Choudhary, Rima; Ramanujam, Bhargavi; Vasantha, Padma M; Tripathi, Manjari

    2016-10-01

    Paraneoplastic syndrome presenting with progressive supranuclear palsy (PSP) phenotype is extremely rare. We report a patient who presented with features of rapidly progressive parkinsonism similar to PSP and was found to have small cell carcinoma of the lung along with seropositivity for onconeural antigen. The patient was treated with immunomodulation and was given chemotherapy for the malignancy and subsequently improved.

  4. Antenatally detected hydronephrosis.

    PubMed

    Piepsz, Amy

    2007-07-01

    The strategy of management of children with hydronephrosis has considerably changed as a result of the development of ultrasound techniques, allowing a prenatal detection. Hydronephrosis is defined as a dilation of the renal collecting system, and several entirely different clinical entities can be considered this general heading, whereas early detection may have a different impact depending on the entity considered. The present work aims to describe a certain number of these clinical entities, to discuss the strategic options of management that are proposed, and to evaluate the role of medical imaging, in particular the radionuclide approach. Congenital ureteropelvic junction anomaly, vesicoureteral reflux, posterior urethral valves, and duplex kidney will be successively considered. Multicystic dysplastic kidney disease, although not classified as hydronephrosis, will be mentioned because it may be mistaken for hydronephrosis.

  5. Rapidly progressive sarcomatoid malignant mesothelioma of the pleura mimicking pulmonary empyema

    PubMed Central

    Fujita, Kohei; Kim, Young Hak; Nakatani, Koichi; Mio, Tadashi

    2015-01-01

    Key Clinical Message Refractory empyema occasionally reflects hidden malignant disease. We presented a rare case of rapidly progressive malignant mesothelioma of the pleura (MPM) mimicking empyema. Physicians should be aware of MPM when patients with empyema are refractory to the standard treatment, and PET-CT may be helpful in establishing a precise diagnosis in such cases. PMID:26509028

  6. Rapidly progressive sarcomatoid malignant mesothelioma of the pleura mimicking pulmonary empyema.

    PubMed

    Fujita, Kohei; Kim, Young Hak; Nakatani, Koichi; Mio, Tadashi

    2015-10-01

    Refractory empyema occasionally reflects hidden malignant disease. We presented a rare case of rapidly progressive malignant mesothelioma of the pleura (MPM) mimicking empyema. Physicians should be aware of MPM when patients with empyema are refractory to the standard treatment, and PET-CT may be helpful in establishing a precise diagnosis in such cases.

  7. Central nervous system systemic lupus erythematosus mimicking progressive multifocal leucoencephalopathy.

    PubMed Central

    Kaye, B R; Neuwelt, C M; London, S S; DeArmond, S J

    1992-01-01

    The case is reported of a patient with central nervous system systemic lupus erythematosus (SLE) with features of progressive multifocal leucoencephalopathy (PML) seen clinically and by magnetic resonance imaging. A brain biopsy sample showed microinfarcts. The use of magnetic resonance imaging and IgG synthesis rates in evaluating central nervous system lupus, the co-occurrence of SLE and PML, and the differentiation of these entities by magnetic resonance imaging and by histology are considered. Images PMID:1444628

  8. CHLORIDE RETENTION IN EXPERIMENTAL HYDRONEPHROSIS

    PubMed Central

    Keith, Norman M.; Pulford, D. Schuyler

    1923-01-01

    1. In acute experimental hydronephrosis chloride retention occurs as well as retention of water, urea, and phenolsulfonephthalein. 2. If both water and chlorides are retained there may be no appreciable rise in the plasma chloride content. 3. When chlorides are retained, but not water, the chloride content of the plasma rises strikingly. 4. After the removal of the ureteral obstruction in acute hydronephrosis all renal functions, water, urea, and chloride excretion, may be rapidly restored in equal degree, or the chlorides may be retained temporarily while there is free excretion of water and urea. 5. In chronic hydronephrosis adequate daily excretion of urea and chlorides may be maintained by a compensatory polyuria. 6. Chloride retention or an abnormal chloride excretion may occur in certain renal lesions when there is no change in the urea, phenolsulfonephthalein, or water excretion. PMID:19868720

  9. Giant Urinary Bladder and Bilateral Giant Hydronephrosis due to Bladder Neck Obstruction: One Case Report and Literature Review.

    PubMed

    Tazi, Mohammed Fadl; Riyach, Omar; Ahallal, Youness; Mellas, Soufiane; Khallouk, Abdelhak; El Fassi, Mohammed Jamal; Farih, Moulay Hassan

    2012-01-01

    Bilateral hydronephrosis secondary to urinary obstruction leads to a buildup of back pressure in the urinary tract and may lead to impairment of renal function. Cases of giant hydronephrosis are rare and usually contain no more than 1-2 litres of fluid in the collecting system. Here, we report a rarely seen case with giant urinary bladder and bilateral giant hydronephrosis due to bladder neck obstruction which contains 4000 mL fluid in the collecting system of the kidney mimicking an ascites in an adult male.

  10. Giant Urinary Bladder and Bilateral Giant Hydronephrosis due to Bladder Neck Obstruction: One Case Report and Literature Review

    PubMed Central

    Tazi, Mohammed Fadl; Riyach, Omar; Ahallal, Youness; Mellas, Soufiane; Khallouk, Abdelhak; El Fassi, Mohammed Jamal; Farih, Moulay Hassan

    2012-01-01

    Bilateral hydronephrosis secondary to urinary obstruction leads to a buildup of back pressure in the urinary tract and may lead to impairment of renal function. Cases of giant hydronephrosis are rare and usually contain no more than 1-2 litres of fluid in the collecting system. Here, we report a rarely seen case with giant urinary bladder and bilateral giant hydronephrosis due to bladder neck obstruction which contains 4000 mL fluid in the collecting system of the kidney mimicking an ascites in an adult male. PMID:22606637

  11. Delayed Presentation of Ureteropelvic Junction Obstruction and Loss of Renal Function After Initially Mild (SFU Grade 1-2) Hydronephrosis.

    PubMed

    Bowen, Diana K; Yerkes, Elizabeth B; Lindgren, Bruce W; Gong, Edward M; Faasse, Mark A

    2015-07-01

    We report 4 pediatric cases of ureteropelvic junction obstruction involving delayed progression of initially mild postnatal hydronephrosis. All 4 children became symptomatic; however, 3 already had a substantial decrement of ipsilateral kidney function by the time of diagnosis. Two of these 3 patients had previous renal scintigraphy demonstrating normal differential function. We caution that counseling regarding hydronephrosis should emphasize the importance of prompt re-evaluation for any symptoms potentially referable to delayed presentation of ureteropelvic junction obstruction, irrespective of initial hydronephrosis grade. Future studies are needed to determine the optimal follow-up regimen for conservative management of hydronephrosis.

  12. Postnatal Evaluation and Outcome of Prenatal Hydronephrosis

    PubMed Central

    Sadeghi-Bojd, Simin; Kajbafzadeh, Abdol-Mohammad; Ansari-Moghadam, Alireza; Rashidi, Somaye

    2016-01-01

    Background: Prenatal hydronephrosis (PNH) is dilation in urinary collecting system and is the most frequent neonatal urinary tract abnormality with an incidence of 1% to 5% of all pregnancies. PNH is defined as anteroposterior diameter (APD) of renal pelvis ≥ 4 mm at gestational age (GA) of < 33 weeks and APD ≥ 7 mm at GA of ≥ 33 weeks to 2 months after birth. All patients need to be evaluated after birth by postnatal renal ultrasonography (US). In the vast majority of cases, watchful waiting is the only thing to do; others need medical or surgical therapy. Objectives: There is a direct relationship between APD of renal pelvis and outcome of PNH. Therefore we were to find the best cutoff point APD of renal pelvis which leads to surgical outcome. Patients and Methods: In this retrospective cohort study we followed 200 patients 1 to 60 days old with diagnosis of PNH based on before or after birth ultrasonography; as a prenatal or postnatal detected, respectively. These patients were referred to the nephrology clinic in Zahedan Iran during 2011 to 2013. The first step of investigation was a postnatal renal US, by the same expert radiologist and classifying the patients into 3 groups; normal, mild/moderate and severe. The second step was to perform voiding cystourethrogram (VCUG) for mild/moderate to severe cases at 4 - 6 weeks of life. Tc-diethylene triamine-pentaacetic acid (DTPA) was the last step and for those with normal VCUG who did not show improvement in follow-up examination, US to evaluate obstruction and renal function. Finally all patients with mild/moderate to severe PNH received conservative therapy and surgery was preserved only for progressive cases, obstruction or renal function ≤35%. All patients’ data and radiologic information was recorded in separate data forms, and then analyzed by SPSS (version 22). Results: 200 screened PNH patients with male to female ratio 3.5:1 underwent first postnatal control US, of whom 65% had normal, 18% mild

  13. Giant hydronephrosis: still a reality!

    PubMed

    Kaura, Kawaljit Singh; Kumar, Manoj; Sokhal, Ashok Kr; Gupta, Ashok Kr; Purkait, Bimalesh; Saini, Durgesh; Sankhwar, Satyanarayan

    2017-09-01

    Giant hydronephrosis (GH) is a rare entity in both developed and developing countries with less than 500 cases reported in the literature. Delayed diagnosis and management of GH, can result in long-term complications like hypertension, rupture of the kidney, renal failure and malignant change. We aim to highlight the importance of this often neglected entity and build a consensus for its early diagnosis and management. Patients with GH were thoroughly worked up, managed and followed up between June 2013 and December 2015 and epidemiologic, radiological, perioperative and follow-up data was recorded. A total of 35 patients (adults and children) were reported. Flank pain in adults and abdominal lump in children were the most common clinical presentation. Percutaneous nephrostomy tube was placed in all patients and detailed work up was done to reach final diagnosis. Pelvi-ureteric junction obstruction (PUJO) was the final diagnosis in 32 patients (91.4%). Kidneys were non-functioning in 13 cases (37.1%) so nephrectomies were performed. Reduction pyeloplasty with nephropexy was done in 21 patients (60%) with 81% success and 23.1% complication rates. GH requires early diagnosis and management to prevent higher nephrectomy rate along with poor success rate of conservative surgery like pyeloplasty.

  14. A new CSF1R mutation presenting with an extensive white matter lesion mimicking primary progressive multiple sclerosis.

    PubMed

    Inui, Toshio; Kawarai, Toshitaka; Fujita, Koji; Kawamura, Kazuyuki; Mitsui, Takao; Orlacchio, Antonio; Kamada, Masaki; Abe, Takashi; Izumi, Yuishin; Kaji, Ryuji

    2013-11-15

    HDLS (Hereditary Diffuse Leukodystrophy with Spheroids) is a hereditary leukodystrophy whose main clinical manifestations include parkinsonism, spasticity, and ataxia. Genetic defects in the colony-stimulating factor 1 receptor (CSF1R) gene have been reported in many HDLS cases. The present report describes a new missense mutation Arg777Gln involving exon 18 of the CSF1R gene in a sporadic patient presenting with tumor-like lesions mimicking primary progressive multiple sclerosis. The patient was initially diagnosed with a progressive variant of multiple sclerosis and received inadequate treatments. Although most HDLS cases have a positive family history, this disease should also be suspected in sporadic patients showing unusual white matter lesions at MRI. © 2013 Elsevier B.V. All rights reserved.

  15. A Case of Sarcoidosis with Interstitial Lung Disease Mimicking Clinically Amyopathic Dermatomyositis and Rapidly Progressive Interstitial Lung Disease

    PubMed Central

    Nogi, Shinichi; Sasaki, Noriko; Chinen, Naofumi; Honda, Kiri; Saito, Eiko; Wakabayashi, Takayuki; Yamada, Chiho; Suzuki, Yasuo

    2014-01-01

    Here, we report a patient with sarcoidosis who developed edematous erythema and interstitial lung disease. At the initial visit, clinically amyopathic dermatomyositis (CADM) with rapidly progressive interstitial lung disease (RP-ILD) was suspected because he had progressive dyspnea but no muscle weakness. The presence of anti-CADM-140/MDA5 autoantibodies was immediately assessed to facilitate a precise diagnosis, with negative results. Thereafter, skin and transbronchial lung biopsies revealed noncaseating granuloma with Langhans giant cells in both specimens, leading to a diagnosis of sarcoidosis. In this case, clinical features of skin and lung were unable to distinguish DM (including CADM) from sarcoidosis, but the lack of anti-CADM-140/MDA5 antibody was useful for differentiating CADM with RP-ILD mimicking sarcoidosis from bona fide sarcoidosis. PMID:25431723

  16. Bilateral ureteropelvic junction stenosis causing hydronephrosis and renal failure in an adult cat.

    PubMed

    Foster, Jonathan D; Pinkerton, Marie E

    2012-12-01

    A 3.5-year-old male neutered cat was presented for investigation of renomegaly appreciated during a routine physical examination. Marked renomegaly due to bilateral hydronephrosis was detected and further testing identified International Renal Interest Society stage 2, non-hypertensive, non-proteinuric chronic kidney disease. Ten months later the cat was evaluated for acute lethargy; severe azotemia with oliguria was documented. Medical therapy failed to result in clinical improvement and the cat was euthanased. Necropsy revealed bilateral marked hydronephrosis secondary to a tortuous proximal ureter consistent with proximal ureteropelvic junction stenosis. This is the first report of this disorder leading to progressive renal failure in a cat.

  17. Ultrasonography of hydronephrosis in the newborn: a practical review

    PubMed Central

    2016-01-01

    Widespread use of fetal ultrasonography is accompanied by more frequent detection of antenatal hydronephrosis. Therefore, sonographic evaluation of neonates with a history of antenatal hydronephrosis is becoming more widespread. As an initial postnatal non-invasive imaging modality, ultrasonography is used to screen for persistence of hydronephrosis, determine the level and severity of obstruction, and contribute to appropriate diagnosis and treatment. This review aims to provide a practical overview of the sonographic evaluation of neonatal hydronephrosis and to describe the sonographic findings of conditions associated with hydronephrosis in the newborn. PMID:27156562

  18. Transitional neonatal hydronephrosis: fact or fantasy

    SciTech Connect

    Homsy, Y.L.; Williot, P.; Danais, S.

    1986-07-01

    Hydronephrosis secondary to an anomalous ureteropelvic junction was detected antenatally in more than 60 neonatal renal units Those 21 units that exhibited partial obstruction or dilatation without obstruction were selected for this study. They were assessed and followed by serial diuretic isotope renography (99mtechnetium-diethylenetriaminepentaacetic acid augmented with furosemide) and ultrasonography. Excretory urography was used selectively. Of the 17 renal units that could be assessed 88 per cent demonstrated labile ureteropelvic junctions. Indeed, in 3 to 6 months, when the definitive status seemed to be attained, 41 per cent (7 units) had deteriorated, 12 per cent (2 units) remained stable and 47 per cent (8 units) underwent spontaneous improvement. We recommend a 3 to 6-month observation period for patients with hydronephrosis secondary to ureteropelvic junction anomalies when definite obstruction cannot be confirmed by isotope renography.

  19. Progressive disseminated histoplasmosis mimicking a flare of systemic lupus erythematosus: a European case report

    PubMed Central

    Peters, E. J.; van Vugt, R. M.; van der Spoel, J. I.; van Dijk, K.

    2016-01-01

    Introduction: Diagnosing progressive disseminated histoplasmosis (PDH) in patients with systemic lupus erythematosus (SLE) is diagnostically challenging. Since PDH is lethal when untreated, awareness of this infection in patients with SLE is of utmost importance. To the best of our knowledge, this is the first description of a case of PDH in a patient with SLE in Europe. Case presentation: A 56-year-old woman of Surinamese descent with a history of SLE, presented with fever and polyarthritis. Although a flare of SLE was suspected initially, cultures of bone marrow and broncho-alveolar lavage fluid grew Histoplasma capsulatum. Conclusion: This case report highlights that physicians should be aware of progressive disseminated histoplasmosis in patients with SLE treated with immunosuppressive agents. The signs and symptoms can easily mimic a SLE flare, which would then be treated with more aggressive immunosuppression. Failure to recognize the infection will therefore invariably lead to death of the patient. Progressive disseminated histoplasmosis is usually not recognized by doctors in non-endemic areas such as Europe. However, globalisation and more frequent intercontinental traffic of immunocompromised patients currently increases the incidence of histoplasmosis in these areas. It is therefore of life-saving importance that doctors are aware of the features of the infection in areas where H. capsulatum is not endemic. PMID:28348765

  20. [Central nervous system leukemia mimicking rapidly progressive HTLV-1 associated myelopathy].

    PubMed

    Haruki, Hiroyo; Tanaka, Shinichiro; Koga, Michiaki; Kawai, Motoharu; Negoro, Kiyoshi; Kanda, Takashi

    2009-03-01

    A 79-year-old woman was suffered from rapidly progressive paresthesia of lower limbs and gait disturbance. After one month, she showed flaccid paraplegia and hyperreflexia in the lower limbs with positive Babinski signs. Anti-HTLV-1 antibody titer was elevated in the serum, but negative in the cerebrospinal fluid (CSF). CSF examination showed mild pleocytosis, elevated protein, and normal glucose content. Adult T cell lymphoma (ATL)-like cells were seen in the CSF. MRI showed no abnormal intensity in the spinal cord and brain. Two months later, she showed rapid worsening of the paraplegia and she became unable to stand. A tentative diagnosis of rapidly progressive HTLV-1 associated myelopathy (HAM) was given, but intravenous methylprednisolone was ineffective. Six months later, she developed pneumonia, and abundant ATL cells were seen in the peripheral blood, suggesting a diagnosis of ATL. Direct infiltration of ATL cells to central nervous system was therefore suggested to have caused neurological abnormalities in this case. One may consider central nervous system leukemia when rapidly progressive HAM-like symptoms and signs are recognized, especially without positive anti-HTLV-1 antibody in the CSF.

  1. Progressive Encephalomyelitis with Rigidity and Myoclonus in an Intellectually Disabled Patient Mimicking Neuroleptic Malignant Syndrome.

    PubMed

    Xu, Zheyu; Prasad, Kalpana; Yeo, Tianrong

    2017-03-24

    We present a case of 32-year-old male with profound mental retardation and autism spectrum disorder who had presented with seizures, rigidity and elevated creatine kinase and was initially diagnosed as neuroleptic malignant syndrome (NMS). The patient subsequently had a complicated clinical course, developing refractory status epilepticus, which lead to the eventual diagnosis of progressive encephalomyelitis with rigidity and myoclonus (PERM). We discuss the clinical similarities and differences between NMS and PERM, and highlight the need to consider alternative diagnoses when the clinical picture of NMS is atypical, particularly in this patient group where the history and clinical examination may be challenging.

  2. High-voltage VIM Region Deep Brain Stimulation Mimicking Progressive Supranuclear Palsy

    PubMed Central

    Patterson, Addie; Okun, Michael S.; Hess, Christopher

    2017-01-01

    Background Deep brain stimulation (DBS) for essential tremor (ET) can cause unwanted side effects. Case Report A patient with ET underwent unilateral dual-lead thalamic DBS. He later developed parkinsonism with atypical features and was diagnosed with progressive supranuclear palsy. During presentation for a second opinion, stimulation-induced side effects were suspected. Inactivation of DBS resolved atypical features and superimposed idiopathic Parkinson disease (PD) was diagnosed. Discussion This case illustrates the importance of recognizing the possible influence of stimulation-induced side effects and discusses when to utilize dual-lead DBS for ET and the co-occurrence of ET and PD. PMID:28373925

  3. Mimicking natural superhydrophobic surfaces and grasping the wetting process: a review on recent progress in preparing superhydrophobic surfaces.

    PubMed

    Yan, Y Y; Gao, N; Barthlott, W

    2011-12-12

    A typical superhydrophobic (ultrahydrophobic) surface can repel water droplets from wetting itself, and the contact angle of a water droplet resting on a superhydrophobic surface is greater than 150°, which means extremely low wettability is achievable on superhydrophobic surfaces. Many superhydrophobic surfaces (both manmade and natural) normally exhibit micro- or nanosized roughness as well as hierarchical structure, which somehow can influence the surface's water repellence. As the research into superhydrophobic surfaces goes deeper and wider, it is becoming more important to both academic fields and industrial applications. In this work, the most recent progress in preparing manmade superhydrophobic surfaces through a variety of methodologies, particularly within the past several years, and the fundamental theories of wetting phenomena related to superhydrophobic surfaces are reviewed. We also discuss the perspective of natural superhydrophobic surfaces utilized as mimicking models. The discussion focuses on how the superhydrophobic property is promoted on solid surfaces and emphasizes the effect of surface roughness and structure in particular. This review aims to enable researchers to perceive the inner principles of wetting phenomena and employ suitable methods for creation and modification of superhydrophobic surfaces.

  4. [Giant hydronephrosis. Diagnostic aspect: report of a case].

    PubMed

    Rabii, A; Joual, M; Hafiani, M; Bennani, S; el Mrini, M; Benjelloun, S

    2000-06-01

    In this study, we have reported an unusual case of giant hydronephrosis of the right kidney diagnosed as a result of pain, and upon palpation the detection of an abdominal mass. An ultrasound examination also indicated the possible presence of a large abdominal liquid mass. The hydatic serology was negative. A complementary CT scan and retroperitoneal approach confirmed the diagnosis of a right giant hydronephrosis with a liquid content of 8 liters, caused by stricture at the pyeloureteral junction with destruction of the kidney. The liquid was drained off. Based on the findings in this case, the pathogenesis, diagnosis and investigation of giant hydronephrosis have been discussed. In the event of giant hydronephrosis with total destruction of the kidney following an anomaly at the pyeloureteral junction, nephrectomy has to be performed. In the presence of a retroperitoneal liquid mass and in the absence of other pathological signs, the diagnosis of a possible giant hydronephrosis should be taken into consideration.

  5. Clinical factors associated with postoperative hydronephrosis after ureteroscopic lithotripsy

    PubMed Central

    Kim, Sun Woo; Ahn, Ji Hoon; Yim, Sang Un; Cho, Yang Hyun; Shin, Bo Sung; Chung, Ho Seok; Yu, Ho Song; Oh, Kyung Jin; Kim, Sun-Ouck; Jung, Seung Il; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung

    2016-01-01

    Purpose This study aimed to determine the predictors of ipsilateral hydronephrosis after ureteroscopic lithotripsy for ureteral calculi. Materials and Methods From January 2010 to December 2014, a total of 204 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients with lack of clinical data, presence of ureteral rupture, and who underwent simultaneous percutaneous nephrolithotomy (PNL) were excluded. Postoperative hydronephrosis was determined via computed tomographic scan or renal ultrasonography, at 6 months after ureteroscopic lithotripsy. Multivariable analysis was performed to determine clinical factors associated with ipsilateral hydronephrosis. Results A total of 137 patients were enrolled in this study. The mean age of the patients was 58.8±14.2 years and the mean stone size was 10.0±4.6 mm. The stone-free rate was 85.4%. Overall, 44 of the 137 patients (32.1%) had postoperative hydronephrosis. Significant differences between the hydronephrosis and nonhydronephrosis groups were noted in terms of stone location, preoperative hydronephrosis, impacted stone, operation time, and ureteral stent duration (all, p<0.05). On multivariable analysis, increasing preoperative diameter of the hydronephrotic kidney (adjusted odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12–1.31; p=0.001) and impacted stone (adjusted OR, 3.01; 95% CI, 1.15–7.61; p=0.031) independently predicted the occurrence of postoperative hydronpehrosis. Conclusions Large preoperative diameter of the hydronephrotic kidney and presence of impacted stones were associated with hydronephrosis after ureteroscopic stone removal. Therefore, patients with these predictive factors undergo more intensive imaging follow-up in order to prevent renal deterioration due to postoperative hydronephrosis. PMID:27617316

  6. Hydronephrosis as a complication of adenocarcinoma of the lung.

    PubMed

    Hiraki, Akio; Ueoka, Hiroshi; Gemba, Kenich; Kuyama, Syouich; Kishino, Daizo; Tabata, Masahiro; Kiura, Katsuyuki; Tanimoto, Mitsune; Harada, Mine

    2003-01-01

    We describe a patient with adenocarcinoma of the lung who developed hydronephrosis secondary to compression by right common iliac lymph node metastases. The most common primary sites of cancers causing ureteral obstruction are the cervix, prostate, bladder and colo-rectum. To date, few reports of ureteral obstruction attributable to lung cancer have been published. Although rare, physicians should be aware that hydronephrosis can complicate the course of patients with non-small cell lung cancer.

  7. Correlates of diuretic renography in experimental hydronephrosis

    SciTech Connect

    Kekomaeki, M.R.; Rikalainen, H.; Ruotsalainen, P.; Bertenyi, C.

    1989-02-01

    We studied the correlations between diuretic renographs and kidney function in experimental hydronephrosis in rabbits. Features of furosemide-stimulated /sup 99m/Tc-diethylenetriamine-pentaacetic acid renographs were compared to the growth rate, thirst test and endogenous creatinine clearance rate in a chronic solitary-kidney animal model. Intravenous pyelograms, done four weeks after laparotomy, left nephrectomy, bladder resection and constriction of the right pyeloureteric junction, showed signs of obstruction in all the 12 animals of the experimental group. An absent tracer washout after intravenous furosemide, found in five animals, was associated with retarded growth, isosthenuria and an abnormal creatinine clearance. In all of the other seven animals, a distinct tracer washout after intravenous furosemide was accompanied with a normal growth rate and creatinine clearance. However, no one of these seven animals had a normal ability to retain water and concentrate urine in the thirst test. We conclude that, in this experimental model, a furosemide-induced tracer washout from the kidney pelvis cannot be taken as a proof of the absence of any upper urinary tract obstruction.

  8. Is Hydronephrosis a Complication after Anterior Lumbar Surgery?

    PubMed Central

    Parks, Ruth M.; Behrbalk, Eyal; Mosharraf, Syed; Müller, Roger M.; Boszczyk, Bronek M.

    2015-01-01

    Study Design Prospective follow-up design. Objective Ureteral injury is a recognized complication following gynecologic surgery and can result in hydronephrosis. Anterior lumbar surgery includes procedures like anterior lumbar interbody fusion (ALIF) and total disk replacement (TDR). Anterior approaches to the spine require mobilization of the great vessels and visceral organs. The vascular supply to the ureter arising from the iliac arteries may be compromised during midline retraction of the ureter, which could theoretically lead to ureter ischemia and stricture with subsequent hydronephrosis formation. Methods Potential candidates with previous ALIF or TDR via anterior retroperitoneal access between January 2008 and March 2012 were chosen from those operated on by a single surgeon in a university hospital setting (n = 85). Renal ultrasound evaluation of hydronephrosis was performed on all participants. Simple descriptive and inferential statistics were used to generate results. Results A total of 37 voluntary participants were recruited (23 male, 14 female subjects; average age 51.8 years). The prevalence of hydronephrosis in our population was 0.0% (95% confidence interval 0 to 8.1%). Conclusions Retraction of the ureter across the midline in ALIF and TDR does not result in an increase in hydronephrosis and appears to be a safe surgical technique. PMID:26682096

  9. BILATERAL HYDRONEPHROSIS IN A SUGAR GLIDER (PETAURUS BREVICEPS).

    PubMed

    Cusack, Lara; Schnellbacher, Rodney; Howerth, Elizabeth W; Jiménez, David A; Mayer, Joerg; Divers, Stephen

    2016-09-01

    An adult, intact male sugar glider ( Petaurus breviceps ) presented for acute caudal abdominal swelling. Treatment by the referring veterinarian included aspiration of urine from the swelling. On physical examination, mild depression, pale mucus membranes, and caudal abdominal swelling were noted. Focused ultrasonographic assessment revealed a fluid-filled caudal abdominal structure and subjective bladder wall thickening. The following day, the sugar glider was severely depressed. Hematology results included hypoglycemia, hyperkalemia, hyponatremia, and azotemia. Ultrasonography revealed bilateral hydronephrosis and hydroureter. Despite supportive care, the animal died. Postmortem examination confirmed bilateral ureteral dilation, renal petechial hemorrhage, and dilation of the right renal pelvis. Submucosal edema, hemorrhage, and lymphoplasmacytic infiltration of the urinary bladder, ureters, and renal pelvises were noted. Hyperplasia of the urinary bladder and ureteral epithelium, coupled with inflammation, may have caused functional obstruction leading to bilateral hydronephrosis and hydroureter. This is the first reported case of hydronephrosis in a marsupial.

  10. Magnetic resonance evaluation of hydronephrosis in the dog

    SciTech Connect

    Thickman, D.; Kundel, H.; Biery, D.

    1984-07-01

    The ability of magnetic resonance (MR) imaging to detect and distinguish various stages of obstruction in the canine kidney was investigated. MR images were obtained at acute, subacute, and chronic stages of experimentally produced hydronephrosis. The renal cortex was distinguished from the renal medulla in the normal dog and in the acute and subacute stages of hydronephrosis. T1 relaxation times of the renal cortex and medulla were measured in vitro in 14 normal and nine experimental animals. These values were used to compute the amount of tissue contrast between the cortex and medulla and were compared with the degree of corticomedullary differentiation seen in the image. A relationship was noted between increasing T1 values and increasing water content. Corticomedullary contrast decreased with obstruction. The variation in corticomedullary image contracts may be useful for assessing the duration of hydronephrosis.

  11. Proximal ureteral ectopia causing hydronephrosis in a kitten.

    PubMed

    D'Ippolito, Paola; Nicoli, Stefano; Zatelli, Andrea

    2006-12-01

    A 2-month-old, female cat was presented for abdomen dilation. The patient was undernourished, and severe left hydronephrosis was diagnosed after clinical, ultrasonographical and radiographical examination. Although pyelography was performed in order to visualise the ureteral course, surgery was necessary to reach a final aetiological diagnosis and treatment. At gross examination, the left ureter crossed the renal capsula at the level of the caudal renal pole, and the subcapsular ureteral segment was markedly dilated. Distal to the renal capsula, the left ureter was very thin when compared to the right. The parenchyma of the left kidney, as suggested by ultrasonographical evaluation, was extremely reduced in thickness. An ureteronephrectomy was performed. Histopathological evaluation revealed glomerular sclerosis and diffuse parenchymal fibrosis. Severe hydronephrosis derived from an altered renal pelvic anatomy and abnormal ureteral course determining functional stenosis. Diagnosis of congenital anomaly before development of complications such as hydronephrosis could have allowed a surgical renal capsulectomy and obstruction relief. To the author's knowledge, this is the first report of severe hydronephrosis associated to altered renal pelvic anatomy and proximal ureteral ectopia in cat.

  12. Hydronephrosis as an Unusual Cause of Acute Pancreatitis

    PubMed Central

    Lugito, Nata Pratama Hardjo; Gunawan, Edy; Chandra, Margaret; Kurniawan, Andree

    2015-01-01

    Acute pancreatitis is an inflammatory disease of the pancreas. The most common cause of acute pancreatitis is gallstone impacting the distal common bile–pancreatic duct (38%) and alcoholism (36%). There have been a few reports in the literature of acute pancreatitis associated with an obstructed urinary system. This case describes a 38-year-old male with acute pancreatitis occurring in the setting of hydronephrosis. A magnetic resonance cholangiopancreaticography (MRCP) showed right-sided severe hydronephrosis pushing the duodenum and head of pancreas anteriorly, thus obliterating distal segment of the common bile duct. There were also multiple right renal stones causing ureteral obstruction and hydronephrosis. Right nephrostomy was performed to release bile duct obstruction. However, sepsis and disseminated intravascular coagulation developed as a complication of acute pancreatitis, and the patient passed away. Although gallstone and alcoholism are the most common causes of acute pancreatitis, other causes should always be considered. Physicians should be aware of right hydronephrosis as one of the possible causes of acute pancreatitis in their workup of patients. PMID:25973285

  13. Molecular Pathology of Murine Ureteritis Causing Obstructive Uropathy with Hydronephrosis

    PubMed Central

    Ichii, Osamu; Otsuka, Saori; Namiki, Yuka; Hashimoto, Yoshiharu; Kon, Yasuhiro

    2011-01-01

    Primary causes of urinary tract obstruction that induces urine retention and results in hydronephrosis include uroliths, inflammation, and tumors. In this study, we analyzed the molecular pathology of ureteritis causing hydronephrosis in laboratory rodents. F2 progenies of C57BL/6 and DBA/2 mice were studied histopathologically and by comprehensive gene expression analysis of their ureters. Incidence of hydronephrosis was approximately 5% in F2 progenies. Histopathologically, this hydronephrosis was caused by stenosis of the proximal ureter, which showed fibrosis and papillary malformations of the proliferative epithelium with infiltrations of B-cell-dominated lymphocytes. Additionally, CD16-positive large granular leukocytes and eosinophils infiltrated from the ureteral mucosa to the muscular layer. Eosinophilic crystals were characteristically observed in the lumen of the ureter and the cytoplasm of large granular leukocytes, eosinophils, and transitional epithelial cells. Comprehensive gene profiling revealed remarkably elevated expression of genes associated with hyperimmune responses through activation of B cells in diseased ureters. Furthermore, diseased ureters showed dramatically higher gene expression of chitinase 3-like 3, known as Ym1, which is associated with formation both of adenomas in the transitional epithelium and of eosinophilic crystals in inflammatory conditions. The Ym1 protein was mainly localized to the cytoplasm of the transitional epithelium, infiltrated cells, and eosinophilic crystals in diseased ureters. We determined that the primary cause of hydronephrosis in F2 mice was ureteritis mediated by the local hyperimmune response with malformation of the transitional epithelium. Our data provide a novel molecular pathogenesis for elucidating causes of aseptic inflammation in human upper urinary tracts. PMID:22114694

  14. Inferior Vena Cava Filter Erosion Causing Symptomatic Obstructive Hydronephrosis

    PubMed Central

    Locke, Nathan; Duchene, David

    2016-01-01

    Abstract Background: Transcaval inferior vena cava (IVC) filter penetration involving the urinary tract is rare, but has been previously reported. We herein present unique management of symptomatic hydronephrosis secondary to erosion of an IVC filter limb into the lumen of the proximal right ureter. Case Presentation: A 59-year-old woman presented with abdominal and right flank pain in October 2015 and was found to have right hydronephrosis, apparently secondary to obstruction from erosion of an IVC filter limb into the proximal right ureter. This was effectively managed with percutaneous, endovascular, and endourologic procedures, without the need for a major invasive surgical procedure. Conclusion: Endovascular removal of the IVC filter was performed safely in this case and can be considered when the urinary tract is involved in filter erosion. PMID:27579443

  15. An unusual cause of unilateral hydronephrosis: invasive colonic amebiasis.

    PubMed

    Pirti, Okay; Koçak, Erdem; Güler, Osman; Koçak, Gülay; Altunkaya, Canan; Caydere, Muzaffer; Köklü, Seyfettin

    2012-01-01

    A 62-year-old man was admitted to our hospital with complaints of abdominal pain and rectal bleeding. Although the colonoscopic examination was highly suggestive of a carcinoma, the histopathological examinations were consistent with chronic inflammation. CT examination revealed a solid lesion from cecum to the ascending colon with right urethral invasion. Percutaneous right nephrostomy was performed for grade 2-3 hydronephrosis. Three days after hospitalization, ileus developed and right hemicolectomy was performed. During surgery we observed that the lesion had invaded the middle part of ureter. So the middle part of ureter was removed with side-to-side urethral anastomosis and 6F double-J catheter was placed. The histopathological findings of resected specimen were consistent with ameboma. Reviewing the literature unilateral hydronephrosis due to colonic amebiasis has not been reported.

  16. [Concurrent tumors in a patient with giant hydronephrosis].

    PubMed

    Pereira Arias, José Gregorio; Ullate Jaime, Vicente; Gutiérrez Díez, José Maria; Ateca Díaz-Obregón, Ricardo; Ramírez Rodríguez, María Mar; Pereda Martínez, Esther; Berreteaga Gallastegui, José Ramón

    2006-01-01

    Giant hydronephrosis, defined as the presence of a liquid volume over 1000 ml within the urinary collector system, is a rare clinical entity, the diagnosis of which is an excellent exercise because it lacks of a defined clinical presentation. We report the case of a 66-year-old male under study for a suspicious digestive tumor due to a long lasting clinical picture with severe cachexia, asthenia, anemia, constipation, and abdominal mass. Radiological tests showed a great right hydronephrosis secondary to a culculus in the ureteral-pelvic junction. Simple nephrectomy was performed, evacuating 7800 ml of serous-hematic liquid from the pyelocalicial system. A histological diagnosis revealed the presence of multiple foci of transitional cell carcinoma and renal cell carcinoma associated. We review the diagnostic and therapeutic features in the literature. Giant hydronephrosis represents a diagnostic dilemma. It may present as an asymptomatic process, with clinical features of abdominal organs compression (bowel or urinary obstruction) or simulate abdominal tumors, massive ascites, or cystic retroperitoneal lesions. Simple nephrectomy is the treatment of choice in most cases, due to the advanced deterioration of the renal unit. Nevertheless, in some cases, in compromised patients, percutaneous drainage may be necessary as previous or definitive treatment to avoid changes in the hemodynamic balance secondary to the sudden abdominal decompression.

  17. Presentation of Progressive Familial Intrahepatic Cholestasis Type 3 Mimicking Wilson Disease: Molecular Genetic Diagnosis and Response to Treatment

    PubMed Central

    Jain, Dhanpat; Schilsky, Michael L.

    2015-01-01

    Progressive familial intrahepatic cholestasis type 3 (PFIC3) is an autosomal recessive disorder of cholestasis of hepatocellular origin, typically seen in infancy or childhood caused by a defect in the ABCB4 located on chromosome 7. Here we report on an older patient, aged 15, who presented with biochemical testing that led to an initial consideration of a diagnosis of Wilson disease (WD) resulting in a delayed diagnosis of PFIC3. Diagnosis of PFIC3 was later confirmed by molecular studies that identified novel mutations in the ABCB4 gene. Cholestasis due to PFIC3 can cause elevated hepatic copper and increased urine copper excretion that overlap with current diagnostic criteria for WD. Molecular diagnostics are very useful for establishing the diagnosis of PFIC3. Ursodeoxycholic acid ameliorates cholestasis in PFIC3, and may help mediate a reduction in hepatic copper content in response to treatment. PMID:26473142

  18. IgG4-related Kidney Disease Mimicking Malignant Ureter Tumor: Case Report and Literature Review.

    PubMed

    Lei, Wen-Hui; Xin, Jun; Shao, Chu-Xiao; Mao, Ming-Feng; Zhu, Chao-Yong; Wu, Chui-Fen; Jin, Lie

    2016-01-01

    Immunoglobulin G4-related disease is a recently recognized systemic disease that can affect any organ or tissue in the body, including the kidneys. IgG4-related kidney disease (IgG4-RKD) is an important part of immunoglobulin G4-related disease. The most common renal manifestation of IgG4-RKD is tubulointerstitial nephritis and glomerular lesions. There, however, is few case of IgG4-RKD mimicking malignant ureter tumor leading to severe hydronephrosis. We herein report an unusual case of IgG4-RKD mimicking malignancy.A 66-year-old Asian man presented to the nephrologist with soreness of loins, anorexia, and acute kidney injury in 2010. His renal function spontaneously improved after 2 weeks' hemodialysis without systemic steroid therapy. Four years later, he presented to the urologist with severe left hydronephrosis because of marked thickness of the left ureter wall. As a ureteral malignancy could not be ruled out, laparoscopic nephroureterectomy was performed.IgG4-related kidney disease was confirmed by the histologic examination. Then, repeat laboratory test showed almost complete recovery of renal function after initiation of steroidal therapy.This case highlights the rare possibility of IgG4-RKD mimicking malignant ureter tumor. Nephrologist and pathologists should be aware of the possibility that hydronephrosis with ureter obstruction may be involved in IgG4-RKD.

  19. Bilateral renal dysplasia, hydronephrosis, and hydroureter in a septic neonatal foal

    PubMed Central

    Gilday, Rebecca A.; Wojnarowicz, Chris; Tryon, Kimberly A.; Lohmann, Katharina L.

    2015-01-01

    A Canadian warmblood foal treated for septic polyarthritis was diagnosed with bilateral congenital renal dysplasia, hydronephrosis, and hydroureter at 2 weeks of age based on abdominal ultrasound and postmortem examination. Intermittent abdominal pain throughout the course of treatment was attributed to hydronephrosis and hydroureter. PMID:25750445

  20. Bird's Nest Filter Causing Symptomatic Hydronephrosis Following Transmural Penetration of the Inferior Vena Cava

    SciTech Connect

    Stacey, C.S. Manhire, A.R.; Rose, D.H.; Bishop, M.C.

    2004-01-15

    We report a case of symptomatic hydronephrosis caused by transcaval penetration of a Bird's Nest filter. Perforation of the wall of the inferior vena cava (IVC) following insertion of a caval filter is a well-recognized complication. Whilst two cases of hydronephrosis have been described with Greenfield filters, no case involving a Bird's Nest filter has been reported previously.

  1. Hydronephrosis and utero-vaginal prolapse in postmenopausal women: management and treatment

    PubMed Central

    LEANZA, V.; CIOTTA, L.; VECCHIO, R.; ZANGHÌ, G.; MAIORANA, A.; LEANZA, G.

    2015-01-01

    Introduction Pelvic organ prolapse is a multifactorial disease. Aim was to evaluate the effect of the whole surgical correction of pelvic floor on hydronephrosis due to severe prolapse. Patients and Methods A retrospective case study on 250 patients presenting with severe uterovaginal prolapse was carried out. Results Hydronephrosis was found in 32/234 (13.7 %). All patients underwent hysterectomy, vaginal apex axial suspension, posterior and anterior repair, vaginally. Prepubic TICT (Tension free Incontinence Cystocoele Treatment) was done in 38 cases (3 with hydronephrosis). Of the 32/234 (13.7 %) patients with hydronephrosis, 18/32 (56.25%) had complete resolution of hydronephrosis after treatment, 14/32 (43.75%) had a reduction of calico-pyelic dilatation, among them 8 patients had a second degree and 6 a first degree of hydronephrosis. Conclusions Vaginal-hysterectomy, axial apex suspension, anterior and posterior repair resulted in either complete resolution or improvement of hydronephrosis. Prepubic TICT did not interfere on mechanical obstruction and maintained postoperative continence in the event of occult Stress Urinary Incontinence (SUI). PMID:26888700

  2. Is Hydronephrosis on Ultrasound Predictive of Ureterolithiasis in Patients with Renal Colic?

    PubMed

    Sternberg, Kevan M; Pais, Vernon M; Larson, Troy; Han, Jullet; Hernandez, Natalia; Eisner, Brian

    2016-10-01

    Renal ultrasound accurately identifies hydronephrosis but it is less sensitive than computerized tomography for the detection of ureterolithiasis. We investigated whether the presence of hydronephrosis on ultrasound was associated with a ureteral stone in patients who underwent both ultrasound and computerized tomography during the evaluation of acute renal colic. We retrospectively reviewed the records of patients from 3 institutions who were evaluated for acute renal colic by both ultrasound and computerized tomography between 2012 and 2015. Patients were included in analysis if ultrasound and computerized tomography were performed on the same day. The presence of ureterolithiasis, stone location and hydronephrosis was reviewed and compared between imaging modalities. Ureteral stones were present in 85 of 144 patients. Ultrasound identified hydronephrosis in 89.8% of patients and a ureteral stone in 25.9%. Computerized tomography identified hydronephrosis in 91.8% of patients and a ureteral stone in 98.8%. In 75.0% of cases the presence or absence of hydronephrosis on ultrasound correctly predicted the presence or absence of a ureteral stone on computerized tomography. Hydronephrosis on ultrasound had a positive predictive value of 0.77 for the presence of a ureteral stone and a negative predictive value of 0.71 for the absence of a ureteral stone. Hydronephrosis on ultrasound did not accurately predict the presence or absence of a ureteral stone on computerized tomography in 25.0% of the patients in this study. Ultrasound is an important tool for evaluating hydronephrosis associated with renal colic but patients may benefit from other studies to confirm the presence or absence of ureteral stones. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Evaluation of Urinary Tract Dilation Classification System for Grading Postnatal Hydronephrosis.

    PubMed

    Hodhod, Amr; Capolicchio, John-Paul; Jednak, Roman; El-Sherif, Eid; El-Doray, Abd El-Alim; El-Sherbiny, Mohamed

    2016-03-01

    We assessed the reliability and validity of the Urinary Tract Dilation classification system as a new grading system for postnatal hydronephrosis. We retrospectively reviewed charts of patients who presented with hydronephrosis from 2008 to 2013. We included patients diagnosed prenatally and those with hydronephrosis discovered incidentally during the first year of life. We excluded cases involving urinary tract infection, neurogenic bladder and chromosomal anomalies, those associated with extraurinary congenital malformations and those with followup of less than 24 months without resolution. Hydronephrosis was graded postnatally using the Society for Fetal Urology system, and then the management protocol was chosen. All units were regraded using the Urinary Tract Dilation classification system and compared to the Society for Fetal Urology system to assess reliability. Univariate and multivariate analyses were performed to assess the validity of the Urinary Tract Dilation classification system in predicting hydronephrosis resolution and surgical intervention. A total of 490 patients (730 renal units) were eligible to participate. The Urinary Tract Dilation classification system was reliable in the assessment of hydronephrosis (parallel forms 0.92). Hydronephrosis resolved in 357 units (49%), and 86 units (12%) were managed by surgical intervention. The remainder of renal units demonstrated stable or improved hydronephrosis. Multivariate analysis revealed that the likelihood of surgical intervention was predicted independently by Urinary Tract Dilation classification system risk group, while Society for Fetal Urology grades were predictive of likelihood of resolution. The Urinary Tract Dilation classification system is reliable for evaluation of postnatal hydronephrosis and is valid in predicting surgical intervention. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. Hypertension and hydronephrosis: rapid resolution of high blood pressure following relief of bilateral ureteric obstruction.

    PubMed

    Chalisey, Anil; Karim, Mahzuz

    2013-03-01

    Hypertension secondary to hydronephrosis is not commonly reported in the medical literature. Tubuloglomerular feedback and the renin-angiotensin-aldosterone axis are thought to mediate this process. We describe a patient presenting with acute kidney injury and bilateral hydronephrosis secondary to pelvic malignancy in which peripheral venous renin and aldosterone were elevated. Her blood pressure improved rapidly following insertion of bilateral nephrostomies. The speed of resolution of hypertension following relief of obstruction suggests that humorally mediated vasoconstriction can play an important role in the mechanism by which hydronephrosis causes hypertension. We also discuss other causes of renal parenchymal compression that may lead to the development of hypertension.

  5. Congenital Nephrogenic Diabetes Insipidus Presented with Bilateral Hydronephrosis: Genetic Analysis of V2R Gene Mutations

    PubMed Central

    Yoo, Tae-Hyun; Ryu, Dong-Ryeol; Song, Young Soo; Lee, Sang Chul; Kim, Hyung Jong; Kim, Joo Seong; Choi, Hoon Young

    2006-01-01

    Most cases of hydronephrosis are caused by urinary tract obstruction. However, excessive polyuric syndrome rarely gives rise to non-obstructive hydronephrosis, megaureter, and a distended bladder. The authors report here on two cases of congenital nephrogenic diabetes insipidus (NDI) with severe bilateral hydronephrosis and megaureter. It is Interesting that the patients were symptomless except for their polyuria, and they both presented with bilateral hydronephrosis. Fluid deprivation testing revealed the presence of AVP resistant NDI. Gene analysis for these patients showed the AVP receptor 2 (V2R) missense mutations (Q225X and S126F), which have previously been reported on in other studies. We made the diagnosis of NDI by using a physiologic test, and we confirmed it by mutation analysis of the V2R gene. PMID:16502494

  6. Klippel-Trenaunay-Weber Syndrome with Kasabach-Merritt Coagulopathy and Hydronephrosis.

    PubMed

    Bhat, Lata; Bisht, Supriya; Khanijo, Kavita

    2015-11-01

    Klippel-Trenaunay-Weber Syndrome is a rare syndrome, consisting of vascular malformation of blood and lymph vessels. A newborn female with respiratory distress from birth, and having vascular malformation involving left thigh. The neonate also had hydronephrosis and developed complication of Kasabach Merritt syndrome. Urogenital abnormalities can be present in Klippel-Trenaunay-Weber syndrome but hydronephrosis is rare. Mortality is high with development of Kasabach Merritt syndrome.

  7. Impact of hydronephrosis on treatment outcome of solitary proximal ureteral stone after extracorporeal shock wave lithotripsy.

    PubMed

    Hsiao, Hsi-Lin; Huang, Shu-Pin; Wu, Wen-Jeng; Lee, Yung-Chin; Li, Wei-Ming; Chou, Yii-Her; Chang, Ai-Wen; Huang, Chun-Hsiung; Sun, Shu-Chin; Liu, Chia-Chu

    2008-10-01

    The purpose of this study was to investigate the impact of hydronephrosis on the treatment outcome of patients with a solitary proximal ureteral stone after extracorporeal shock wave lithotripsy (ESWL). A total of 182 consecutive patients who underwent ESWL for a solitary proximal ureteral stone of between 5 and 20 mm in size in our institution were included in this study. The degree of hydronephrosis was defined by renal ultrasonography. Patient data, stone size, shock wave numbers and shock wave energy were also recorded. Treatment outcome was evaluated 3 months after the first session of ESWL. In multivariate analysis, only the maximal stone length (odds ratio [OR], 0.15; 95% confidence interval [CI], 0.03-0.91; p = 0.04) and the degree of hydronephrosis (OR, 0.40; 95% CI, 0.16-0.98; p = 0.045) were significant predicting factors for stone-free status 3 months after ESWL. For stones < or = 10 mm, the stone-free rate decreased from 80% in patients with mild hydronephrosis to 56.4% in those with moderate to severe hydronephrosis. For stones > 10 mm, the stone-free rate decreased further, from 65.2% in patients with mild hydronephrosis to 33.3% in those with moderate to severe hydronephrosis. In summary, patients with a solitary proximal ureteral stone and a stone > 10 mm, the treatment outcome after ESWL was not good if moderate to severe hydronephrosis was noted on ultrasonography. Alternative treatments, such as ureteroscopic lithotripsy, may be appropriate as initial treatment or after failure of one session of ESWL.

  8. Risk factors for febrile urinary tract infection in infants with prenatal hydronephrosis: comprehensive single center analysis.

    PubMed

    Zareba, Piotr; Lorenzo, Armando J; Braga, Luis H

    2014-05-01

    We assessed risk factors for urinary tract infection in children with prenatal hydronephrosis We identified 376 infants with prenatal hydronephrosis in an institutional database. The occurrence of febrile urinary tract infection in the first 2 years of life was ascertained by chart review. Febrile urinary tract infection was defined as a positive culture from a catheterized urine specimen in a patient with a fever of 38.0C or greater. Multivariate logistic regression was used to assess gender, circumcision status, hydronephrosis grade, vesicoureteral reflux grade and antibiotic prophylaxis as predictors of the risk of urinary tract infection. Included in analysis were 277 males and 99 females. Hydronephrosis was high grade in 128 infants (34.0%) and vesicoureteral reflux was present in 79 (21.0%). Antibiotic prophylaxis was prescribed in 60.4% of patients, preferentially to females vs males (70.7% vs 56.7%), those with high vs low grade hydronephrosis (70.3% vs 55.2%) and those with vs without vesicoureteral reflux (96.2% vs 50.8%). On multivariate analysis there was an association between high grade hydronephrosis and an increased risk of urinary tract infection (adjusted OR 2.40, 95% CI 1.26-4.56). Females (adjusted OR 3.16, 95% CI 0.98-10.19) and uncircumcised males (adjusted OR 3.63, 95% CI 1.18-11.22) were also at higher risk than circumcised males. Antibiotic prophylaxis was not associated with a decreased risk of urinary tract infection (adjusted OR 0.93, 95% CI 0.45-1.94). High grade hydronephrosis, female gender and uncircumcised status in males are independent risk factors for febrile urinary tract infection in infants with prenatal hydronephrosis. Antibiotic prophylaxis did not reduce the risk of urinary tract infection in the study group. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. Variable Resource Utilization in the Prenatal and Postnatal Management of Isolated Hydronephrosis.

    PubMed

    Dy, Geolani W; Ellison, Jonathan S; Fu, Benjamin C; Holt, Sarah K; Gore, John L; Merguerian, Paul A

    2017-10-01

    To characterize contemporary resource utilization and medical outcomes for infants with antenatal hydronephrosis and their mothers from a national claims database. We hypothesize that management of isolated hydronephrosis (IHN) varies widely, with decreased imaging following the 2010 Society for Fetal Urology Consensus Statement. Using MarketScan claims from 2007 to 2013, we identified infants 0-12 months of age with hydronephrosis and linked mothers. Those with urologic diagnoses more specific than hydronephrosis, additional urologic comorbidities, or postnatal surgeries were excluded. Resource utilization including prenatal and postnatal imaging, laboratory studies, hospital admissions, and medical outcomes within the first year was captured. Demographics, maternal characteristics, utilization measures, and outcomes were compared across imaging intensity groups based on number of postnatal ultrasounds received using bivariate analysis. Among 801,919 mother-child pairs, 8610 infants (1.1%) had hydronephrosis or a related diagnosis. A total of 5876 (68.2%) met inclusion criteria for IHN. Patients underwent a mean 5.3 ± 3.5 prenatal and 2.1 ± 1.3 postnatal ultrasounds before age 1. Imaging practices were unchanged following the Society for Fetal Urology consensus statement. Antenatal hydronephrosis prevalence in an insured population is consistent with published ranges. Prenatal imaging in IHN is variable and potentially excessive. Future study into the efficacy of evidence-based pathways in reducing excess utilization is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Atypical Ormond's disease associated with bile duct stricture mimicking cholangiocarcinoma.

    PubMed

    Quante, Michael; Appenrodt, Beate; Randerath, Simone; Wolff, Martin; Fischer, Hans-Peter; Sauerbruch, Tilman

    2009-01-01

    A 55-year-old woman with suspected hilar cholangiocarcinoma presented with jaundice and dilated intrahepatic bile ducts owing to high-grade hepatic duct confluence stenosis. The suspected tumour and the entire extrahepatic bile duct system were resected and Roux-en-Y hepaticojejunostomy was performed. Histological investigations showed perihepatic fibrosis but no signs of malignancy. One year later the patient developed bilateral hydronephrosis caused by ureteral obstruction. Since the patient had a gynaecological history of widespread inflammation, she was referred for transabdominal operative ureterolysis combined with hysterectomy and adnexectomy. Histological investigations as well as fluorodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) findings were compatible with retroperitoneal fibrosis (Ormond's disease). Treatment with tamoxifen was initiated. To the best of our knowledge, only a few cases of intraperitoneal fibroses mimicking cholangiocarcinoma followed by the typical symptoms of retroperitoneal Ormond's disease have been reported.

  11. Resource utilization and costs associated with the diagnostic evaluation of nonrefluxing primary hydronephrosis in infants.

    PubMed

    Akhavan, Ardavan; Shnorhavorian, Margarett; Garrison, Louis P; Merguerian, Paul A

    2014-09-01

    Long-term evaluation of postnatal nonrefluxing primary hydronephrosis presents a dilemma for urologists since most cases resolve without surgery. We report longitudinal resource utilization and costs associated with diagnostic evaluation of infants with isolated primary nonrefluxing hydronephrosis to determine the costs associated with diagnosing a surgical case, and we assess the implications using a cost-consequences analysis. A retrospective chart review was used to capture resource utilization for all patients younger than 6 months with hydronephrosis evaluated at our institution during a 5-year period. Infants with confounding urological diagnoses were excluded. Payer and societal perspectives were used. Costs were estimated from resource utilization, including radiographic imaging and clinical encounter types. Data were collected from first clinic visit until surgery or resolution or 3 years, whichever was shortest. Of 165 included patients surgical rates for hydronephrosis were 0% for grade I, 5% for grade II, 21% for grade III and 74% for grade IV. Median respective costs of identifying a single surgical case per increasing hydronephrosis grade 0 to IV were infinite, $37,600, $11,741 and $2,124 (p <0.001), respectively. Diagnostic evaluation of higher grades of hydronephrosis is significantly more productive in terms of identifying patients requiring surgery vs evaluation of patients with lower grade disease. In patients with grades I and II hydronephrosis a more abbreviated diagnostic strategy than the current standard of care may be warranted. For the population in this analysis we project that a less intensive approach could save about 24% of costs. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Yo-yo reflux in an incomplete duplex system causing severe hydronephrosis in a patient with contralateral renal agenesis.

    PubMed

    Rehder, Peter; Petersen, Johannes; Hofmann, Karin J; Schenk, Claudia; Trieb, Thomas; Glodny, Bernhard

    2008-01-01

    This is a report of a case of a 26-year-old patient suffering from progressive renal insufficiency with a neurogenic bladder disorder due to a lipomyelomeningocele. She had renal agenesis on the left side and grade III hydronephrosis of both segments of a right duplex kidney with a bifid ureter joining further distal to the kidney. Both ureters were dilated. The cause was found to be a yo-yo reflux between the two halves of the kidney. Following bladder augmentation and pyelopyelostomy, renal insufficiency improved to stage III and has now been stable for four years. Due to the contralateral renal agenesis, the case is a unique illustration of the functional effect of the yo-yo reflux and pyelopyelostomy.

  13. Hydronephrosis alters cardiac ACE2 and Mas receptor expression in mice.

    PubMed

    Zhang, Yanling; Ma, Lulu; Wu, Junyan; Chen, Tingting

    2015-06-01

    Hydronephrosis is characterized by substantial loss of tubules and affects renin secretion in the kidney. However, whether alterations of angiotensin-converting enzyme (ACE), ACE2 and Mas receptor in the heart are observed in hydronephrosis is unknown. Thus, we assessed these components in hydronephrotic mice treated with AT1 receptor blockade and ACE inhibitor. Hydronephrosis was induced by left ureteral ligation in Balb/C mice except sham-operated animals. The levels of cardiac ACE, ACE2 and Mas receptor were measured after treatment of losartan or enalapril. Hydronephrosis led to an increase of ACE level and a decrease of ACE2 and Mas receptor in the heart. Losartan decreased cardiac ACE level, but ACE2 and Mas receptor levels significantly increased in hydronephrotic mice (p < 0.01). Enalapril increased ACE2 levels (p < 0.01), but did not affect Mas receptor in the heart. Plasma renin activity (PRA) and Ang II decreased in hydronephrotic mice, but significantly increased after treatment with losartan or enalapril. Hydronephrosis increased cardiac ACE and suppressed ACE2 and Mas receptor levels. AT1 blockade caused sustained activation of cardiac ACE2 and Mas receptor, but ACE inhibitor had the limitation of such activation of Mas receptor in hydronephrotic animals. © The Author(s) 2015.

  14. [Hydronephrosis as a complication of the appendiceal abscess: report of a case].

    PubMed

    Iida, K; Yamaguchi, K; Nishimura, Y; Tominaga, T

    2000-03-01

    We report a case of appendiceal abscess complicated with right hydronephrosis in a 67-year-old woman. She visited our department complaining of right flank pain. Intravenous pyelography (IVP) showed hydronephrosis and hydroureter on right and a narrow ureter at the pelvic brim. A pelvic computed tomographic scan revealed a low density area measuring 44 x 37 mm in size, anterior to the right ureter, which was thought to be a pelvic tumor. Further examination did not reveal the origin of the tumor. An exploratory laparotomy was performed. The tumor developed from the cecum and adhered to the right ureter. The appendix was not found. The tumor was resected with the cecum while the ureter was preserved. Histological investigations revealed an appendiceal abscess. The postoperative course was uneventful. IVP after the operation showed the hydronephrosis to have resolved.

  15. Evaluation of painful hydronephrosis in pregnancy: magnetic resonance urographic patterns in physiological dilatation versus calculous obstruction.

    PubMed

    Spencer, J A; Chahal, R; Kelly, A; Taylor, K; Eardley, I; Lloyd, S N

    2004-01-01

    We evaluated magnetic resonance urography (MRU) appearances in symptomatic hydronephrosis in pregnancy and compared urographic patterns in physiological and calculous disease. A total of 24 consecutive pregnant women with symptomatic hydronephrosis underwent MRU, comprising an overview fast T2-weighted examination of the abdomen and pelvis, and thick slab, heavily T2-weighted MRU images, followed by focused, high resolution T2-weighted sequences obtained in an axial and coronal oblique plane through the level of ureteral caliber change. Of these 24 pregnant women 15 were found to have physiological hydronephrosis, 7 had calculous disease and 2 had preexisting urinary anomalies. MRU findings in physiological hydronephrosis cases were extrinsic compression of the middle third of the ureter, no filling defect and a collapsed ureter below it. Obstruction by ureteral calculi was seen at points of ureteral narrowing in the ureter, that is at the vesicoureteral junction in 2 cases, in the compressed mid ureter in 3 and at the pelviureteral junction in 1. Nonobstructive renal calculi were seen in another patient. Calculi presented throughout pregnancy but physiological hydronephrosis presented only in the late second and third trimesters. With distal calculi the MRU appearance was the double kink sign with constriction at the pelvic brim and the vesicoureteral junction with a standing column of urine in the pelvic ureter. There was renal edema and perirenal extravasation. Small calculi were only identified using high resolution T2-weighted magnetic resonance imaging. MRU is a valuable and well tolerated investigation for evaluating painful hydronephrosis in pregnancy. There are characteristic and differing urographic appearances in physiological and calculous obstruction.

  16. Determination of the Need for Surgical Intervention in Infants Diagnosed with Fetal Hydronephrosis in China

    PubMed Central

    Zhang, Lei; Liu, Chao; Li, Yan; Sun, Chao; Li, Xiang

    2016-01-01

    Background Hydronephrosis is a common congenital condition. The detection of fetal hydronephrosis by ultrasound presents a treatment dilemma. This study aims to examine postnatal follow-up and treatment for hydronephrosis diagnosed prenatally. Material/Methods This was a retrospective study of 210 infants with hydronephrosis diagnosed at the Qilu Hospital (Shangdong, China) between January 2005 and January 2013. The patient cohort was divided into four groups based on prenatal ultrasound examinations using the Society for Fetal Urology (SFU) classification system. Data on follow-up investigations and treatment methods were extracted from the charts and analyzed. Results Patients with SFU grade 1, 2, and 3 hydronephrosis (n=125, n=74, and n=11, respectively) were followed for two years. In all, 2.4%, 18.9%, and 90.9% of patients with SFU grade 1, 2, and 3 hydronephrosis, respectively, underwent surgery. SFU grade 3 (HR=9.23, 95% CI: 1.43–59.74, p=0.02), APD (HR=2.81, 95% CI: 1.11–7.10, p=0.03), and parenchymal thickness (HR=0.42, 95% CI: 0.24–0.71, p=0.001) were independently associated with the occurrence of surgery. For anterioposterior diameter, using a cut-off point of 1.1, the area under the curve was 0.86, Youden index was 0.556, sensitivity was 70.4%, and specificity was 85.3%. For parenchymal thickness, using a cut-off point of 5, AUC was 0.79, Youden index was 0.478, sensitivity was 74.1%, and specificity was 73.8%. Conclusions Patients with SFU grade 2 hydronephrosis require long-term follow-up. Surgery and close postsurgical observation may be necessary for patients with SFU grade 3 and 4 hydronephrosis. An initial B-mode ultrasound screening at 7–10 days after birth may help make an optimal diagnosis and treatment selection. PMID:27816985

  17. Melorheostosis mimicking synovial osteochondromatosis.

    PubMed

    Wadhwa, Vibhor; Chhabra, Avneesh; Samet, Jonathan D

    2014-01-01

    Melorheostosis is an uncommon, sporadic, sclerosing bone lesion that may affect the adjacent soft tissues. It has been associated with many entities such as osteopoikilosis, soft tissue vascular malformations, bone and soft tissue tumors, nephrotic syndrome, segmental limb contractures, osteosarcoma, desmoid tumor, and mesenteric fibromatosis. Synovial osteochondromatosis is a benign neoplasia of the hyaline cartilage presenting as nodules in the subsynovial tissue of a joint or tendon sheath. The intra-articular extension of melorheostosis mimicking synovial osteochondromatosis has not been reported before. In this article, the authors describe an unusual case mimicking synovial chondromatosis arising as a result of melorheostosis and their characteristic imaging findings.

  18. Obstructive urolithiasis, unilateral hydronephrosis, and probable nephrolithiasis in a 12-year-old Clydesdale gelding.

    PubMed

    Macbeth, Bryan J

    2008-03-01

    A 12-year-old Clydesdale gelding was presented for colic and dysuria. Obstructive urolithiasis and chronic renal disease were diagnosed via transurethral endoscopy and percutaneous ultrasonography. Nephroliths, hydronephrosis, and peri-ureteral fibrosis were present. Surgical intervention was declined and the gelding was managed medically with antibiotics and dietary modification.

  19. Renal dysfunction due to hydronephrosis by SAPHO syndrome: a case report

    PubMed Central

    Kakoki, Katsura; Miyata, Yasuyoshi; Enokizono, Mikako; Uetani, Masataka; Sakai, Hideki

    2015-01-01

    Key Clinical Message Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis (SAPHO) syndrome shows varied pathological symptoms. This is the first report of hydronephrosis due to the mechanical compression of bilateral ureters as a result of SAPHO syndrome. From our experience, MRI is the most useful imaging examination to check the upper urinary tract in SAPHO syndrome. PMID:26331013

  20. Renal dysfunction due to hydronephrosis by SAPHO syndrome: a case report.

    PubMed

    Kakoki, Katsura; Miyata, Yasuyoshi; Enokizono, Mikako; Uetani, Masataka; Sakai, Hideki

    2015-08-01

    Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis (SAPHO) syndrome shows varied pathological symptoms. This is the first report of hydronephrosis due to the mechanical compression of bilateral ureters as a result of SAPHO syndrome. From our experience, MRI is the most useful imaging examination to check the upper urinary tract in SAPHO syndrome.

  1. Risk factors for febrile urinary tract infection in children with prenatal hydronephrosis: a prospective study.

    PubMed

    Braga, Luis H; Farrokhyar, Forough; D'Cruz, Jennifer; Pemberton, Julia; Lorenzo, Armando J

    2015-05-01

    We prospectively investigated the impact of risk factors for febrile urinary tract infection in infants with postnatally confirmed prenatal hydronephrosis. Patients seen for prenatal hydronephrosis from 2010 to 2013 were prospectively followed. Those with ectopic ureters and ureteroceles, posterior urethral valves and neuropathic bladders were excluded. The primary outcome was febrile catheter specimen urinary tract infection. We performed univariate analysis of 7 a priori risk factors, including age, hydronephrosis grade (low-I or II vs high-III or IV), type (isolated hydronephrosis vs hydroureteronephrosis), continuous antibiotic prophylaxis, vesicoureteral reflux grade, gender and circumcision status. Time to febrile urinary tract infection curves analyzed by Cox proportional regression were generated to adjust for confounders. We collected data on 334 patients, of whom 78% were male. A febrile urinary tract infection developed in 65 patients (19%) at a median of 4 months (range 1 to 31). High grade hydronephrosis was present in 192 infants (57%). Continuous antibiotic prophylaxis was prescribed in 96 cases (29%). Of patients on continuous antibiotic prophylaxis 69% had high grade hydronephrosis. Vesicoureteral reflux was identified in 57 of 238 patients in whom voiding cystourethrogram was done. Reflux was grade I to III in 14 cases and grade IV or V in 43. Two-thirds of the patients with reflux were on continuous antibiotic prophylaxis. Circumcision was performed in 95 males (36%). Cox proportional regression identified female gender (HR 3.3, p = 0.02), uncircumcised males (HR 3.2, p = 0.02), hydroureteronephrosis (HR 10.9, p <0.01), vesicoureteral reflux (HR 20.8, p <0.01) and lack of continuous antibiotic prophylaxis (HR 5.2, p <0.01) as risk factors for febrile urinary tract infection. Subgroup analysis excluding vesicoureteral reflux showed that high grade prenatal hydronephrosis was also a significant risk factor (HR 3.0, p = 0.04). After patients

  2. Reliability assessment of Society for Fetal Urology ultrasound grading system for hydronephrosis.

    PubMed

    Keays, M A; Guerra, L A; Mihill, J; Raju, G; Al-Asheeri, N; Geier, P; Gaboury, I; Matzinger, M; Pike, J; Leonard, M P

    2008-10-01

    The Society for Fetal Urology introduced a subjective grading system for classifying hydronephrosis that has important implications in patient diagnosis, treatment and outcome. The grading system is frequently used to standardize the severity of hydronephrosis, and compare results among patients and centers. Despite widespread use to our knowledge no groups have investigated the reliability of the grading system since its introduction. We assessed the intrarater and interrater reliability of the Society for Fetal Urology grading system for hydronephrosis and examined levels of agreement by the degree of hydronephrosis (grades 0 to 4) and level of experience (staff vs trainee). A series of 50 pediatric renal ultrasound images from patients with a diagnosis of hydronephrosis were assessed by 4 staff individuals and 4 trainees using the Society for Fetal Urology grading system. Ultrasound images included the kidneys, ureters and bladder to be consistent with practice. After 7 to 14 days each rater repeated the assessment. The nonweighted Cohen kappa statistic was used to estimate intrarater and interrater reliability by Society for Fetal Urology grade and training level. Staff and trainee raters independently assigned Society for Fetal Urology grades to 50 patients (99 renal units). The average number of images per ultrasound was 41, including the right and left kidneys. Overall interrater agreement for staff individuals was substantial for grade 0, moderate for grades 1, 2 and 4, and only slight to fair for grade 3. Intrarater agreement was substantial to almost perfect for staff agreement (range 69% to 94%, kappa 0.56 to 0.89) and trainees (range 63% to 90%, kappa 0.48 to 0.85). Our study suggests that the Society for Fetal Urology grading system has good intrarater but modest interrater reliability. Individual rater interpretations of the grading system may explain the modest interrater agreement. Proposed modifications to the Society for Fetal Urology

  3. Sensitivity of Emergency Bedside Ultrasound to Detect Hydronephrosis in Patients with Computed Tomography-proven Stones

    PubMed Central

    Riddell, Jeff; Case, Aaron; Wopat, Ross; Beckham, Stephen; Lucas, Mikael; McClung, Christian D.; Swadron, Stuart

    2014-01-01

    Introduction Non-contrast computed tomography (CT) is widely regarded as the gold standard for diagnosis of urolithiasis in emergency department (ED) patients. However, it is costly, time-consuming and exposes patients to significant doses of ionizing radiation. Hydronephrosis on bedside ultrasound is a sign of a ureteral stone, and has a reported sensitivity of 72–83% for identification of unilateral hydronephrosis when compared to CT. The purpose of this study was to evaluate trends in sensitivity related to stone size and number. Methods This was a structured, explicit, retrospective chart review. Two blinded investigators used reviewed charts of all adult patients over a 6-month period with a final diagnosis of renal colic. Of these charts, those with CT evidence of renal calculus by attending radiologist read were examined for results of bedside ultrasound performed by an emergency physician. We included only those patient encounters with both CT-proven renal calculi and documented bedside ultrasound results. Results 125 patients met inclusion criteria. The overall sensitivity of ultrasound for detection of hydronephrosis was 78.4% [95% confidence interval (CI)=70.2–85.3%]. The overall sensitivity of a positive ultrasound finding of either hydronephrosis or visualized stones was 82.4% [95%CI: 75.6%, 89.2%]. Based on a prior assumption that ultrasound would detect hydronephrosis more often in patients with larger stones, we found a statistically significant (p=0.016) difference in detecting hydronephrosis in patients with a stone ≥6 mm (sensitivity=90% [95% CI=82–98%]) compared to a stone <6 mm (sensitivity=75% [95% CI=65–86%]). For those with 3 or more stones, sensitivity was 100% [95% CI=63–100%]. There were no patients with stones ≥6 mm that had both a negative ultrasound and lack of hematuria. Conclusion In a population with CT-proven urolithiasis, ED bedside ultrasonography had similar overall sensitivity to previous reports but showed better

  4. Incidental vesicoureteral reflux in neonates with antenatally detected hydronephrosis and other renal abnormalities.

    PubMed

    Zerin, J M; Ritchey, M L; Chang, A C

    1993-04-01

    Postnatal imaging findings were reviewed in 130 neonates and young infants referred for imaging evaluation of antenatally detected renal abnormalities. All children underwent voiding cystourethrography and upper urinary tract imaging with sonography and/or renal scintigraphy. Vesicoureteral reflux was present in 49 patients (38%) and was bilateral in 24. All grades of reflux were observed. Reflux occurred in 41 of 98 neonates (42%) in whom postnatal imaging revealed persistent upper tract abnormalities (eg, hydronephrosis, cysts, renal agenesis) and in eight of 32 (25%) with normal findings at postnatal sonography and/or renal scintigraphy. Reflux was the single most common urologic diagnosis and was the only postnatal abnormality in 12 patients (9%). The authors conclude that neonates with antenatally detected hydronephrosis should be routinely screened for reflux with voiding cystography. Detection and aggressive management of reflux in the asymptomatic neonate in whom renal growth and function are unimpaired theoretically offer the best opportunity for preventing renal injury later in childhood.

  5. Giant hydronephrosis and secondary pyelonephritis induced by Salmonella dublin in a Holstein calf

    PubMed Central

    Taghipur Bazargani, T; Khodakaram-Tafti, A; Ashrafi, I; Abbassi, A. M.

    2015-01-01

    Hydronephrosis occurs as a congenital or an acquired condition following obstruction of the urinary tract. In this study, a four month old male Holstein calf with emaciation, growth retardation and a poor dry scruffy hair coat was examined because of remarkable distention of right abdomen. At necropsy, right kidney was hydronephrotic as a very big fluid-filled round pelvis with the presence of multilocular cysts bulged from the cortical surface. With sectioning, more than 10 L of bloody fluid poured out from this sac. Microscopic examination showed severe atrophy of cortical tissue and fibrosis of the medulla. Also, the dilated pelvis was composed of fibrinous exudate and necrosis of epithelium associated with multifocal aggregations of neutrophils and bacterial microcolonies. In a culture and serotyping of isolated bacteria, Salmonella dublin was determined. In conclusion, S. dublin induced pyelonephritis secondary to congenital giant hydronephrosis is the first report in cattle in the world. PMID:27175163

  6. Congenital imperforate hymen with bilateral hydronephrosis, polydactyly and laryngocele: A rare neonatal presentation.

    PubMed

    Ozturk, Hulya; Yazici, Burhan; Kucuk, Adem; Senses, Dursun Ali

    2010-01-01

    Imperforate hymen is a rare congenital malformation to present with symptoms in the neonatal period. We present a case of a 5-day-old neonate with a marked interlabial swelling causing urinary retention. Imaging revealed hydrometrocolpos, hydrosalpinx, and bilateral hydronephrosis. Additionally, our patient had polydactyly of both feet and hands, and laryngocele that have not been previously described in literature. Hymenectomy is the mainstay of management to prevent the development of hematocolpos, pain, and possible retrograde menstruation.

  7. Benign multicystic peritoneal mesothelioma associated with hydronephrosis and colovesical fistula formation: report of a case.

    PubMed

    McCaffrey, James C; Foo, Fung J; Dalal, Neha; Siddiqui, Kamran H

    2009-01-01

    Mesotheliomas usually arise from the pleura and are malignant. We report an unusual case of benign peritoneal mesothelioma presenting in a 59-year-old woman. The disease resulted in bilateral hydronephrosis, colovesical fistula formation, recurrent small bowel obstruction and chronic abdominal pain. To date only a handful of cases have been reported and to the best of our knowledge, none has been so aggressive.

  8. Renal Artery Embolization - A First Line Treatment Option For End-Stage Hydronephrosis

    SciTech Connect

    Mitra, Kakali; Prabhudesai, Vikramaditya; James, R. Lester; Jones, Robert W. A.; French, Michael E.; Cowling, Mark; West, David J.

    2004-09-15

    Conventionally poorly functioning hydronephrotic kidneys have been removed if they are symptomatic. In our unit, patients are offered renal artery embolization as an alternative treatment option. Patients and Methods: Fifteen patients (11 male, 4 female) with a mean age of 32.9 yr (20-51 yrs) have undergone renal artery embolization for symptomatic hydronephrosis with poor function. Mean follow-up was 64.13 weeks (range 14-200). All patients had loin pain and hydronephrosis. Twelve patients had primary pelvi-ureteric junction obstruction (PUJO). Two patients had poorly functioning hydronephrotic kidneys secondary to chronic calculous obstruction. One patient had chronic pain in an obstructed but reasonably functioning kidney following a previous pyeloplasty for PUJO which demanded intervention. Mean split function on renography was 11% (range 0-46%). Selective renal artery embolization was carried out under antibiotic cover using a 7 Fr balloon occlusion catheter and absolute alcohol, steel coils, and polyvinyl alcohol particles.Results: Nine patients developed post-embolization syndrome of self-limiting pain and pyrexia with no evidence of sepsis. One patient required readmission with this condition. One patient developed a hematoma at the puncture site. Mean hospital stay was 2.3 days. Fourteen patients are happy with the result and are completely pain free. One patient has minor discomfort but is delighted with the result. Nine patients have had follow-up ultrasound confirming resolution of the hydronephrosis. Conclusion: Renal artery embolization is an effective, safe, well-tolerated minimally invasive treatment option in end-stage hydronephrosis and we routinely offer it as an alternative to nephrectomy.

  9. The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis.

    PubMed

    Nguyen, Hiep T; Herndon, C D Anthony; Cooper, Christopher; Gatti, John; Kirsch, Andrew; Kokorowski, Paul; Lee, Richard; Perez-Brayfield, Marcos; Metcalfe, Peter; Yerkes, Elizabeth; Cendron, Marc; Campbell, Jeffrey B

    2010-06-01

    The evaluation and management of fetuses/children with antenatal hydronephrosis (ANH) poses a significant dilemma for the practitioner. Which patients require evaluation, intervention or observation? Though the literature is quite extensive, it is plagued with bias and conflicting data, creating much confusion as to the optimal care of patients with ANH. In this article, we summarized the literature and proposed recommendations for the evaluation and management of ANH.

  10. Tracheobronchial Amyloidosis Mimicking Tracheal Tumor.

    PubMed

    Tanrıverdi, Elif; Özgül, Mehmet Akif; Uzun, Oğuz; Gül, Şule; Çörtük, Mustafa; Yaşar, Zehra; Acat, Murat; Arda, Naciye; Çetinkaya, Erdoğan

    2016-01-01

    Tracheobronchial amyloidosis is a rare presentation and accounts for about 1% of benign tumors in this area. The diagnosis of disease is delayed due to nonspecific pulmonary symptoms. Therapeutic approaches are required to control progressive pulmonary symptoms for most of the patients. Herein, we report a case of a 68-year-old man admitted with progressive dyspnea to our institution for further evaluation and management. He was initially diagnosed with and underwent management for bronchial asthma for two years but had persistent symptoms despite optimal medical therapy. Pulmonary computed tomography scan revealed severe endotracheal stenosis. Bronchoscopy was performed and showed endotracheal mass obstructing 70% of the distal trachea and mimicking a neoplastic lesion. The mass was successfully resected by mechanical resection, argon plasma coagulation (APC), and Nd-YAG laser during rigid bronchoscopy. Biopsy materials showed deposits of amorphous material by hematoxylin and eosin staining and these deposits were selectively stained with Congo Red. Although this is a rare clinical condition, this case indicated that carrying out a bronchoscopy in any patient complaining of atypical bronchial symptoms or with uncontrolled asthma is very important.

  11. Tracheobronchial Amyloidosis Mimicking Tracheal Tumor

    PubMed Central

    Özgül, Mehmet Akif; Uzun, Oğuz; Yaşar, Zehra; Acat, Murat; Arda, Naciye; Çetinkaya, Erdoğan

    2016-01-01

    Tracheobronchial amyloidosis is a rare presentation and accounts for about 1% of benign tumors in this area. The diagnosis of disease is delayed due to nonspecific pulmonary symptoms. Therapeutic approaches are required to control progressive pulmonary symptoms for most of the patients. Herein, we report a case of a 68-year-old man admitted with progressive dyspnea to our institution for further evaluation and management. He was initially diagnosed with and underwent management for bronchial asthma for two years but had persistent symptoms despite optimal medical therapy. Pulmonary computed tomography scan revealed severe endotracheal stenosis. Bronchoscopy was performed and showed endotracheal mass obstructing 70% of the distal trachea and mimicking a neoplastic lesion. The mass was successfully resected by mechanical resection, argon plasma coagulation (APC), and Nd-YAG laser during rigid bronchoscopy. Biopsy materials showed deposits of amorphous material by hematoxylin and eosin staining and these deposits were selectively stained with Congo Red. Although this is a rare clinical condition, this case indicated that carrying out a bronchoscopy in any patient complaining of atypical bronchial symptoms or with uncontrolled asthma is very important. PMID:27594885

  12. Co-occurrence of congenital hydronephrosis and FOXL2-associated blepharophimosis, ptosis, epicanthus inversus syndrome (BPES).

    PubMed

    Gulati, Reena; Verdin, Hannah; Halanaik, Dhanapathi; Bhat, B Vishnu; De Baere, Elfride

    2014-10-01

    Blepharophimosis, ptosis, epicanthus inversus syndrome (BPES) is an autosomal dominantly inherited congenital malformation of the eyelids. Diagnostic criteria include blepharophimosis, ptosis, epicanthus inversus and telecanthus. Type І BPES has additional features of premature ovarian failure and female infertility, while type ІІ occurs isolated. We report a two-year old male child with typical features of BPES and bilateral congenital hydronephrosis. The child, first-born to non-consanguineous parents, presented to us with hypertension. Congenital hydronephrosis and reduced renal function were confirmed by renal dynamic scan. Pyeloplasty and stent placement were performed with subsequent resolution of hypertension. On follow up, growth and development are appropriate for age. His father has similar but less severe features of BPES. Sequencing of the FOXL2 gene revealed a heterozygous FOXL2 mutation c.672_701dup, which is a recurrent 30-bp duplication leading to expansion of the polyalanine tract (p.Ala225_Ala234dup), in both father and son. Additional atypical clinical features have been reported previously in BPES patients with this mutation. However, this is the first report of a renal congenital anomaly in a BPES patient with this or other mutations. Although a pleiotropic effect of the FOXL2 mutation cannot be excluded, the co-occurrence of congenital hydronephrosis and BPES may represent two different entities. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. Therapeutic approaches and long-term follow-up for prenatal hydronephrosis

    PubMed Central

    Aydogdu, Bahattin; Tireli, Gulay; Demirali, Oyhan; Guvenc, Unal; Besik, Cemile; Sander, Serdar; Kiyak, Aysel

    2016-01-01

    Objective: This study summarises the outcomes of 149 patients who underwent surgery for antenatally diagnosed unilateral hydronephrosis. Methods: The medical records of such patients over a 23-year period were reviewed retrospectively. Age at the time of operation, preoperative and postoperative mean pelvic diameter on ultrasound, split renal function, washout patterns on scintigraphy, and early and late complications were recorded. Results: The mean preoperative follow-up period was five months (range: 1–66 months). One patient was operated on after 12 months and two patients after five years of follow-up. Mean preoperative pelvic diameter and renal function were 30.8 mm and 38.6%, respectively; all patients had an obstructive wash-out pattern. In the postoperative period, the corresponding measurements were 11.7 mm and 39.2%, with 111 non-obstructive, 24 partially obstructive, and 14 obstructive wash-out patterns. Three patients with severe caliectasis and low renal function underwent surgery despite mild hydronephrosis. The mean postoperative follow-up period was six (range 4–11) years. Complications developed in 14 (9.3%) patients. Conclusion: Patients with antenatal hydronephrosis may need surgery even after a follow-up period of six years. Because of the potential late development of complications, postoperative follow-up should be continued for 10 years. PMID:27375711

  14. Supranormal renal function in unilateral hydronephrosis: does it represent true hyperfunction?

    PubMed

    Maenhout, Annelies; Ham, Hamphrey; Ismaili, K; Hall, M; Dierckx, R A; Piepsz, A

    2005-12-01

    The existence of supranormal differential renal function in unilateral hydronephrosis remains controversial. While some authors consider it as fact, others believe that it is just a technical artifact. Within our department, chromium-51 ethylene diamine tetra-acetic acid (Cr-EDTA) renal clearance is systematically performed in conjunction with technetium-99m mercaptoacetyltriglycine (MAG3) renograms to derive an absolute single kidney glomerular filtration rate (SKGFR). Our data allows us to ascertain whether supranormal differential renal function in unilateral hydronephrosis might be due to hypofunction of the contralateral kidney. Children with marked unilateral hydronephrosis were selected from a large database of MAG3 diuretic(s) renograms. We excluded patients with posterior urethral valves, duplex anomalies, neurogenic bladder, solitary kidney, and those who underwent any previous urological surgery. We also excluded children who had an early furosemide injection (F0 procedure), selecting only those having received furosemide at the end of the renogram (F+20 test). Seventy-three patients (92 renograms) fulfilled these criteria. Differential renal function was calculated using the integral method. Hydronephrotic kidney with a relative uptake > or =55% was defined as supranormal. Six renograms (four patients) demonstrated supranormal relative function on the hydronephrotic side. However, the SKGFR of these kidneys was in all cases within the range of normal values, while the contralateral side demonstrated borderline low SKGFR. Increased relative function on the side of the hydronephrotic kidney is relatively infrequent. When it occurs, it may be related to a borderline hypofunction of the contralateral kidney.

  15. Intramedullary cervical neurenteric cyst mimicking an abscess.

    PubMed

    Muzumdar, D; Bhatt, Y; Sheth, J

    2008-01-01

    We describe a cervical intramedullary neurenteric cyst in a 12-year-old male patient who presented with gradual onset and progressively worsening neck pain, spastic quadriparesis and impaired sensation in the C(2) dermatome. MR imaging revealed a well-defined peripherally enhancing cystic intramedullary lesion with a posteroinferior enhancing nodule at the C(2)-C(3) level mimicking an abscess. There was no evidence of spinal dysraphism. The lesion was completely resected through a posterior approach and the patient showed radical improvement in his symptomatology. At follow-up after 3 years, he was asymptomatic and the MR imaging showed no evidence of any residual or recurrent cyst. The case presented here is unique, since a spinal neurenteric cyst showing intense peripheral contrast enhancement mimicking an abscess is unusual. The radiological features, pathogenesis and surgical considerations in cervical intramedullary neurenteric cysts are discussed and the relevant literature is briefly reviewed.

  16. Retroperitoneal laparoscopy management for ureteral fibroepithelial polyps causing hydronephrosis in children: a report of five cases.

    PubMed

    Dai, L N; Chen, C D; Lin, X K; Wang, Y B; Xia, L G; Liu, P; Chen, X M; Li, Z R

    2015-10-01

    Hydronephrosis is a common disease in children and may be caused by ureteral fibroepithelial polyps (UFP). Ureteral fibroepithelial polyps are rare in children and are difficult to precisely diagnose before surgery. Surgical treatment for symptomatic UFP is recommended. At the present institution, retroperitoneal laparoscopy has been used to treat five boys with UFP since 2006. To highlight the significance of UFP as an etiological factor of hydronephrosis in children and evaluate the applicative value of retroperitoneal laparoscopy in the treatment of children with UFP. Between 2006 and 2013 five boys underwent retroperitoneal laparoscopy at the present institution. They were identified with UFP by review of the clinical database. Detailed data were collected, including: radiographic studies, gross anatomical pathology, and pathology and radiology reports. All boys had been followed up at least every 6 months. All of the boys were aged between 7 and 16 years (mean 9.8 years). The main symptoms were flank pain (all five) and hematuria (three). Radiographic examination showed that all of the boys presented with incomplete ureteral obstruction and hydronephrosis. The ureteral fibroepithelial polyps were located near the left UPJ or the left proximal ureter. All of the boys had the UFP removed: three underwent retroperitoneal laparoscopic dismembered Anderson-Hynes pyeloplasty and polypectomy, and two had retroperitoneal laparoscopic ureteral anastomosis. These polyps were all on the left side and between 15 and 35 mm in length (mean 22 mm) (Figure). All of the boys recovered well and were discharged from hospital. The postoperative histological report confirmed that the specimens were UFP. Hydronephrosis was periodically assessed by ultrasonography (using the same method as pre-surgical ultrasonography) after surgery. Mean follow-up was 33 months (range 6-58 months) and no complications were found afterwards. Ureteral fibroepithelial polyps are rare but rather

  17. Urticaria mimickers in children.

    PubMed

    Mathur, Anubhav N; Mathes, Erin F

    2013-01-01

    Acute urticaria is a self-limited cutaneous condition marked by transient, erythematous, and pruritic wheals. It is a hypersensitivity response that is often secondary to infection, medications, or food allergies in children. In contrast, the urticarial "mimickers" described in this review article are often seen in the context of fever and extracutaneous manifestations in pediatric patients. The differential diagnosis ranges from benign and self-limited hypersensitivity responses to multisystem inflammatory diseases. Establishing the correct diagnosis of an urticarial rash in a pediatric patient is necessary to both prevent an unnecessary work up for self-limited conditions and to appropriately recognize and evaluate multisystem inflammatory disorders. Herein, we describe two cases to illustrate the clinical manifestations, laboratory findings, histopathology and differential diagnoses for several mimickers of acute urticaria including: urticaria multiforme, serum sickness like reaction, Henoch-Schönlein purpura, acute hemorrhagic edema of infancy, systemic onset juvenile idiopathic arthritis, cryopyrin associated periodic syndromes, and urticarial vasculitis. © 2013 Wiley Periodicals, Inc.

  18. Society for fetal urology recommendations for postnatal evaluation of prenatal hydronephrosis--will fewer voiding cystourethrograms lead to more urinary tract infections?

    PubMed

    St Aubin, Melissa; Willihnganz-Lawson, Katie; Varda, Briony K; Fine, Matthew; Adejoro, Oluwakayode; Prosen, Tracy; Lewis, Jane M; Shukla, Aseem R

    2013-10-01

    There is no consensus on the extent and mode of postnatal imaging after a diagnosis of prenatal hydronephrosis. We validated the protocol of our practice, which parallels current Society for Fetal Urology (SFU) recommendations, in limiting voiding cystourethrogram, while examining its impact on the incidence of febrile urinary tract infections. A secondary goal was to examine predictors of postnatal intervention. We evaluated a cohort of 117 infants with prenatal hydronephrosis and retrospectively reviewed outcomes. Excluded from study were 30 infants with anatomical abnormalities. Third trimester prenatal ultrasound was done to evaluate SFU grade, laterality and anteroposterior diameter. Cox proportional hazard model and chi-square analysis were used to assess predictors of resolution and surgical intervention. A total of 87 infants with a median followup of 33.5 months were included in analysis. Postnatal voiding cystourethrogram was done in 52 patients, of whom 7 had vesicoureteral reflux. In 6 infants (6.9%) a febrile urinary tract infection developed, which was diagnosed with a catheter specimen during followup. In 3 infants a urinary tract infection developed immediately after catheterization. Anteroposterior diameter 9 mm or greater and SFU grade 3 or greater independently predicted the need for postnatal intervention (p = 0.0014 and 0.001, respectively). With adherence to our protocol, voiding cystourethrogram was avoided in almost half of evaluated infants. No infant diagnosed with vesicoureteral reflux had a urinary tract infection. Catheterization was associated with a urinary tract infection in 50% of cases. An anteroposterior diameter of 9 mm or greater and a SFU grade of 3 or greater were associated with postnatal progression to surgery. Patients with a SFU grade of 4 progressed to surgical intervention at a faster rate than those with a grade of greater than 3. Copyright © 2013 American Urological Association Education and Research, Inc. Published

  19. Critical role of cyclooxygenase-2 activation in pathogenesis of hydronephrosis caused by lactational exposure of mice to dioxin

    SciTech Connect

    Nishimura, Noriko Matsumura, Fumio; Vogel, Christopher F.A.; Nishimura, Hisao; Yonemoto, Junzo; Yoshioka, Wataru; Tohyama, Chiharu

    2008-09-15

    Congenital hydronephrosis is a serious disease occurring among infants and children. Besides the intrinsic genetic factors, in utero exposure to a xenobiotic, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), has been suggested to induce hydronephrosis in rodents owing to anatomical obstruction in the ureter. Here, we report that hydronephrosis induced in mouse pups exposed lactationally to TCDD is not associated with anatomical obstruction, but with abnormal alterations in the subepithelial mesenchyma of the ureter. In the kidneys of these pups, the expressions of a battery of inflammatory cytokines including monocyte chemoattractant protein (MCP)-1, tumor necrosis factor {alpha} (TNF{alpha}) and interleukin (IL) -1{beta} were up-regulated as early as postnatal day (PND) 7. The amounts of cyclooxygenase (COX) -2 mRNA and protein as well as prostaglandin E2 (PGE{sub 2}) were conspicuously up-regulated in an arylhydrocarbon-receptor-dependent manner in the TCDD-induced hydronephrotic kidney, with a subsequent down-regulation of the gene expressions of Na{sup +} and K{sup +} transporters, NKCC2 and ROMK. Daily administration of a COX-2 selective inhibitor to newborns until PND 7 completely abrogated the TCDD-induced PGE{sub 2} synthesis and gene expressions of inflammatory cytokines and electrolyte transporters, and eventually prevented the onset of hydronephrosis. These findings suggest an essential role of COX-2 in mediating the TCDD action of inducing hydronephrosis through the functional impairment rather than the anatomical blockade of the ureter.

  20. Impact of magnetic resonance urography and ultrasonography on diagnosis and management of hydronephrosis and megaureter in paediatric patients.

    PubMed

    Wildbrett, Peer; Langner, Sönke; Lode, Holger; Abel, Jürgen; Otto, Sylke; Hosten, Norbert; Barthlen, Winfried

    2012-01-01

    (1) To evaluate the diagnostic value of magnetic resonance urography (MRU) in comparison with ultrasonography (US) to determine the extent of upper urinary tract dilation and (2) to evaluate the impact of MRU on therapy management. From January 2005 to December 2010, paediatric patients with hydronephrosis or megaureter who underwent MRU in addition to standard work-up imaging were included. Data were retrospectively collected and analysed in comparison with the data obtained from results by US. Forty-five patients with upper urinary tract dilatation were included into the study. Twenty-six patients (58%) had a hydronephrosis and 19 patients (42%) presented with a megaureter. Diagnosis was established in all patients by multimodulary imaging work-up including micturating cysto-urethrography, MAG3 renography, US and MRU and could be confirmed in all patients who underwent surgery (n = 28). Hydronephrosis was detected in 26 of 26 patients by US (100% sensitivity) and in 25 of 26 patients (96%) by MRU (Not significant (n.s.)). Megaureter was detected in 17 of 19 patients (sensitivity 89%) by US and in 18 of 19 patients (sensitivity 95%) by MRU (n.s.). In all 45 patients, MRU had no impact on surgical or conservative management of hydronephrosis or megaureter. In our experience, MRU was not superior to US in detecting hydronephrosis or megaureter and had no impact on the surgical or conservative management of upper urinary tract dilation.

  1. Ultrasound based computer-aided-diagnosis of kidneys for pediatric hydronephrosis

    NASA Astrophysics Data System (ADS)

    Cerrolaza, Juan J.; Peters, Craig A.; Martin, Aaron D.; Myers, Emmarie; Safdar, Nabile; Linguraru, Marius G.

    2014-03-01

    Ultrasound is the mainstay of imaging for pediatric hydronephrosis, though its potential as diagnostic tool is limited by its subjective assessment, and lack of correlation with renal function. Therefore, all cases showing signs of hydronephrosis undergo further invasive studies, like diuretic renogram, in order to assess the actual renal function. Under the hypothesis that renal morphology is correlated with renal function, a new ultrasound based computer-aided diagnosis (CAD) tool for pediatric hydronephrosis is presented. From 2D ultrasound, a novel set of morphological features of the renal collecting systems and the parenchyma, is automatically extracted using image analysis techniques. From the original set of features, including size, geometric and curvature descriptors, a subset of ten features are selected as predictive variables, combining a feature selection technique and area under the curve filtering. Using the washout half time (T1/2) as indicative of renal obstruction, two groups are defined. Those cases whose T1/2 is above 30 minutes are considered to be severe, while the rest would be in the safety zone, where diuretic renography could be avoided. Two different classification techniques are evaluated (logistic regression, and support vector machines). Adjusting the probability decision thresholds to operate at the point of maximum sensitivity, i.e., preventing any severe case be misclassified, specificities of 53%, and 75% are achieved, for the logistic regression and the support vector machine classifier, respectively. The proposed CAD system allows to establish a link between non-invasive non-ionizing imaging techniques and renal function, limiting the need for invasive and ionizing diuretic renography.

  2. Unilateral ureteric stone associated with gross hydronephrosis and kidney shrinkage: a cadaveric report

    PubMed Central

    Tay, Ern-Wei; Bay, Boon-Huat

    2014-01-01

    Ureteric stones are a common cause of obstruction of the urinary tract, usually presenting with characteristic signs and symptoms, such as acute ureteric colic and hematuria. Occasionally, stones may present with non-specific symptoms such as low back pain and remain unidentified, leading to stone growth, chronic ureteric obstruction and complications such as hydronephrosis and renal damage. Here, we report a large ureteric stone in a cadaver with complete obstruction at the left ureterovesical junction, resulting in severe dilatation of the left ureter and renal pelvis. PMID:25548725

  3. Chronic partial obstructive urolithiasis causing hydronephrosis and chronic renal failure in a steer.

    PubMed

    Aldridge, B M; Garry, F B

    1992-07-01

    A 13-month-old Angus steer was examined with a 6-week history of lethargy, malaise and dribbling urine. Laboratory exam revealed crystalluria and poor renal function. Ultrasound revealed hydronephrosis and hydroureter. Euthanasia was chosen because of a poor prognosis for economic recovery. Necropsy demonstrated numerous calculi causing partial urethral obstruction approximately 25 cm from the end of the penis. Secondary renal changes were confirmed. Urolithiasis occurs commonly in ruminants. Secondary obstruction is usually complete with severe consequences. This is the first report of chronic partial obstructive urolithiasis resulting in endstage renal disease.

  4. Prevesical Calcification and Hydronephrosis in a Girl Treated for Vesicoureteral Reflux

    PubMed Central

    Kuipers, Sarah; van der Horst, Eric H. J. R.; Verbeke, Jonathan I. M. L.; Bökenkamp, Arend

    2016-01-01

    The endoscopic STING procedure using Deflux is a common and minimal invasive treatment for vesicoureteral reflux. Herein we present the case of an 11-year-old girl with loin pain and de novo hydronephrosis and megaureter on the left. Ultrasound and plain abdominal X-ray demonstrated a calcification at the ureterovesical junction. She had been treated with Deflux injections 5 years before. The clinical quiz addresses the differential diagnosis, workup, and pathogenesis of calcifications at the ureterovesical junction following endoscopic reflux therapy. PMID:27408905

  5. [Morphogenesis of connective tissue in patients with hydronephrosis caused by stricture of ureteric-pelvic segment of various etiology].

    PubMed

    Savenkov, V I

    2015-02-01

    In patients, suffering hydronephrosis stages II-III, caused by the ureteric-pelvic segment (UPS) obstruction due to inborn failures of urinary system, the collagen types I and III ratio reduction, and in acquired obstruction--its enhancement, are noted in interstitium, renal parenchyma vessels and the UPS walls. While obstruction in patients due to inborn failures in vascular basal membranes a deficiency of collagen type IV and appearance of nontypical for vascular basal membranes intersticial collagen type Il are observed. In the acquired UPS, obstruction the, enhancement of content of collagen type IV is revealed only. These disorders are mostly pronounced in patients with the disease recurrence. There was proposed diagnostic coefficient of ratio between collagens types I and III in patients, suffering hydronephrosis, caused by obstruction of various etiology. In hydronephrosis, caused by the UPS stricture, the cytokines disbalance occurs, impacting processes of collagen formation.

  6. Mimicking the Moon

    NASA Image and Video Library

    2014-11-03

    When Galileo first observed Venus displaying a crescent phase, he excitedly wrote to Kepler (in anagram) of Venus mimicking the moon-goddess. He would have been delirious with joy to see Saturn and Titan, seen in this image, doing the same thing. More than just pretty pictures, high-phase observations -- taken looking generally toward the Sun, as in this image -- are very powerful scientifically since the way atmospheres and rings transmit sunlight is often diagnostic of compositions and physical states. In this example, Titan's crescent nearly encircles its disk due to the small haze particles high in its atmosphere refracting the incoming light of the distant Sun. This view looks toward the sunlit side of the rings from about 3 degrees above the ringplane. The image was taken in violet light with the Cassini spacecraft wide-angle camera on Aug. 11, 2013. The view was obtained at a distance of approximately 1.1 million miles (1.7 million kilometers) from Saturn and at a Sun-Saturn-spacecraft, or phase, angle of 154 degrees. Image scale is 64 miles (103 kilometers) per pixel. http://photojournal.jpl.nasa.gov/catalog/PIA18291

  7. Loss of Dgcr8-mediated microRNA expression in the kidney results in hydronephrosis and renal malformation.

    PubMed

    Bartram, Malte P; Dafinger, Claudia; Habbig, Sandra; Benzing, Thomas; Schermer, Bernhard; Müller, Roman-Ulrich

    2015-04-14

    Small non-coding RNA molecules (miRNAs) play a pivotal role in regulating gene expression in development. miRNAs regulate key processes at the cellular level and thereby influence organismal and tissue development including kidney morphogenesis. A miRNA molecule is initially synthesized as a longer hairneedle-shaped RNA transcript and then processed through an enzymatic complex that contains the RNA-processing enzyme Drosha and its essential interactor Dgcr8. Resulting pre-miRNAs are then cleaved by Dicer. Recent data showed that loss of Dicer resulted in severe developmental kidney phenotypes. However, as Dicer has multiple miRNA-independent functions, it was not entirely clear whether the observed renal phenotypes could be exclusively attributed to a lack of miRNA expression. We analyzed the role of miRNAs in kidney development by conditional gene deletion of Dgcr8 in the developing kidney using a transgenic mouse line that expresses Cre recombinase in the distal nephron and derivatives of the ureteric bud in kidney development. Animals with a gene deletion of Dgcr8 in these tissues developed severe hydronephrosis, kidney cysts, progressive renal failure and premature death within the first two months after birth, a phenotype strongly resembling Dicer deletion. Here we show that conditional gene deletion of the essential miRNA-processing enzyme Dgcr8 in the developing renal tubular system results in severe developmental defects and kidney failure. These data confirm earlier findings obtained in Dicer knock-out animals and clearly illustrate the essential role of miRNAs in kidney development. The data suggests that miRNA dysregulation may play an important, yet ill-defined role in the pathogenesis of inborn defects of the genitourinary system and indicate that miRNA defects may be causative in the development of human disease.

  8. Bilateral hydronephrosis

    MedlinePlus

    ... upper urinary tract obstruction In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; ... of urinary tract obstruction. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; ...

  9. Protein-losing enteropathy in a young African-American woman with abdominal pain, diarrhea and hydronephrosis.

    PubMed

    Gornisiewicz, M; Rodriguez, M; Smith, J K; Saag, K; Alarcón, G S

    2001-01-01

    The case of a 21-year-old African-American woman who presented with abdominal pain, diarrhea and hydronephrosis and who proved to have protein-losing enteropathy secondary to systemic lupus erythematosus is discussed. This is an unusual complication of lupus.

  10. Is There Hope for Renal Growth on Imaging Studies Following Ureteral Reimplant for Boys With Fetal Hydronephrosis and Urinary Reflux?

    PubMed Central

    Wang, Ming-Hsien

    2015-01-01

    Reflux nephropathy is thought to be the etiology for renal maldevelopment. We present two boys with fetal hydronephrosis and sterile vesicoureteral reflux (VUR). There was lack of renal growth of the refluxing renal units on surveillance renal ultrasound. Parents elected to undergo open ureteral reimplants. Post-surgical ultrasounds demonstrated improved renal growth. PMID:26793522

  11. [A CASE OF ASCENDING COLON CANCER RECURRENCE WITH INTRALUMINAL URETERAL DISSEMINATION MIMICKING PRIMARY URETERAL CANCER, DETECTED DURING INVESTIGATION FOR FEVER].

    PubMed

    Nishiyama, Ryuichi; Kubota, Masashi; Kanno, Toru; Okada, Takashi; Higashi, Yoshihito; Yamada, Hitoshi

    2015-10-01

    A 69-year-old woman visited our hospital with a chief complaint of fever. Five years ago, she was diagnosed as ascending colon cancer and received right hemi-colectomy. One year later, local recurrence with right hydronephrosis was detected, and she received chemotherapy -4 cycles of modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) plus bevacizumab, and 12 cycles of fluorouracil, leucovorin, and irinotecan (FOLFIRI) plus bevacizumab- for two years. Local recurrence and right hydronephrosis disappeared on positron emission tomography performed 4 years postoperatively. This time, abdominal computed tomography for investigation of fever showed a relapse of right hydronephrosis and pyonephrosis. Cystoscopy revealed non-papillary tumor from the right ureteral orifice. Pelvic magnetic resonance imaging showed multiple tumors in the right ureter, and the distal lesion projecting into the bladder. After the general condition became well by right nephrostomy for infection control, transurethral resection of bladder tumor was performed. Histological examination of the specimen revealed a metastatic tubular adenocarcinoma (colon origin). Although right nephrectomy was performed for pyonephrosis control, she died of local progression of ascending colon cancer 10 months after first visit. Intraluminal ureteral progression of carcinoma originating from organs other than urinary tract is very rare. To our knowledge, this is the 9th report in the English or Japanese literature. In this case we could not rule out primary ureteral cancer preoperatively, and histological examination revealed intraluminal ureteral dissemination of ascending colon cancer.

  12. Congenital Nephrogenic Diabetes Insipidus Presented With Bilateral Hydronephrosis and Urinary Infection: A Case Report.

    PubMed

    Zheng, Kewen; Xie, Yi; Li, Hanzhong

    2016-05-01

    Nephrogenic diabetes insipidus (NDI) is a condition resulting from the kidney's impaired response to circulating antidiuretic hormone (ADH), leading to polydipsia and polyuria. Urinary tract dilatation caused by NDI is a rare situation. Here, we report a case of congenital NDI presented with bilateral hydronephrosis.A 15-year-old boy complaining a history of intermittent fever was admitted to Peking Union Medical College Hospital. He voided 10 to 15 L of urine daily. Radiographic examination revealed severe dilatation of bilateral renal pelvis, ureter, and bladder. Urinalysis shows hyposthenuria.He was diagnosed NDI since born. Transient insertion of a urethral catheter helped to relieve fever. Medical therapy of hydrochlorothiazide and amiloride was prescribed and effective.Dilatation of urinary tract caused by diabetes insipidus is rare, but may be present in severe condition. Therefore, it is crucial for clinicians to perform early treatment to avoid impairment of renal function.

  13. A case of disseminated recurrent retroperitoneal plasmacytoma with left obstructive hydronephrosis.

    PubMed

    Mainali, Naba Raj; Jalota, Leena; Pathak, Ranjan; Jain, Shashank

    2014-07-03

    Retroperitoneal extramedullary plasmacytoma (EMP) is a rare condition that often poses a diagnostic challenge. This is mainly due to its unusual location and non-specific symptoms especially in its early stages. Retroperitoneal plasmacytoma with renal involvement is an extremely rare entity and to date, less than 25 cases have been reported in the literature. We describe a case of a 65-year-old woman with primary retroperitoneal plasmacytoma, confirmed by ultrasound-guided biopsy and histopathological examination, with unilateral left obstructive hydronephrosis and metastasis to the lungs. Our patient was started on chemotherapy to which she did not respond. Subsequently, she resorted to palliative measures. Our case highlights key aspects of clinical presentation, diagnosis and treatment options available for management of retroperitoneal plasmacytoma. 2014 BMJ Publishing Group Ltd.

  14. A case of disseminated recurrent retroperitoneal plasmacytoma with left obstructive hydronephrosis

    PubMed Central

    Mainali, Naba Raj; Jalota, Leena; Pathak, Ranjan; Jain, Shashank

    2014-01-01

    Retroperitoneal extramedullary plasmacytoma (EMP) is a rare condition that often poses a diagnostic challenge. This is mainly due to its unusual location and non-specific symptoms especially in its early stages. Retroperitoneal plasmacytoma with renal involvement is an extremely rare entity and to date, less than 25 cases have been reported in the literature. We describe a case of a 65-year-old woman with primary retroperitoneal plasmacytoma, confirmed by ultrasound-guided biopsy and histopathological examination, with unilateral left obstructive hydronephrosis and metastasis to the lungs. Our patient was started on chemotherapy to which she did not respond. Subsequently, she resorted to palliative measures. Our case highlights key aspects of clinical presentation, diagnosis and treatment options available for management of retroperitoneal plasmacytoma. PMID:24994764

  15. Congenital Nephrogenic Diabetes Insipidus Presented With Bilateral Hydronephrosis and Urinary Infection

    PubMed Central

    Zheng, Kewen; Xie, Yi; Li, Hanzhong

    2016-01-01

    Abstract Nephrogenic diabetes insipidus (NDI) is a condition resulting from the kidney's impaired response to circulating antidiuretic hormone (ADH), leading to polydipsia and polyuria. Urinary tract dilatation caused by NDI is a rare situation. Here, we report a case of congenital NDI presented with bilateral hydronephrosis. A 15-year-old boy complaining a history of intermittent fever was admitted to Peking Union Medical College Hospital. He voided 10 to 15 L of urine daily. Radiographic examination revealed severe dilatation of bilateral renal pelvis, ureter, and bladder. Urinalysis shows hyposthenuria. He was diagnosed NDI since born. Transient insertion of a urethral catheter helped to relieve fever. Medical therapy of hydrochlorothiazide and amiloride was prescribed and effective. Dilatation of urinary tract caused by diabetes insipidus is rare, but may be present in severe condition. Therefore, it is crucial for clinicians to perform early treatment to avoid impairment of renal function. PMID:27258490

  16. Semi-automatic assessment of pediatric hydronephrosis severity in 3D ultrasound

    NASA Astrophysics Data System (ADS)

    Cerrolaza, Juan J.; Otero, Hansel; Yao, Peter; Biggs, Elijah; Mansoor, Awais; Ardon, Roberto; Jago, James; Peters, Craig A.; Linguraru, Marius George

    2016-03-01

    Hydronephrosis is the most common abnormal finding in pediatric urology. Thanks to its non-ionizing nature, ultrasound (US) imaging is the preferred diagnostic modality for the evaluation of the kidney and the urinary track. However, due to the lack of correlation of US with renal function, further invasive and/or ionizing studies might be required (e.g., diuretic renograms). This paper presents a computer-aided diagnosis (CAD) tool for the accurate and objective assessment of pediatric hydronephrosis based on morphological analysis of kidney from 3DUS scans. The integration of specific segmentation tools in the system, allows to delineate the relevant renal structures from 3DUS scans of the patients with minimal user interaction, and the automatic computation of 90 anatomical features. Using the washout half time (T1/2) as indicative of renal obstruction, an optimal subset of predictive features is selected to differentiate, with maximum sensitivity, those severe cases where further attention is required (e.g., in the form of diuretic renograms), from the noncritical ones. The performance of this new 3DUS-based CAD system is studied for two clinically relevant T1/2 thresholds, 20 and 30 min. Using a dataset of 20 hydronephrotic cases, pilot experiments show how the system outperforms previous 2D implementations by successfully identifying all the critical cases (100% of sensitivity), and detecting up to 100% (T1/2 = 20 min) and 67% (T1/2 = 30 min) of non-critical ones for T1/2 thresholds of 20 and 30 min, respectively.

  17. Dirofilariasis Mimicking an Acute Scrotum.

    PubMed

    Bertozzi, Mirko; Rinaldi, Victoria Elisa; Prestipino, Marco; Giovenali, Paolo; Appignani, Antonino

    2015-10-01

    Human infections caused by Dirofilaria repens have been reported in many areas of the world. We describe a case of a 3-year-old child with an intrascrotal mass caused by D repens mimicking an acute scrotum. This represents the first case of scrotal dirofilariasis described in pediatric age with such an unusual presentation.

  18. Xanthogranulomatous cholecystitis mimicking gallbladder cancer.

    PubMed

    Ewelukwa, Ofor; Ali, Omair; Akram, Salma

    2014-05-08

    Xanthogranulomatous cholecystitis (XGC) is a benign, uncommon variant of chronic cholecystitis characterised by focal or diffuse destructive inflammatory process of the gallbladder (GB). Macroscopically, it appears like yellowish tumour-like masses in the wall of the GB. This article reports on a 74-year-old woman with XGC mimicking GB cancer.

  19. Nephrectomy in an Asian small-clawed otter (Amblonyx cinereus) with pyelonephritis and hydronephrosis secondary to ureteral obstruction.

    PubMed

    Higbie, Christine T; Carpenter, James W; Armbrust, Laura J; Klocke, Emily; Almes, Kelli

    2014-09-01

    A 10-yr-old, captive, intact male Asian small-clawed otter (Amblonyx cinereus) with a history of bilateral nephrolithiasis was presented for acute-onset lethargy and inappetance of 5 days duration. On physical examination, the otter was about 8% dehydrated and a palpable fluid wave was present in the abdomen. An abdominal ultrasound revealed hydronephrosis of the left kidney and a hyperechoic structure present within the lumen of the left ureter, causing an obstruction. A urinalysis revealed struvite crystalluria, bacteriuria, and an elevated pH. Following 4 days of antibiotic therapy, a left ureteronephrectomy was performed. Upon opening the kidney to retrieve calculi, a large amount of purulent material was noted within the renal pelvis. To the authors' knowledge, this is the first documented case of a nephrectomy in an Asian small-clawed otter. Nephrectomy should be considered as a viable option for treatment of ureteral obstruction, hydronephrosis, or severe pyelonephritis.

  20. [X-ray evaluation of renal function in children with hydronephrosis as a criterion in the selection of therapeutic tactics].

    PubMed

    Bosin, V Iu; Murvanidze, D D; Sturua, D G; Nabokov, A K; Soloshenko, V N

    1989-01-01

    The anatomic parameters of the kidneys and the rate of glomerular filtration were measured in 77 children with unilateral hydronephrosis and in 27 children with nonobstructive diseases of the urinary tract according to the clearance of an opaque medium during excretory urography. Alterations in the anatomic parameters of the kidneys in obstructive affection did not reflect the gravity of functional disorders. It has been established that there is a possibility of carrying out a separate assessment of filtration function of the hydronephrotic and contralateral kidneys. A new diagnostic criterion is offered, namely an index of relative clearance, which enables one to measure the degree of compensatory phenomena in the preserved glomeruli and the extent of sclerotic process. It has been demonstrated that accurate measurement of the functional parameters of the affected kidney should underlie the treatment choice in children with unilateral hydronephrosis.

  1. Cartilage Delamination Flap Mimicking a Torn Medial Meniscus

    PubMed Central

    Bin Abd Razak, Hamid Rahmatullah; Amit Kanta, Mitra

    2016-01-01

    We report a case of a chondral delamination lesion due to medial parapatellar plica friction syndrome involving the medial femoral condyle. This mimicked a torn medial meniscus in clinical and radiological presentation. Arthroscopy revealed a chondral delamination flap, which was debrided. Diagnosis of chondral lesions in the knee can be challenging. Clinical examination and MRI have good accuracy for diagnosis and should be used in tandem. Early diagnosis and treatment of chondral lesions are important to prevent progression to early osteoarthritis. PMID:28070434

  2. Diagnosis of noncalcareous hydronephrosis: role of magnetic resonance urography and noncontrast computed tomography.

    PubMed

    Shokeir, Ahmed A; El-Diasty, Tarek; Eassa, Waleed; Mosbah, Ahmed; Mohsen, Tarek; Mansour, Osama; Dawaba, Mohamed; El-Kappany, Hamdy

    2004-02-01

    To evaluate the role of magnetic resonance urography (MRU) and noncontrast computed tomography (NCCT) in the diagnosis of noncalcareous hydronephrosis when excretory urography (intravenous urography) is either contraindicated or inconclusive. A total 108 consecutive patients with noncalcareous hydronephrosis were included in this study. In all patients, intravenous urography was either contraindicated or could not determine the diagnosis. In all patients, calculus obstruction was excluded by NCCT and all underwent heavily T2-weighted MRU. The final definitive diagnosis was established by retrograde or antegrade ureterography, endoscopy, or open surgery and was considered the reference standard for the diagnosis of obstruction. Normal kidneys in patients with unilateral obstruction were considered the reference standard for the absence of obstruction. The results of MRU were compared with those of NCCT regarding sensitivity, specificity, and overall accuracy. Of the 108 patients, 5 had bilateral obstruction and the remaining 103 had unilateral obstruction. Of the latter group, 5 had a solitary kidney; therefore, the total number of renal units was 211 (113 obstructed and 98 normal units). Ureteral strictures were identified by NCCT in 15 (28%) of 54 and by MRU in 45 (83%) of 54 patients. Bladder, ureter, or prostate tumors causing ureteral obstruction could be diagnosed in one half of the 54 patients with such tumors by NCCT (27 of 54) and in all but 2 patients by MRU (52 of 54). Both NCCT and MRU could identify all extraurinary causes of obstruction. Overall, of the 113 kidneys with noncalculus obstruction, the cause could be identified by MRU in 102 (sensitivity of 90%) and by NCCT in 47 (sensitivity of 42%), a difference of statistically significant value in favor of MRU (P <0.001). The specificity of T2-weighted MRU and NCCT was 100% and 99%, respectively (not a statistically significant difference). The overall accuracy of T2-weighted MRU and NCCT was 95% and

  3. Investigation and identification of etiologies involved in the development of acquired hydronephrosis in aged laboratory mice with the use of high-frequency ultrasound imaging

    PubMed Central

    Springer, Danielle A.; Allen, Michele; Hoffman, Victoria; Brinster, Lauren; Starost, Matthew F.; Bryant, Mark; Eckhaus, Michael

    2014-01-01

    Laboratory mice develop naturally occurring lesions that affect biomedical research. Hydronephrosis is a recognized pathologic abnormality of the mouse kidney. Acquired hydronephrosis can affect any mouse, as it is caused by any naturally occurring disease that impairs free urine flow. Many etiologies leading to this condition are of particular significance to aging mice. Non-invasive ultrasound imaging detects renal pelvic dilation, renal enlargement, and parenchymal loss for pre-mortem identification of this condition. High-frequency ultrasound transducers produce high-resolution images of small structures, ideal for detecting organ pathology in mice. Using a 40 MHz linear array transducer, we obtained high-resolution images of a diversity of pathologic lesions occurring within the abdomen of seven geriatric mice with acquired hydronephrosis that enabled a determination of the underlying etiology. Etiologies diagnosed from the imaging results include pyelonephritis, neoplasia, urolithiasis, mouse urologic syndrome, and spontaneous hydronephrosis, and were confirmed at necropsy. A retrospective review of abdominal scans from an additional 149 aging mice shows that the most common etiologies associated with acquired hydronephrosis are mouse urologic syndrome and abdominal neoplasia. This report highlights the utility of high-frequency ultrasound for surveying research mice for age-related pathology, and is the first comprehensive report of multiple cases of acquired hydronephrosis in mice. PMID:25143818

  4. Genital Prolapse Causing Urinary Obstruction and Hydronephrosis in a Neonate: A Case and Review of the Literature

    PubMed Central

    Lockwood, Gina; Durkee, Charles; Groth, Travis

    2012-01-01

    Neonatal genital prolapse is a rare condition seen early in life, often in conjunction with spinal cord anomalies. We present a case of a 38-week gestational age female in whom urinary obstruction and bilateral hydronephrosis resulted from genital prolapse. We suggest that although a serious urologic outcome can potentially result from this condition, cure for both can be achieved swiftly and without major complications. PMID:26023398

  5. Missed Appendicitis: Mimicking Urologic Symptoms

    PubMed Central

    Akhavizadegan, Hamed

    2012-01-01

    Appendicitis, a common disease, has different presentations. This has made its diagnosis difficult. This paper aims to present two cases of missed appendicitis with completely urologic presentation and the way that helped us to reach the correct diagnosis. The first case with symptoms fully related to kidney and the second mimicking epididymorchitis hindered prompt diagnosis. Right site of the pain, relapsing fever, frequent physical examination, and resistance to medical treatment were main clues which help us to make correct diagnosis. PMID:23326748

  6. Mitochondrial and cytoskeletal alterations are involved in the pathogenesis of hydronephrosis in ICR/Mlac-hydro mice.

    PubMed

    Isarangkul, Duangnate; Wiyakrutta, Suthep; Kengkoom, Kanchana; Reamtong, Onrapak; Ampawong, Sumate

    2015-01-01

    The pathogenesis of congenital hydronephrosis in laboratory animals has been studied for many years, yet little is known about the underlying mechanism of this disease. In this study, we investigated a MS-based comparative proteomics approach to characterize the differently expressed proteins between kidney tissue samples of ICR/Mlac-hydro and wild-type mice. Interestingly, proteomic results exhibited several mitochondrial protein alterations especially the up-regulation of 60 kDa heat shock protein (Hsp60), stress-70 protein (GRP75) dysfunction, and down-regulation of voltage-dependent anion-selective channel protein 1 (VDAC-1). The results demonstrated that mitochondrial alteration may lead to inadequate energy-supply to maintain normal water reabsorption from the renal tubule, causing hydronephrosis. Moreover, the alteration of cytoskeleton proteins in the renal tubule, in particular the up-regulation of tubulin beta-4B chain (Tb4B) and N-myc downstream-regulated gene 1 protein (Ndr-1) may also be related due to their fundamental roles in maintaining cell morphology and tissue stability. In addition, cytoskeletal alterations may consequence to the reduction of glyceraldehydes-3-phosphate dehydrogenase (GAPDH), cytoplasmic enzyme, which modulates the capacity of structural proteins. Our findings highlight a number of target proteins that may play a crucial role in congenital hydronephrosis and emphasize that the disorder of mitochondria and cytoskeleton proteins may be involved.

  7. Impact of magnetic resonance urography on preoperative diagnostic workup in children affected by hydronephrosis: should IVU be replaced?

    PubMed

    Leppert, A; Nadalin, S; Schirg, E; Petersen, C; Kardorff, R; Galanski, M; Fuchs, J

    2002-10-01

    The aim of this study was to determine the role of magnetic resonance urography (MRU) in preoperative diagnostic workup of children with hydronephrosis in a prospective clinical study with comparison of MRU, standard diagnostic investigations, and intraoperative findings. Thirty-one children with hydronephrosis secondary to different causes underwent ultrasound scan (US), intravenous urography (IVU), micturation cysto-urethrography (MCU), isotope nephrography (ING) and MRU. For MRU the authors performed sagittal and coronal halve-Fourier SSFSE scans in a 1.5 Tesla MR system. T1- and T2-weighted sequences were used in axial orientation to improve morphologic information. In 24 patients, preoperative data were compared with intraoperative findings. Comparison of the different imaging modalities proved MRU to be able to provide more detailed information about the correct localization of stenoses along the urinary tract and the morphology of renal parenchyma. MRU showed the highest concordance of all imaging modalities with intraoperative findings. As a reliable investigation, MRU has the potentials to replace IVU in preoperative diagnostic workup of hydronephrosis in childhood. Copyright 2002, Elsevier Science (USA). All rights reserved.

  8. Mitochondrial and cytoskeletal alterations are involved in the pathogenesis of hydronephrosis in ICR/Mlac-hydro mice

    PubMed Central

    Isarangkul, Duangnate; Wiyakrutta, Suthep; Kengkoom, Kanchana; Reamtong, Onrapak; Ampawong, Sumate

    2015-01-01

    The pathogenesis of congenital hydronephrosis in laboratory animals has been studied for many years, yet little is known about the underlying mechanism of this disease. In this study, we investigated a MS-based comparative proteomics approach to characterize the differently expressed proteins between kidney tissue samples of ICR/Mlac-hydro and wild-type mice. Interestingly, proteomic results exhibited several mitochondrial protein alterations especially the up-regulation of 60 kDa heat shock protein (Hsp60), stress-70 protein (GRP75) dysfunction, and down-regulation of voltage-dependent anion-selective channel protein 1 (VDAC-1). The results demonstrated that mitochondrial alteration may lead to inadequate energy-supply to maintain normal water reabsorption from the renal tubule, causing hydronephrosis. Moreover, the alteration of cytoskeleton proteins in the renal tubule, in particular the up-regulation of tubulin beta-4B chain (Tb4B) and N-myc downstream-regulated gene 1 protein (Ndr-1) may also be related due to their fundamental roles in maintaining cell morphology and tissue stability. In addition, cytoskeletal alterations may consequence to the reduction of glyceraldehydes-3-phosphate dehydrogenase (GAPDH), cytoplasmic enzyme, which modulates the capacity of structural proteins. Our findings highlight a number of target proteins that may play a crucial role in congenital hydronephrosis and emphasize that the disorder of mitochondria and cytoskeleton proteins may be involved. PMID:26309577

  9. Diagnostic value of combined static-excretory MR Urography in children with hydronephrosis.

    PubMed

    Emad-Eldin, Sally; Abdelaziz, Omar; El-Diasty, Tarek A

    2015-03-01

    The aim of this study was to determine the feasibility, accuracy and diagnostic potential of combined static-excretory MR Urography in children with sonographically detected hydronephrosis. We prospectively evaluated 28 children (11 girls and 17 boys), mean age 8.3 years (range 2 months-16 years). Static-excretory MR Urography was performed in all cases. The results of MR Urography were compared with the results of other imaging modalities, cystoscopy and surgery. In 28 children, 61 renal units were evaluated by MR Urography (the renal unit is the kidney and its draining ureter). The final diagnoses included: normal renal units (n = 23); uretropelvic junction obstruction (n = 14); megaureter (n = 8); midureteric stricture (n = 1), complicated duplicated systems (n = 5), post ESWL non-obstructive dilation (n = 2), extrarenal pelvis (n = 4), dysplastic kidney (n = 4). Complex pathology and more than one disease entity in were found in 7 children. The MRI diagnosis correlated with the final diagnosis in 57 units, with diagnostic accuracy 93.4%. In conclusions static and excretory MRU give both morphological and functional information in a single examination without exposure to ionizing radiation and iodinated contrast agent. It is a valuable imaging technique for children with upper urinary tract dilatation; especially in cases of complex congenital pathologies and severely hydronephrotic kidney.

  10. Gravity-assisted drainage imaging in the assessment of pediatric hydronephrosis

    PubMed Central

    Acker, Matthew R.; Clark, Roderick; Anderson, Peter

    2016-01-01

    Introduction: As early detection of hydronephrosis increases, we require better methods of distinguishing between pediatric patients who require pyeloplasty vs. those with transient obstruction. Gravity-assisted drainage (GAD) as part of a standardized diuretic renography protocol has been suggested as a simple and safe method to differentiate patients. Methods: Renal scans of 89 subjects with 121 hydronephrotic renal units between January 2004 and March 2007 were identified and analyzed. Results: Of all renal units, 65% showed obstruction. GAD maneuver resulted in significant residual tracer drainage in eight renal units, moderate drainage in 12 renal units, and some improvement in 40 units after the GAD maneuver. Of the eight renal units with significant residual tracer drainage, only two proceeded to pyeloplasty. After pyeloplasty, nine children had improved time to half maximum (T1/2 Max) and 13 were unchanged. Conclusions: Our study was limited due to its retrospective design and descriptive analyses, but includes a sufficient number of subjects to conclude that GAD as part of a diuretic renography protocol is an effective and simple technique that can help prevent unnecessary surgical procedures in pediatric patients. PMID:27217854

  11. Continuous antibiotic prophylaxis in the setting of prenatal hydronephrosis and vesicoureteral reflux

    PubMed Central

    Wong, Nathan C.; Koyle, Martin A.; Braga, Luis H.

    2017-01-01

    Continuous antibiotic prophylaxis (CAP) has traditionally been offered for children with recurrent urinary tract infections (UTIs) or those at risk, including children diagnosed with prenatal hydronephrosis (HN) and vesicoureteral reflux (VUR). However, indications for antibiotic prophylaxis are controversial, data on who should benefit from this therapy is conflicting and, thus, guidelines are unable to provide conclusive recommendations. In the setting of prenatal HN, although randomized trials are currently underway, most evidence is derived from low- to moderate-quality observational studies. Although there is no benefit in those with low-grade HN, a systematic review of the available studies showed that high-grade HN patients on prophylaxis experienced fewer infections with an estimated number needed to treat of 7. On the other hand, there are eight randomized trials that have investigated the use of antibiotic prophylaxis in the setting of VUR. Although four of the studies have demonstrated some value of prophylaxis and the other four have not, meta-analysis has shown an overall benefit of antibiotic prophylaxis in preventing infections. The observed differences are likely due to different inclusion criteria and study heterogeneity. Although generalizing results of meta-analyses to all children is tempting, an individualized approach, by determining which patients best behave like those of the included studies, is recommended. PMID:28265311

  12. Diagnostic value of combined static-excretory MR Urography in children with hydronephrosis

    PubMed Central

    Emad-Eldin, Sally; Abdelaziz, Omar; El-Diasty, Tarek A.

    2014-01-01

    The aim of this study was to determine the feasibility, accuracy and diagnostic potential of combined static-excretory MR Urography in children with sonographically detected hydronephrosis. We prospectively evaluated 28 children (11 girls and 17 boys), mean age 8.3 years (range 2 months–16 years). Static-excretory MR Urography was performed in all cases. The results of MR Urography were compared with the results of other imaging modalities, cystoscopy and surgery. In 28 children, 61 renal units were evaluated by MR Urography (the renal unit is the kidney and its draining ureter). The final diagnoses included: normal renal units (n = 23); uretropelvic junction obstruction (n = 14); megaureter (n = 8); midureteric stricture (n = 1), complicated duplicated systems (n = 5), post ESWL non-obstructive dilation (n = 2), extrarenal pelvis (n = 4), dysplastic kidney (n = 4). Complex pathology and more than one disease entity in were found in 7 children. The MRI diagnosis correlated with the final diagnosis in 57 units, with diagnostic accuracy 93.4%. In conclusions static and excretory MRU give both morphological and functional information in a single examination without exposure to ionizing radiation and iodinated contrast agent. It is a valuable imaging technique for children with upper urinary tract dilatation; especially in cases of complex congenital pathologies and severely hydronephrotic kidney. PMID:25750748

  13. Megakaryocytes mimicking metastatic breast carcinoma.

    PubMed

    Hoda, Syed A; Resetkova, Erika; Yusuf, Yasmin; Cahan, Anthony; Rosen, Paul P

    2002-05-01

    False-positive diagnosis of lymph nodes occurs when a benign element in a lymph node, or in its capsule, is interpreted as metastatic carcinoma. This report describes a patient with breast carcinoma who had megakaryocytes in axillary sentinel lymph nodes mimicking metastatic carcinoma. The patient had no history of a hematologic disease, and we found no evidence of a concurrent hematopoietic disorder. The megakaryocytes were reactive for CD31, CD61, and von Willebrand factor, but not for cytokeratin (AE1/AE3). Megakaryocytes should be added to the list of benign histologic abnormalities that may simulate metastatic carcinoma in a sentinel lymph node.

  14. Norwegian scabies mimicking rupioid psoriasis*

    PubMed Central

    Costa, Juliana Bastos; de Sousa, Virna Lygia Lobo Rocha; da Trindade Neto, Pedro Bezerra; Paulo Filho, Thomás de Aquino; Cabral, Virgínia Célia Dias Florêncio; Pinheiro, Patrícia Moura Rossiter

    2012-01-01

    Norwegian scabies is a highly contagious skin infestation caused by an ectoparasite, Scarcoptes scabiei var. Hominis, which mainly affects immunosuppressed individuals. Clinically, it may simulate various dermatoses such as psoriasis, Darier's disease, seborrheic dermatitis, among others. This is a case report of a 33-year-old woman, immunocompetent, diagnosed with generalized anxiety disorder (cancer phobia), who had erythematous, well-defined plaques, covered with rupioid crusts, on her neck, axillary folds, breast, periumbilical region, groin area, besides upper back and elbows, mimicking an extremely rare variant of psoriasis, denominated rupioid psoriasis. PMID:23197214

  15. Tinea capitis mimicking folliculitis decalvans.

    PubMed

    Tangjaturonrusamee, C; Piraccini, B M; Vincenzi, C; Starace, M; Tosti, A

    2011-01-01

    We report on an adult patient with tinea capitis caused by Microsporum canis, who presented with diffuse alopecia and follicular pustules, mimicking folliculitis decalvans. Examination of the scalp showed severe alopecia with prominent involvement of the frontal and vertex scalp: the skin was markedly erythematous with pustules and brownish crusts. Videodermoscopy revealed visible follicular ostia, numerous pustular lesions and several comma hairs. Fluconazole 150 mg a week for 8 weeks associated with ketoconazole shampoo cleared the inflammatory lesions and produced complete hair regrowth. © 2009 Blackwell Verlag GmbH.

  16. The great mimickers of rosacea.

    PubMed

    Olazagasti, Jeannette; Lynch, Peter; Fazel, Nasim

    2014-07-01

    Although rosacea is one of the most common conditions treated by dermatologists, it also is one of the most misunderstood. It is a chronic disorder affecting the central parts of the face and is characterized by frequent flushing; persistent erythema (ie, lasting for at least 3 months); telangiectasia; and interspersed episodes of inflammation with swelling, papules, and pustules. Understanding the clinical variants and disease course of rosacea is important to differentiate this entity from other conditions that can mimic rosacea. Herein we present several mimickers of rosacea that physicians should consider when diagnosing this condition.

  17. Splenic inflammatory pseudotumor mimicking angiosarcoma.

    PubMed

    Hsu, Chao-Wen; Lin, Chieh-Hsin; Yang, Tsung-Lung; Chang, Hong-Tai

    2008-11-07

    Splenic tumors are rare. Differentiation of the tumors before operation is of great value regarding the outcome. A case of a 32-year-old man with a splenic inflammatory pseudotumor (IPT) mimicking splenic angiosarcoma is described. The tumor was highly suspected of being splenic angiosarcoma based on radiological findings preoperatively. However, after splenectomy, histopathological examinations revealed splenic IPT. Splenic IPT and angiosarcoma are rare and often pose diagnostic difficulties because the clinical and radiological findings are obscure. Due to large differences in prognosis, we briefly reviewed the clinical, radiological, and pathological features of both of the tumors.

  18. Splenic inflammatory pseudotumor mimicking angiosarcoma

    PubMed Central

    Hsu, Chao-Wen; Lin, Chieh-Hsin; Yang, Tsung-Lung; Chang, Hong-Tai

    2008-01-01

    Splenic tumors are rare. Differentiation of the tumors before operation is of great value regarding the outcome. A case of a 32-year-old man with a splenic inflammatory pseudotumor (IPT) mimicking splenic angiosarcoma is described. The tumor was highly suspected of being splenic angiosarcoma based on radiological findings preoperatively. However, after splenectomy, histopathological examinations revealed splenic IPT. Splenic IPT and angiosarcoma are rare and often pose diagnostic difficulties because the clinical and radiological findings are obscure. Due to large differences in prognosis, we briefly reviewed the clinical, radiological, and pathological features of both of the tumors. PMID:19009664

  19. Granuloma inguinale mimicking as squamous cell carcinoma of penis

    PubMed Central

    Pilani, Abhishek; Vora, Rita; Anjaneyan, Gopikrishnan

    2014-01-01

    Granuloma inguinale (GI) is an acquired chronic, slowly progressive, mildly contagious disease of venereal origin, characterized by granulomatous ulceration of the genitalia and neighboring sites, with little or no tendency to spontaneous healing caused by Klebsiella (Calymmatobacterium) granulomatis. A 55-year-old male presented with fissured, foul smelling, fungating growth over prepuce with phimosis mimicking squamous cell carcinoma (SCC) without lymphadenopathy. It started with painless papulonodular showed pseudoepitheliomatous hyperplasia, infiltration in dermis, acanthosis and vacuolated macrophages suggestive of GI and not showing any histopathological features of SCC. Patient was successfully treated by giving cotrimoxazole twice a day for 21 days. Here, we presented a case of GI mimicking SCC of penis, which was diagnosed on basis of histopathology and treated with excision followed by medical therapy with cotrimoxazole. PMID:24958990

  20. Correlation of cystatin C and creatinine based estimates of renal function in children with hydronephrosis

    PubMed Central

    Momtaz, Hossein-Emad; Dehghan, Arash; Karimian, Mohammad

    2016-01-01

    Introduction: The use of a simple and accurate glomerular filtration rate (GFR) estimating method aiming minute assessment of renal function can be of great clinical importance. Objectives: This study aimed to determine the association of a GFR estimating by equation that includes only cystatin C (Gentian equation) to equation that include only creatinine (Schwartz equation) among children. Patients and Methods: A total of 31 children aged from 1 day to 5 years with the final diagnosis of unilateral or bilateral hydronephrosis referred to Besat hospital in Hamadan, between March 2010 and February 2011 were consecutively enrolled. Schwartz and Gentian equations were employed to determine GFR based on plasma creatinine and cystatin C levels, respectively. Results: The proportion of GFR based on Schwartz equation was 70.19± 24.86 ml/min/1.73 m2, while the level of this parameter based on Gentian method and using cystatin C was 86.97 ± 21.57 ml/min/1.73 m2. The Pearson correlation coefficient analysis showed a strong direct association between the two levels of GFR measured by Schwartz equation based on serum creatinine level and Gentian method and using cystatin C (r = 0.594, P < 0.001). The linear association between GFR values measured with the two methods included cystatin C based GFR = 50.8+ 0.515 × Schwartz GFR. The correlation between GFR values measured by using serum creatinine and serum cystatin C measurements remained meaningful even after adjustment for patients’ gender and age (r = 0.724, P < 0.001). Conclusion: The equation developed based on cystatin C level is comparable with another equation, based on serum creatinine (Schwartz formula) to estimate GFR in children. PMID:27069964

  1. Antibiotic prophylaxis for prevention of urinary tract infections in prenatal hydronephrosis: An updated systematic review

    PubMed Central

    Easterbrook, Bethany; Capolicchio, John-Paul; Braga, Luis H.

    2017-01-01

    Introduction: While continuous antibiotic prophylaxis (CAP) is currently recommended to prevent urinary tract infections (UTIs) in infants with prenatal hydronephrosis (HN), this recommendation is not evidence-based. The objective of this study was to systematically determine whether CAP reduces UTIs in the HN population. Methods: Applicable trials were identified through an electronic search of MEDLINE (1946–2015), EMBASE (1980–2016), CINAHL (1982–2016), and CENTRAL (1993–2016) and through a hand search of American Urological Association (AUA) (2012–2015) and European Society for Pediatric Urology (ESPU) (2012–2015) abstracts, as well as reference lists of included trials. The search strategy was not limited by language or year of publication. Eligible studies compared CAP to no CAP in patients with antenatal HN, <2 years of age, and reported development of UTI and HN grades. Two independent reviewers performed title and abstract screening, full-text review, and quality appraisal. Results: Of 1518 citations screened, 11 were included, contributing 3909 patients for final analysis. Of these, four (36%) were considered high-quality when assessed by the Newcastle Ottawa Scale. Meta-analysis of the non-randomized trials (n=10) provided similar pooled UTI rates, regardless of CAP use: 9.9% (95% confidence interval [CI] 8.4–11.4%) for CAP and 7.5% (95% CI 6.4–8.6%) for no CAP. Conclusions: This systematic review and meta-analysis suggests there may be value in providing CAP to infants with high-grade HN; however, due to the very low-quality data from non-randomized studies, important clinical variables, such as circumcision status, were unable to be assessed. PMID:28265307

  2. Inverse heat mimicking of given objects

    NASA Astrophysics Data System (ADS)

    Alwakil, Ahmed; Zerrad, Myriam; Bellieud, Michel; Amra, Claude

    2017-03-01

    We address a general inverse mimicking problem in heat conduction. The objects to cloak and mimic are chosen beforehand; these objects identify a specific set of space transformations. The shapes that can be mimicked are derived from the conductivity matrices. Numerical calculation confirms all of the analytical predictions. The technique provides key advantages for applications and can be extended to the field of waves.

  3. Challenging mimickers of primary systemic vasculitis.

    PubMed

    Miloslavsky, Eli M; Stone, John H; Unizony, Sebastian H

    2015-01-01

    The need to distinguish true primary systemic vasculitis from its multiple potential mimickers is one of the most challenging diagnostic conundrums in clinical medicine. This article reviews 9 challenging vasculitis mimickers: fibromuscular dysplasia, calciphylaxis, segmental arterial mediolysis, antiphospholipid syndrome, hypereosinophilic syndrome, lymphomatoid granulomatosis, malignant atrophic papulosis, livedoid vasculopathy, and immunoglobulin G4-related disease.

  4. Transcatheter Embolization of High-flow Renal Arteriovenous Fistula Using N-butyl Cyanoacrylate Accompanied by Delayed Hydronephrosis

    PubMed Central

    Mizuno, Atsushi; Morita, Yuka; Fuwa, Sokun; Arioka, Hiroko; Harano, Yumi; Niwa, Koichiro; Saida, Yukihisa

    2016-01-01

    Renal arteriovenous fistula (AVF) is an uncommon anomaly characterized by the communication between renal arteries and veins. Renal AVFs are often asymptomatic but are occasionally accompanied by hematuria or heart failure. Transcatheter closure with embolization is a safe and effective treatment for renal AVF. We herein report an 87-year-old patient with heart failure due to renal AVF who was treated by transcatheter embolization. She developed bacteremia with hydronephrosis, which is a rare complication following the embolization of renal AVF. PMID:27904109

  5. Black hole mimickers: Regular versus singular behavior

    SciTech Connect

    Lemos, Jose P. S.; Zaslavskii, Oleg B.

    2008-07-15

    Black hole mimickers are possible alternatives to black holes; they would look observationally almost like black holes but would have no horizon. The properties in the near-horizon region where gravity is strong can be quite different for both types of objects, but at infinity it could be difficult to discern black holes from their mimickers. To disentangle this possible confusion, we examine the near-horizon properties, and their connection with far away asymptotic properties, of some candidates to black mimickers. We study spherically symmetric uncharged or charged but nonextremal objects, as well as spherically symmetric charged extremal objects. Within the uncharged or charged but nonextremal black hole mimickers, we study nonextremal {epsilon}-wormholes on the threshold of the formation of an event horizon, of which a subclass are called black foils, and gravastars. Within the charged extremal black hole mimickers we study extremal {epsilon}-wormholes on the threshold of the formation of an event horizon, quasi-black holes, and wormholes on the basis of quasi-black holes from Bonnor stars. We elucidate whether or not the objects belonging to these two classes remain regular in the near-horizon limit. The requirement of full regularity, i.e., finite curvature and absence of naked behavior, up to an arbitrary neighborhood of the gravitational radius of the object enables one to rule out potential mimickers in most of the cases. A list ranking the best black hole mimickers up to the worst, both nonextremal and extremal, is as follows: wormholes on the basis of extremal black holes or on the basis of quasi-black holes, quasi-black holes, wormholes on the basis of nonextremal black holes (black foils), and gravastars. Since in observational astrophysics it is difficult to find extremal configurations (the best mimickers in the ranking), whereas nonextremal configurations are really bad mimickers, the task of distinguishing black holes from their mimickers seems to

  6. Development of hydronephrosis secondary to poorly managed neurogenic bowel requiring surgical disimpaction in a patient with spinal cord injury: A case report

    PubMed Central

    Downs, Jairon; Wolfe, Tracy; Walker, Heather

    2014-01-01

    Context Case of an adult patient with paraplegia managing neurogenic bladder with intermittent catheterization who was not performing a standard bowel program for management of neurogenic bowel. Findings Patient presented with increasing spasticity, fecal incontinence, and abdominal pain and ultimately was hospitalized for management. Imaging revealed massive fecal impaction, resulting in ureteral obstruction and hydronephrosis. Despite repeated aggressive bowel regimens, serial abdominal X-rays showed continued large stool burden. Ultimately surgical intervention was required to evacuate the colon and subsequently the hydronephrosis resolved. Conclusion/Clinical relevance This case illustrates the importance of proper management of neurogenic bowel, as significant medical complications, such as hydronephrosis can occur with poorly managed neurogenic bowel. PMID:24617444

  7. Pediatric myositis ossificans mimicking osteosarcoma.

    PubMed

    Yamaga, Kensaku; Kobayashi, Eisuke; Kubota, Daisuke; Setsu, Nokitaka; Tanaka, Yuya; Minami, Yusuke; Tanzawa, Yoshikazu; Nakatani, Fumihiko; Kawai, Akira; Chuman, Hirokazu

    2015-10-01

    Myositis ossificans (MO) is a rare benign cause of heterotopic bone formation in soft tissue that most commonly affects young adults, typically following trauma. We report the case of an 11-year-old girl who developed MO mimicking osteosarcoma in her right shoulder. Plain radiography and computed tomography showed poorly defined flocculated densities in the soft tissue and a periosteal reaction along the proximal humerus. On magnetic resonance imaging, the mass displayed an ill-defined margin and inhomogeneous signal change. Histologically, the mass had a pseudosarcomatous appearance. Based on these findings, the patient was initially misdiagnosed with osteosarcoma at another hospital. The diagnosis was difficult because the patient was 11 years old and had no trauma history, with atypical radiographic changes and a predilection for the site of origin for osteosarcomas. We finally made the correct diagnosis of MO by carefully reviewing and reflecting on the pathological differences between stages. © 2015 Japan Pediatric Society.

  8. Cervical spinal meningioma mimicking intramedullary spinal tumor.

    PubMed

    Senturk, Senem; Guzel, Aslan; Guzel, Ebru; Bayrak, Aylin Hasanefendioğlu; Sav, Aydin

    2009-01-01

    Case report. To report a very unusual spinal meningioma, mimicking an intramedullary spinal tumor. Spinal meningiomas, usually associated with signs and symptoms of cord or nerve root compression, are generally encountered in women aged over 40. Radiologic diagnosis is often established by their intradural extramedullary location on magnetic resonance images. A 60-year-old woman had a 6-month history of progressive weakness in her upper extremities, difficulty in walking, and cervical pain radiating through both arms. Neurologic examination revealed motor strength deficiency in all her extremities, with extensor reflexes, clonus, and bilateral hyper-reflexiveness. A sensory deficit was present all over her body. Magnetic resonance images revealed that the spinal cord appeared expanded with an ill-defined, homogeneously contrast-enhanced, lobulated, eccentric mass at the C1-C3 level. The patient was operated with a preliminary diagnosis of an intramedullary tumor. At surgery, the mass was found to be extramedullary, and gross total resection was performed. Histopathological examination revealed a meningioma characterized by the presence of fibrous and meningothelial components. The patient was able to ambulate with a cane, and extremity strength and sensation improved 2 months after surgery. Spinal meningiomas can mimic intramedullary tumors, and should be considered in differential diagnosis of intradural tumors with atypical appearance.

  9. Microfabricated adhesive mimicking gecko foot-hair

    NASA Astrophysics Data System (ADS)

    Geim, A. K.; Dubonos, S. V.; Grigorieva, I. V.; Novoselov, K. S.; Zhukov, A. A.; Shapoval, S. Yu.

    2003-07-01

    The amazing climbing ability of geckos has attracted the interest of philosophers and scientists alike for centuries. However, only in the past few years has progress been made in understanding the mechanism behind this ability, which relies on submicrometre keratin hairs covering the soles of geckos. Each hair produces a miniscule force ~10-7 N (due to van der Waals and/or capillary interactions) but millions of hairs acting together create a formidable adhesion of ~10 N cm-2: sufficient to keep geckos firmly on their feet, even when upside down on a glass ceiling. It is very tempting to create a new type of adhesive by mimicking the gecko mechanism. Here we report on a prototype of such 'gecko tape' made by microfabrication of dense arrays of flexible plastic pillars, the geometry of which is optimized to ensure their collective adhesion. Our approach shows a way to manufacture self-cleaning, re-attachable dry adhesives, although problems related to their durability and mass production are yet to be resolved.

  10. Diseases mimicking intussusception: diagnostic dilemma.

    PubMed

    Karakus, Suleyman Cuneyt; Ozokutan, Bulent Hayri; Ceylan, Haluk

    2014-10-01

    Intussusception is a common abdominal emergency in early childhood. The aim of this study was to describe the diseases mimicking intussusception and to discuss the causes and management of these conditions. Seven patients who were initially diagnosed as having intussusception on abdominal ultrasonography but who had a final diagnosis of diseases other than intussusception were reviewed retrospectively. Two patients with ileocolic intussusception underwent ultrasonography-guided reduction with a hydrostatic method but the ultrasonographic findings persisted. At surgery, only edematous ileocecal valve and mesenteric lymphadenopathy were observed. In three patients with Henoch-Schönlein purpura, initial abdominal ultrasonography showed intussusception. The patients with no sign of obstructive symptoms were managed conservatively with a diagnosis of intramural hemorrhage and on follow up the ultrasonographic findings of intussusception was resolved. One patient with the target sign on computed tomography and ultrasonography of the abdomen underwent ileocolic resection and end-to-end anastomosis due to a tumor in the cecum. There was no evidence of intussusception. One patient with a cyst in the right lower quadrant accompanying intussusception on ultrasonography of the abdomen underwent ultrasonography-guided reduction but the ultrasonographic findings persisted. On exploration, only cecal duplication cyst without intussusception was detected. Cecal resection including the cyst and end-to-end ileocolic anastomosis were performed. Ultrasonography, color Doppler ultrasonography, barium or hydrostatic enema and computed tomography are helpful in diagnosing intussusception, but patients with radiologic findings of intussusception should be evaluated on symptoms and clinical findings before surgical intervention. Also, other diseases mimicking intussusception should be kept in mind in the differential diagnosis. © 2014 Japan Pediatric Society.

  11. Conservative/surgical treatment predictors of maternal hydronephrosis: results of a single-center retrospective non-randomized non-controlled observational study.

    PubMed

    Ercil, Hakan; Arslan, Burak; Ortoglu, Ferhat; Alma, Ergun; Unal, Umut; Deniz, Mehmet Eflatun; Senturk, Aykut Bugra; Gurbuz, Zafer Gokhan

    2017-08-01

    To determine the parameters that may help the clinicians decide the best suitable treatment method for the pregnant women with symptomatic hydronephrosis which will be based on the easily accessible laboratory tests, monitoring methods and clinical symptoms. Digital data and documents of 246 pregnant women with symptomatic hydronephrosis who were hospitalized in our clinic between the dates of January 2011 and January 2016 were retrospectively evaluated. All patients were statistically evaluated in terms of age, symptomatic maximal anterior-posterior diameter of the renal pelvis (MADP), parity, C-reactive protein (CRP) level, white blood cell count (WBC), presence of pyuria, growth of urine culture, fever, serum urine and creatinine levels, visual analog scale (VAS) score of pre- and post-therapy and threatened preterm labor. The study includes a total of 211 pregnant women with symptomatic hydronephrosis. In the second and third trimester groups, the surgical treatment group statistically provided higher levels of CRP, WBC and VAS. Mean MADP in the second trimester of the conservative and surgical groups where symptomatic hydronephrosis was on the right side was 16.67 ± 4.67 and 28.68 ± 7.70 mm, respectively. Mean MADP in the third trimester group of the conservative and surgical groups where symptomatic hydronephrosis was on the right side was 16.96 ± 5.96 and 28.85 ± 7.64 mm, respectively. In patients with symptomatic pregnancy hydronephrosis, the likelihood of surgical treatment for CRP levels, WBC counts and VAS is high.

  12. Postnatal assessment of growth, nutrition, and urinary tract infections of infants with antenatally detected hydronephrosis.

    PubMed

    Yavascan, Onder; Aksu, Nejat; Anil, Murat; Kara, Orhan D; Aydin, Yahya; Kangin, Murat; Cetinkaya, Ergun; Bal, Alkan

    2010-09-01

    The widespread utilization of prenatal ultrasonography and the detection of antenatal hydronephrosis (AH) have raised the importance of postnatal follow-up of these infants. In this study, we aimed to determine the importance of an early diagnosis for the treatment of urinary tract malformations (UTM) as well as the postnatal evaluation of growth and nutrition status and the frequency of urinary tract infection (UTI) in infants with AH. We evaluated 246 infants (183 boys, 63 girls) whose routine antenatal scans showed an anterior-posterior pelvic diameter (APPD) ≥5 mm. Of the 246 patients, 175 (71.1%) were found to be pathological and 71 were evaluated as normal after the follow-up period. The median follow-up periods of normal and abnormal cases were 45.7 and 43.4 months, respectively. All cases with or without UTM were evaluated in terms of UTI, scars on DMSA, growth [Height Z score (HZ), Weight Z score (WZ)] and nutrition [Weight height index (WHI)] status. The annual UTI frequency was higher in cases with UTM (1.32 ± 1.66 episode/year) than in cases without abnormality (0.27 ± 0.67 episode/year) (P < 0.001). The postnatal evaluation of growth and nutritional status in children with UTM (mean WHI, HZ, and WZ scores: 96.82 ± 10.21, 0.03 ± 0.54 and 0.04 ± 0.61, respectively) was found to be significantly worse than in cases without abnormality (102.25 ± 9.84, 0.14 ± 0.64 and 0.24 ± 0.76, respectively), (P < 0.05). In abnormal patients, the mean WHI, HZ, and WZ were significantly improved to 101.63 ± 9.75, 0.26 ± 1.07, and 0.28 ± 0.98, respectively, and HZ or WZ scores were found to be similar when compared to normals. In conclusion, postnatal early management of infants with AH seems to prevent frequent UTIs and nutritional disturbances enabling normal growth.

  13. Congenital imperforate hymen with hydrocolpos and hydronephrosis associated with severe hydramnios and increase of maternal ovarian steroidogenic enzymes.

    PubMed

    Karteris, Emmanouil; Foster, Helen; Karamouti, Maria; Goumenou, Anastasia

    2010-06-01

    To study clinical features of patient presented with severe hydramnios, associated with hydronephrosis, that was antenatally diagnosed and has been successfully treated immediately after birth. At a molecular level, we investigated the gene expression of key steroidogenic enzymes from the maternal ovary. Ultrasound scan, MRI, semi-quantitative RT-PCR SETTING: The patient was admitted to the University Hospital, University of Crete, Medical School, Greece, where all clinical data has been obtained. Gene expression studies took place at Biosciences, Brunel University, UK. Semi-quantitative RT-PCR analyses revealed that there is upregulation of key steroidogenic genes in the maternal ovary, including steroidogenic acute regulatory protein, and the cytochrome P450 heme-containing proteins CYP11A, CYP17 and CYP19. From a clinical perspective, the prenatal ultrasound scan and MRI findings showed a multicystic pelvic mass, bilateral hydronephrosis and prior to delivery severe polyhydramnios. This clinical case is the only one that we have found in the current literature where congenital imperforate hymen accompanied with hematocolpos is associated with renal obstruction in combination with polyhydramnios and increase in maternal steroidogenic enzymes. Copyright 2010. Published by Elsevier Inc.

  14. Hydronephrosis in the Wnt5a-ablated kidney is caused by an abnormal ureter-bladder connection.

    PubMed

    Yun, Kangsun; Perantoni, Alan O

    The Wnt5a null mouse is a complex developmental model which, among its several posterior-localized axis defects, exhibits multiple kidney phenotypes, including duplex kidney and loss of the medullary zone. We previously reported that ablation of Wnt5a in nascent mesoderm causes duplex kidney formation as a result of aberrant development of the nephric duct and abnormal extension of intermediate mesoderm. However, these mice also display a loss of the medullary region late in gestation. We have now genetically isolated duplex kidney formation from the medullary defect by specifically targeting the progenitors for both the ureteric bud and metanephric mesenchyme. The conditional mutants fail to form a normal renal medulla but no longer exhibit duplex kidney formation. Approximately 1/3 of the mutants develop hydronephrosis in the kidneys either uni- or bilaterally when using Dll1Cre. The abnormal kidney phenotype becomes prominent at E16.5, which approximates the time when urine production begins in the mouse embryonic kidney, and is associated with a dramatic increase in apoptosis only in mutant kidneys with hydronephrosis. Methylene blue dye injection and histologic examination reveal that aberrant cell death likely results from urine toxicity due to an abnormal ureter-bladder connection. This study shows that Wnt5a is not required for development of the renal medulla and that loss of the renal medullary region in the Wnt5a-deleted kidney is caused by an abnormal ureter-bladder connection.

  15. Multiple uterine angioleiomyomas mimicking an ovarian neoplasm: a case report.

    PubMed

    Hakverdi, S; Dolapçioğlu, K; Güngören, A; Yaldiz, M; Hakverdi, A U

    2009-01-01

    Angioleiomyoma is a rare benign neoplasm that originates from smooth muscle cells and contains thick-walled blood vessels. A 69-year-old woman had been complaining of progressive abdominal distention for the last five years. At the exploration, a tumoral mass that could not be differentiated as to whether it had its origin from the uterus or ovary was specified. The patient underwent total hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO). On pathologic examination of the specimen, the tumor was diagnosed as an angioleiomyoma. Here, we present a case of giant-multiple uterine angioleiomyomas mimicking an ovarian neoplasm.

  16. Bone tumor mimickers: A pictorial essay

    PubMed Central

    Mhuircheartaigh, Jennifer Ni; Lin, Yu-Ching; Wu, Jim S

    2014-01-01

    Focal lesions in bone are very common and many of these lesions are not bone tumors. These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes. Many of these tumor mimickers can be left alone, while others can be due to a significant disease process. It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup. Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety. PMID:25114385

  17. Humanlike Robots - Synthetically Mimicking Humans

    NASA Technical Reports Server (NTRS)

    Bar-Cohen, Yoseph

    2012-01-01

    Nature inspired many inventions and the field of technology that is based on the mimicking or inspiration of nature is widely known as Biomimetics and it is increasingly leading to many new capabilities. There are numerous examples of biomimetic successes including the copying of fins for swimming, and the inspiration of the insects and birds flight. More and more commercial implementations of biomimetics are appearing and behaving lifelike and applications are emerging that are important to our daily life. Making humanlike robots is the ultimate challenge to biomimetics and, for many years, it was considered science fiction, but such robots are becoming an engineering reality. Advances in producing such robot are allowing them to perform impressive functions and tasks. The development of such robots involves addressing many challenges and is raising concerns that are related to fear of their application implications and potential ethical issues. In this paper, the state-of-the-art of humanlike robots, potential applications and challenges will be reviewed.

  18. Humanlike Robots - Synthetically Mimicking Humans

    NASA Technical Reports Server (NTRS)

    Bar-Cohen, Yoseph

    2012-01-01

    Nature inspired many inventions and the field of technology that is based on the mimicking or inspiration of nature is widely known as Biomimetics and it is increasingly leading to many new capabilities. There are numerous examples of biomimetic successes including the copying of fins for swimming, and the inspiration of the insects and birds flight. More and more commercial implementations of biomimetics are appearing and behaving lifelike and applications are emerging that are important to our daily life. Making humanlike robots is the ultimate challenge to biomimetics and, for many years, it was considered science fiction, but such robots are becoming an engineering reality. Advances in producing such robot are allowing them to perform impressive functions and tasks. The development of such robots involves addressing many challenges and is raising concerns that are related to fear of their application implications and potential ethical issues. In this paper, the state-of-the-art of humanlike robots, potential applications and challenges will be reviewed.

  19. Fibrosing mediastinitis mimicking bronchogenic carcinoma

    PubMed Central

    Bayiz, Hulya; Mutluay, Neslihan; Koyuncu, Adem; Demirag, Funda; Dagli, Gulfidan; Berktas, Bahadir; Berkoglu, Mine

    2013-01-01

    Fibrosing mediastinitis is a rare but benign disorder characterized by an excessive fibrotic reaction in the mediastinum which can result in compromise of airways, great vessels, and other mediastinal structures. In this paper we presented a patient with fibrosing mediastinitis mimicking bronchogenic carcinoma. The patient was a 32-year-old diabetic male admitting with cough and hemoptysis. There was a right hilar mass and multiple mediastinal conglomerated lymph nodes on chest computed tomography. Positron emission tomography with computed tomography (PET/CT) scan demonstrated increased fluorodeoxyglucose (FDG) uptake at the right hilar mass lesion and mediastinal lymph nodes. Fiberoptic bronchoscopy showed mucosal distortion of right upper lobe. Pathologic examination of the mucosal biopsy revealed inflammation. Endobronchial ultrasound guided transbronchial needle and cervical mediastinoscopic lymph node biopsies were undiagnostic. Diagnostic thoracotomy confirmed the diagnosis fibrosing mediastinitis. Administration of six months of systemic corticosteroid and antituberculous therapy was not beneficial. In conclusion, despite being a rare clinical entity, fibrosing mediastinitis should be kept in mind in the differential diagnosis of mediastinal mass lesions of unknown etiology. The diagnosis is exceptionally difficult in the presence of atypical radiological findings. The treatment is particularly challenging without any proven effective therapy. PMID:23372962

  20. Inverse heat mimicking of given objects

    PubMed Central

    Alwakil, Ahmed; Zerrad, Myriam; Bellieud, Michel; Amra, Claude

    2017-01-01

    We address a general inverse mimicking problem in heat conduction. The objects to cloak and mimic are chosen beforehand; these objects identify a specific set of space transformations. The shapes that can be mimicked are derived from the conductivity matrices. Numerical calculation confirms all of the analytical predictions. The technique provides key advantages for applications and can be extended to the field of waves. PMID:28252031

  1. Treatment of uterine prolapse with bilateral hydronephrosis in a young nulliparous woman; a new minimally invasive extraperitoneal technique.

    PubMed

    Kurt, S; Guler, T; Canda, M T; Demirtas, Ö; Tasyurt, A

    2014-06-01

    A 37-year-old nulligravid woman presented with a 2-year history of uterine prolapse along with mixed incontinence. Gynecological examination confirmed third degree cystocele and uterine prolapse. Renal ultrasonography showed enlarged kidneys and marked dilation of the bilateral pelvicalyceal system. She was hospitalized and a ring pessary was inserted after bladder catheterization. Her preoperative evaluation was performed and the patient was operated one month after her first admission. Anterior colporrhaphy along with Kurt Extraperitoneal Ligamentopexy was performed without any complication. A control visit on second postoperative month revealed recovery of incontinence symptoms and no prolapse was observed. To our knowledge this is the first reported treatment of a case with bilateral hydronephrosis due to uterine prolapse that were corrected and overcame with a novel minimally invasive extraperitoneal approach by fixation of bilateral round ligaments to the rectus fascia sheet.

  2. Unilateral congenital giant megaureter with renal dysplasia compressing contralateral ureter and causing bilateral hydronephrosis: a case report and literature review.

    PubMed

    Yu, Mingming; Ma, Geng; Ge, Zheng; Lu, Rugang; Deng, Yongji; Guo, Yunfei

    2016-02-09

    Congenital giant megaureter (CGM) is uncommon in the pediatric population. The major clinical presentations are marked protruberances and abdominal cysts. We reported a case of CGM with almost the whole left ureter dilation accompanied with a 1 cm stricture at the entrance of the bladder and renal dysplasia, immediately compressing the contralateral ureter and causing bilateral hydronephrosis for the first time. At one-stage of the operation, a left nephrostomy with a right ureterolysis were performed, and a poor left kidney function was found. Then, the left kidney and ureter were cut off by nephroureterectomy at the second-stage. Eventually, the follow-up showed that the patient recovered well by abdominal ultrasound. Based on the findings of these reported literatures, CGM is rare. The physical and imaging examinations are essential for the diagnosis of CGM, and the appropriate treatment methods should be performed based on patients' specific condition.

  3. Chronically elevated levels of short-chain fatty acids induce T cell-mediated ureteritis and hydronephrosis1

    PubMed Central

    Park, Jeongho; Goergen, Craig J.; HogenEsch, Harm; Kim, Chang H.

    2016-01-01

    Short-chain fatty acids (SCFAs) are major products of gut microbial fermentation and profoundly affect host health and disease. SCFAs generate IL-10+ regulatory T cells, which may promote immune tolerance. However, SCFAs can also induce Th1 and Th17 cells upon immunological challenges and, therefore, also have the potential to induce inflammatory responses. Because of the seemingly paradoxical SCFA activities in regulating T cells, we investigated, in depth, the impact of elevated SCFA levels on T cells and tissue inflammation in mice. Orally administered SCFAs induced effector (Th1 and Th17) and regulatory T cells in ureter and kidney tissues, and induced T-cell mediated ureteritis leading to kidney hydronephrosis (hereafter called C2RD). Kidney hydronephrosis in C2RD was caused by ureteral obstruction, which was, in turn, induced by SCFA-induced inflammation in the ureteropelvic junction (UPJ) and proximal ureter. Oral administration of all major SCFAs, such as acetate, propionate, and butyrate, induced the disease. We found that C2RD development is dependent on mTOR activation, T cell-derived inflammatory cytokines such as IFNγ and IL-17, and gut microbiota. Young or male animals were more susceptible than old or female animals respectively. However, SCFA receptor (GPR41 or GPR43) deficiency did not affect C2RD development. Thus, SCFAs, when systemically administered at levels higher than physiological levels, cause dysregulated T cell responses and tissue inflammation in the renal system. The results provide insights into the immunological and pathological effects of chronically elevated SCFAs. PMID:26819206

  4. Role of Urinary and Serum Carbohydrate Antigen 19-9 as a Biomarker in Diagnosis of Adult Giant Hydronephrosis

    PubMed Central

    Tomar, Vinay; Yadav, Sher Singh; Vyas, Nachiket; Yadav, Suresh; Sathian, Brijesh

    2016-01-01

    Introduction The most common cause of adult Giant Hydronephrosis (GH) is congenital Uretero-Pelvic Junction (UPJ) obstruction. Conventional imaging modalities, like Intravenous Urography (IVU) and Computed Tomography Urography (CTU) and radionuclide renal scan can be fallacious. Serum carbohydrate antigen 19-9 (CA19-9) is a useful tumour marker for gastrointestinal and pancreatic cancer. Only a few studies and case reports have shown raised serum levels due to benign hydronephrosis and GH. Aim To investigate the prognostic role of urine and serum CA19-9 in the diagnosis and follow-up of adult GH due to UPJ obstruction. Materials and Methods The present hospital based observational study was conducted on 24 adult patients (Group 1) with unilateral GH due to UPJ obstruction. Twenty four healthy adults were included as control (Group 2). Serum and voided urine samples were collected to evaluate Carbohydrate Antigen (CA) 19-9 in each group. During surgery, urine from the affected pelvis was collected to determine CA19-9 level. Patients were followed up after surgery at 3 and 9 months with serum and voided urine samples for CA19-9 level. Results Preoperative Serum and voided urine CA19-9 were significantly greater in Group1 than in controls, which significantly correlated inversely with preoperative percentage renal function and glomerular filtration rate. Postoperative improvement in renal function significantly correlated inversely with serum and voided urine CA19-9 at 3 and 9 months. Conclusion Voided urine CA19-9 can be a non-invasive clinical marker in adult GH due to UPJ obstruction. The clinical implications of these data for diagnosis and follow-up of these patients are significant. Our findings suggest, significant decrease in urinary Ca19-9 level during follow-up is predictive of excellent surgical outcome and resolution of renal damage. PMID:27790508

  5. Associations of Initial Society for Fetal Urology Grades and Urinary Tract Dilatation Risk Groups with Clinical Outcomes in Patients with Isolated Prenatal Hydronephrosis.

    PubMed

    Braga, Luis H; McGrath, Melissa; Farrokhyar, Forough; Jegatheeswaran, Kizanee; Lorenzo, Armando J

    2017-03-01

    There are limited comparative data on the predictive value of the 2 most commonly used classification systems, that is SFU (Society for Fetal Urology) hydronephrosis grades and urinary tract dilatation risk groups, in regard to the future risk of surgical intervention and the development of febrile urinary tract infection. We explored this topic in infants with isolated hydronephrosis. After screening 938 patients with prenatal hydronephrosis from 2009 to 2016 we selected 322 patients with ureteropelvic junction obstruction-like hydronephrosis for study. Hydronephrosis grades were prospectively collected at baseline, surgery and last followup. Gender, circumcision status, antibiotic prophylaxis and renal pelvis anteroposterior diameter were captured. The primary outcome was pyeloplasty and the development of febrile urinary tract infection. Comparative analyses between SFU grades/urinary tract dilatation groups and the primary outcome were performed with the Fisher exact and log rank tests. Mean ± SD age at presentation was 3.3 ± 2.6 months and mean followup was 22 ± 19 months. Pyeloplasty was performed in 32% of patients with SFU III/IV vs 31% with urinary tract dilatation 2/3. The rate of febrile urinary tract infection in patients with SFU III/IV was similar to that in those with urinary tract dilatation group 2/3 (8% vs 10%). Children with SFU III/IV showed a significantly higher rate of surgery than those with SFU I/II (32% vs 2%, p <0.01). Similar findings were seen when using urinary tract dilatation groups to compare patients at low risk (1) vs moderate/high risk (2/3). Both grading systems equally allowed for proper risk stratification and prediction of clinical outcomes based on baseline ultrasound. They correctly separated most infants who underwent surgery or in whom febrile urinary tract infection developed from those who could be treated nonsurgically. Use of the new urinary tract dilatation classification should not affect how families of

  6. Recurrent epiploic appendagitis mimicking appendicitis and cholecystitis

    PubMed Central

    Hearne, Christopher B.; Taboada, Jorge

    2017-01-01

    Epiploic appendagitis (EA) is a rare cause of acute abdominal pain caused by inflammation of an epiploic appendage. It has a nonspecific clinical presentation that may mimic other acute abdominal pathologies on physical exam, such as appendicitis, diverticulitis, or cholecystitis. However, EA is usually benign and self-limiting and can be treated conservatively. We present the case of a patient with two episodes of EA, the first mimicking acute appendicitis and the second mimicking acute cholecystitis. Although recurrence of EA is rare, it should be part of the differential diagnosis of acute, localized abdominal pain. A correct diagnosis of EA will prevent unnecessary hospitalization, antibiotic use, and surgical procedures. PMID:28127129

  7. Tissue mimicking materials for dental ultrasound

    PubMed Central

    Singh, Rahul S.; Culjat, Martin O.; Grundfest, Warren S.; Brown, Elliott R.; White, Shane N.

    2008-01-01

    While acoustic tissue mimicking materials have been explored for a variety of soft and hard biological tissues, no dental hard tissue mimicking materials have been characterized. Tooth phantoms are necessary to better understand acoustic phenomenology within the tooth environment and to accelerate the advancement of dental ultrasound imaging systems. In this study, soda lime glass and dental composite were explored as surrogates for human enamel and dentin, respectively, in terms of compressional velocity, attenuation, and acoustic impedance. The results suggest that a tooth phantom consisting of glass and composite can effectively mimic the acoustic behavior of a natural human tooth. PMID:18396919

  8. Tissue mimicking materials for dental ultrasound.

    PubMed

    Singh, Rahul S; Culjat, Martin O; Grundfest, Warren S; Brown, Elliott R; White, Shane N

    2008-04-01

    While acoustic tissue mimicking materials have been explored for a variety of soft and hard biological tissues, no dental hard tissue mimicking materials have been characterized. Tooth phantoms are necessary to better understand acoustic phenomenology within the tooth environment and to accelerate the advancement of dental ultrasound imaging systems. In this study, soda lime glass and dental composite were explored as surrogates for human enamel and dentin, respectively, in terms of compressional velocity, attenuation, and acoustic impedance. The results suggest that a tooth phantom consisting of glass and composite can effectively mimic the acoustic behavior of a natural human tooth.

  9. Systemic sarcoidosis mimicking malignant metastatic disease

    PubMed Central

    Hammen, Irena; Sherson, David Lee; Davidsen, Jesper Roemhild

    2015-01-01

    We present a case of systemic sarcoidosis involving the liver, pancreas, lungs, mediastinal and intraabdominal lymph nodes and bones. Multiple organ system manifestations mimicked malignant metastatic disease. The diagnosis was established with clinical, radiological, and pathological findings after neoplasm was ruled out by pathological tests. The patient showed rapid symptom remission with systemic steroid treatment. PMID:26672956

  10. Lymphomatoid granulomatosis mimicking interstitial lung disease.

    PubMed

    Braham, Emna; Ayadi-Kaddour, Aïda; Smati, Belhassen; Ben Mrad, Sonia; Besbes, Mohammed; El Mezni, Faouzi

    2008-11-01

    Lymphoid granulomatosis is a rare form of pulmonary angiitis. This case report presents a patient with lymphoid granulomatosis in whom the clinical presentation, radiological features and the partial response to corticosteroid therapy mimicked interstitial lung disease. Lymphoid granulomatosis was only diagnosed at post-mortem examination. The range of reported clinical presentations, diagnostic approaches and outcomes are described.

  11. Gorham's disease of the mandible mimicking periodontal disease on radiograph.

    PubMed

    Mignogna, Michele Davide; Fedele, Stefano; Lo Russo, Lucio; Lanza, Alessandro; Marenzi, Gaetano; Sammartino, Gilberto

    2005-09-01

    Gorham's disease is a rare disorder characterized by spontaneous and progressive osteolysis of one or more skeletal bones. The radiographic findings associated with Gorham's disease are particularly dramatic, as in some cases a complete resorption of the involved bone can occur, leading to the definition of phantom bone, vanishing bone, or disappearing bone disease. A 24-year-old female patient with a previous diagnosis of periodontal disease and progressive mandibular alveolar bone loss was referred to our Oral Medicine section. The initial radiographic picture showed infrabony defects and horizontal bone loss. After further extensive local and systemic evaluation, including histopathological, laboratory and imagine techniques investigations, the patient was diagnosed to be affected by Gorham's disease. Meanwhile the progression of the osteolytic process had caused the loosening of all the left mandibular teeth and a pathologic fracture. Appropriate medical therapy was successful in stabilizating the resorptive process, with no evidence of further progressive disease. When Gorham's disease involves the mandible, the role of the periodontologist is extremely important in diagnosing promptly the disorder and preventing the functional and aesthetic consequences of advanced and extensive bone loss. Gorham's disease should be included among the pathologic entities mimicking periodontal disease on radiograph, such as inflammatory disease (e.g. osteomyelitis), endocrine disease (e.g. hyperparathyroidism), intra-osseous malignancies or metastases, lymphoma, histiocytosis X, mainly eosinophilic granuloma, infective process (e.g. tuberculosis and actinomycosis), odontogenic tumours.

  12. Teflon granulomas mimicking cerebellopontine angle tumors following microvascular decompression.

    PubMed

    Deep, Nicholas L; Graffeo, Christopher S; Copeland, William R; Link, Michael J; Atkinson, John L; Neff, Brian A; Raghunathan, Aditya; Carlson, Matthew L

    2017-03-01

    To report two patients with a history of microvascular decompression (MVD) for hemifacial spasm who presented with Teflon granulomas (TG) mimicking cerebellopontine angle (CPA) tumors and to perform a systematic review of the English-language literature. Case series at a single tertiary academic referral center and systematic review. Retrospective chart review with analysis of clinical, radiological, and histopathological findings. Systematic review using PubMed, Embase, MEDLINE, and Web of Science databases. Two patients with large skull base TGs mimicking CPA tumors clinically and radiographically were managed at the authors' institution. The first presented 4 years after MVD with asymmetrical sensorineural hearing loss, multiple progressive cranial neuropathies, and brainstem edema due to a growing TG. Reoperation with resection of the granuloma confirmed a foreign-body reaction consisting of multinucleated giant cells containing intracytoplasmic Teflon particles. The second patient presented 11 years after MVD with asymmetrical sensorineural hearing loss and recurrent hemifacial spasm. No growth was noted over 2 years, and the patient has been managed expectantly. Only one prior case of TG after MVD for hemifacial spasm has been reported in the English literature. TG is a rare complication of MVD for hemifacial spasm. The diagnosis should be suspected in patients presenting with a new-onset enhancing mass of the CPA after MVD, even when performed decades earlier. A thorough clinical and surgical history is critical toward establishing an accurate diagnosis to guide management and prevent unnecessary morbidity. Surgical intervention is not required unless progressive neurologic complications ensue. 4 Laryngoscope, 127:715-719, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Nitric Oxide Is an Important Mediator of Renal Tubular Epithelial Cell Death in Vitro and in Murine Experimental Hydronephrosis

    PubMed Central

    Kipari, Tiina; Cailhier, Jean-Francois; Ferenbach, David; Watson, Simon; Houlberg, Kris; Walbaum, David; Clay, Spike; Savill, John; Hughes, Jeremy

    2006-01-01

    Macrophages play a pivotal role in tissue injury and fibrosis during renal inflammation. Although macrophages may induce apoptosis of renal tubular epithelial cells, the mechanisms involved are unclear. We used a microscopically quantifiable co-culture assay to dissect the cytotoxic interaction between murine bone marrow-derived macrophages and Madin-Darby canine kidney cells and primary murine renal tubular epithelial cells. The induction of tubular cell apoptosis by cytokine-activated macrophages was reduced by inhibitors of nitric oxide synthase whereas tubular cell proliferation was unaffected. Furthermore, cytokine-activated macrophages derived from mice targeted for the deletion of inducible nitric oxide synthase were noncytotoxic. We then examined the role of nitric oxide in vivo by inhibiting inducible nitric oxide synthase in the model of murine experimental hydronephrosis. l-N6-(1-iminoethyl)-lysine was administered in the drinking water between days 5 and 7 after ureteric obstruction. Macrophage infiltration was comparable between groups, but treatment significantly inhibited tubular cell apoptosis at day 7. Tubular cell proliferation was unaffected. Inducible nitric oxide synthase blockade also reduced interstitial cell apoptosis and increased collagen III deposition. These data indicate that nitric oxide is a key mediator of macrophage-directed tubular cell apoptosis in vitro and in vivo and also modulates tubulointerstitial fibrosis. PMID:16877341

  14. Spherical boson stars as black hole mimickers

    SciTech Connect

    Guzman, F. S.; Rueda-Becerril, J. M.

    2009-10-15

    We present spherically symmetric boson stars as black hole mimickers based on the power spectrum of a simple accretion disk model. The free parameters of the boson star are the mass of the boson and the fourth-order self-interaction coefficient in the scalar field potential. We show that even if the mass of the boson is the only free parameter, it is possible to find a configuration that mimics the power spectrum of the disk due to a black hole of the same mass. We also show that for each value of the self-interaction a single boson star configuration can mimic a black hole at very different astrophysical scales in terms of the mass of the object and the accretion rate. In order to show that it is possible to distinguish one of our mimickers from a black hole, we also study the deflection of light.

  15. Pulmonary diseases with imaging findings mimicking aspergilloma.

    PubMed

    Gazzoni, Fernando Ferreira; Severo, Luiz Carlos; Marchiori, Edson; Guimarães, Marcos Duarte; Garcia, Tiago Severo; Irion, Klaus L; Camargo, José Jesus; Felicetti, José Carlos; de Mattos Oliveira, Flavio; Hochhegger, Bruno

    2014-06-01

    Patients with preexisting lung cavities are at risk of developing intracavitary fungal colonization. Because Aspergillus spp. are the most commonly implicated fungi, these fungal masses are called aspergillomas. Their characteristic "ball-in-hole" appearance, however, may be found in a variety of other conditions that can produce radiologic findings mimicking aspergilloma. In this paper, we review the main diseases that may mimic the radiographic findings of aspergilloma, with brief descriptions of clinical, radiologic, and histopathologic findings.

  16. Isolated giant molluscum contagiosum mimicking epidermoid cyst

    PubMed Central

    Uzuncakmak, Tugba K.; Kuru, Burce C.; Zemheri, Ebru I.; Zindanci, Ilkin; Turkoglu, Zafer; Kavala, Mukaddes

    2016-01-01

    Molluscum contagiosum is a benign cutaneous viral infection which is caused by double- stranded DNA poxvirus. It affects mainly children and young adults and usually presents with single or multiple umblicated papules or nodules on face, arms, legs and anogenital regions. It may present in atypical size and clinical appearance in patients with altered or impaired immunity and rarely in immuncompetent patients. Herein we present an immuncompetent young adult patient with isolated giant molluscum contagiosum, which was mimicking epidermoid cyst clinically. PMID:27648389

  17. Mad honey intoxication mimicking acute coronary syndrome.

    PubMed

    Dur, Ali; Sonmez, Ertan; Civelek, Cemil; AhmetTurkdogan, Kenan; AkifVatankulu, Mehmet; Sogut, Ozgur

    2014-09-01

    Mad honey intoxication or grayanotoxin poisoning is caused by consumption of grayanotoxin-containing toxic honey produced from leaves and flowers of the Rhododendron family. Despite the rarity of intoxication cases, the correct diagnosis and treatment are required because of the significance of haemodynamic disturbance and confounding of symptoms for disease identification. We report herein a case of a patient with mad honey intoxication mimicking acute non-ST segment elevation myocardial infarction and review the pathophysiology and diagnostic considerations.

  18. A Pilocytic Astrocytoma Mimicking a Clinoidal Meningioma

    PubMed Central

    Hong, Christopher S.; Lehman, Norman L.; Sauvageau, Eric

    2014-01-01

    Pilocytic astrocytomas and meningiomas are benign, primary brain tumors that may involve the optic tract. Classically, the presence of a dural “tail” sign may differentiate a meningioma from other intracranial lesions. In this report, we describe a mass with the typical appearance of a clinoidal meningioma on magnetic resonance imaging (MRI) but postoperatively diagnosed as a pilocytic astrocytoma. This case illustrates the rare occurrence of a pilocytic astrocytoma mimicking a meningioma on MRI. PMID:24744944

  19. Rare Mimickers of Exostosis: A Case Series

    PubMed Central

    Perubhotla, Lakshmi Manasa

    2016-01-01

    Exophytic growths from bones are a common entity. Osteochondroma is the most common benign exophytic lesion and we tend to diagnose every benign looking exophytic lesion as osteochondroma. Here we reported two entities of cases, one was Nora’s lesion and another one was supracondylar process of humerus, both of which were mimickers of osteochondroma and their salient and differentiating features from osteochondromas. PMID:27630926

  20. Conservative management in ureteric hydronephrosis due to deep endometriosis: Could the levonorgestrel-intrauterine device be an option?

    PubMed

    Simón, Elisa; Tejerizo, Álvaro; Muñoz, José Luis; Álvarez, Carmen; Marqueta, Laura; Jiménez, Jesús S

    2017-07-01

    Endometriosis can affect up to 10% of women of reproductive age, in a wide range of clinical presentations that vary from mild to severe or deep endometriosis. Deep endometriosis can affect the urinary tract in 1-5% to 15-25% cases. Even though deep endometriosis' surgeries are usually complex with higher rate of complications, conservative management is not always considered as an option because of its high failure rates. This paper describes two cases of deep endometriosis with ureteric involvement (hydronephrosis) treated conservatively with a double-pigtail stent plus a Levonorgestrel intrauterine device, after conservative surgery, who remained symptom free with no evidence of recurrence at 3 years follow-up, avoiding radical high-risk surgery. Impact statement Several treatments have been described for endometriosis. From a symptomatic perspective, conservative medical management has been proposed with a variable response. Concerning deep endometriosis (affecting the urinary or digestive tract), the definitive treatment has always been thought to be radical surgery. However, this can lead to several complications. To illustrate a possible more conservative approach this paper describes two cases of deep infiltrating endometriosis affecting the ureter, treated conservatively with a temporary pigtail ureter stent plus a Levonorgestrel intrauterine device. The management demonstrates that, in a selected population, conservative treatment solves the urinary disease avoiding the surgical complications and, what is more, improving patients' symptoms in a permanent way. Further prospective studies are needed to confirm whether the introduction of this management in clinical practice would reduce the need for surgery thereby, avoiding high-risk surgery and improving the success rate of conservative management.

  1. Idiopathic Transverse Myelitis Mimicking an Intramedullary Spinal Cord Tumor

    PubMed Central

    Fanous, Andrew A.; Olszewski, Nathan P.; Lipinski, Lindsay J.; Qiu, Jingxin

    2016-01-01

    The differential diagnoses for spinal cord lesions include spinal tumors and inflammatory processes. The distinction between these pathologies can be difficult if solely based on imaging. We report for the first time to our knowledge a case of idiopathic transverse myelitis (ITM) mimicking a discrete cervical spinal lesion in a 66-year-old man who presented with gait instability and neck pain. The patient's symptoms failed to resolve after an initial course of steroid therapy. Surgical biopsy confirmed the diagnosis of ITM. Subsequent treatment with dexamethasone resulted in complete resolution of the symptoms as well as the intramedullary enhancement. ITM is most common in the cervical and thoracic spine, spanning 3-4 spinal segments. It usually occupies more than 50% of the cross-sectional area of the spinal cord and tends to be central, uniform, and symmetric. It exhibits patchy and peripheral contrast enhancement. These criteria are useful guidelines that help distinguish ITM from neoplastic spinal lesions. A decision to perform biopsy must take into consideration the patient's clinical symptoms, the rate of progression of neurological deficits, and the imaging characteristics of the lesion. Surgical biopsy for questionable lesions should be reserved for patients with progressive neurological deficits refractory to empirical medical therapy. PMID:27672469

  2. Trastuzumab-Induced Myocardiotoxicity Mimicking Acute Coronary Syndrome

    PubMed Central

    Ribeiro, K.B.; Miranda, C.H.; Andrade, J.M.; Galli, L.G.; Tiezzi, D.G.; Oliveira, H.F.; Zola, F.E.; Volpe, G.; Pazin-Filho, A.; Peria, F.M.

    2012-01-01

    Trastuzumab is an important biological agent in the treatment of HER2-positive breast cancer, with effects on response rates, progression-free survival, overall survival and quality of life. Although this drug is well tolerated in terms of adverse effects, trastuzumab-associated myocardiotoxicity has been described to have an incidence of 0.6–4.5% and in rare cases, the drug can trigger severe congestive heart failure with progression to death or even mimic acute coronary syndrome with complete left bundle branch blockade. In this paper is reported a case of trastuzumab-associated myocardiotoxicity manifesting as acute coronary syndrome in a 69-year-old female. The patient is currently undergoing a conservative clinical treatment that restricts overexertion. The majority of clinical studies report trastuzumab-induced cardiotoxicity as a rare event, and, when present, characterized by mild to moderate clinical signs, the ease of reversibility with pharmacological measures and the temporary discontinuation of the medication. Conversely, it is vital for the oncologist/cardiologist to consider the possibility that trastuzumab-induced cardiotoxicity may manifest itself as a severe clinical case, mimicking acute coronary syndrome, justifying careful risk stratification and adequate cardiac monitoring, especially in high-risk patients. PMID:22666200

  3. Breast cancer cell behaviors on staged tumorigenesis-mimicking matrices derived from tumor cells at various malignant stages.

    PubMed

    Hoshiba, Takashi; Tanaka, Masaru

    2013-09-20

    Extracellular matrix (ECM) has been focused to understand tumor progression in addition to the genetic mutation of cancer cells. Here, we prepared "staged tumorigenesis-mimicking matrices" which mimic in vivo ECM in tumor tissue at each malignant stage to understand the roles of ECM in tumor progression. Breast tumor cells, MDA-MB-231 (invasive), MCF-7 (non-invasive), and MCF-10A (benign) cells, were cultured to form their own ECM beneath the cells and formed ECM was prepared as staged tumorigenesis-mimicking matrices by decellularization treatment. Cells showed weak attachment on the matrices derived from MDA-MB-231 cancer cells. The proliferations of MDA-MB-231 and MCF-7 was promoted on the matrices derived from MDA-MB-231 cancer cells whereas MCF-10A cell proliferation was not promoted. MCF-10A cell proliferation was promoted on the matrices derived from MCF-10A cells. Chemoresistance of MDA-MB-231 cells against 5-fluorouracil increased on only matrices derived from MDA-MB-231 cells. Our results showed that the cells showed different behaviors on staged tumorigenesis-mimicking matrices according to the malignancy of cell sources for ECM preparation. Therefore, staged tumorigenesis-mimicking matrices might be a useful in vitro ECM models to investigate the roles of ECM in tumor progression.

  4. Nontuberculous mycobacterial pulmonary disease mimicking lung cancer

    PubMed Central

    Hong, Su Jin; Kim, Tae Jung; Lee, Jae-Ho; Park, Jeong-Soo

    2016-01-01

    Abstract To describe the features and clinical implications of computed tomography (CT), positron emission tomography (PET), and percutaneous needle aspiration biopsy (PCNB) in pulmonary nontuberculous mycobacterial (NTM) disease manifesting as a solitary nodule, mass, or mass-like consolidation mimicking malignancy. Among a cohort of 388 patients with NTM pulmonary disease, 14 patients with clinically and radiologically suspected lung cancer were included in our study. Two chest radiologists evaluated CT features, including lesion type (nodule, mass, or mass-like consolidation), morphologic features (margin, degree of enhancement, calcification), and presence of accompanying findings suggestive of NTM pulmonary disease (bronchiectasis with clustered centrilobular nodules or upper-lobe cavitary lesions) by consensus. Diagnostic procedures for microbiologic diagnosis of NTM disease and clinical outcome were reviewed. Incidence of NTM pulmonary disease presenting as solitary nodule/mass (n = 8) or mass-like consolidation (n = 6) was 3.6% (14 of 388). Most lesions were detected incidentally during routine health check-up or evaluation of other disease (11 of 14, 79%). Lesions typically showed poor contrast-enhancement (9 of 12) and internal calcification (6 of 14). No lesions had CT features suggestive of NTM pulmonary disease. All 4 lesions for which PET/CT imaging was performed showed strong fluorodeoxyglucose uptake simulating malignant lesions (mean, 4.9; range, 3.6–7.8). PCNB revealed mycobacterial histology in 6 of 11 specimens and positive culture results were obtained for 7 of 7 specimens. NTM pulmonary disease may present as a solitary nodule, mass, or mass-like consolidation mimicking malignancy. CT features and PCNB are important to diagnose NTM disease mimicking lung cancer to avoid unnecessary surgery. PMID:27367996

  5. Brucellosis in spondyloarthritis mimicking an exacerbation.

    PubMed

    Garip, Y; Eser, F; Erten, S; Yilmaz, O; Yildirim, P

    2014-01-01

    Spondyloarthritis are a group of chronic inflammatory diseases that affect the axial skeleton, entheses and peripheral joints and may have extraarticular manifestations such as uveitis, psoriasis and inflammatory bowel disease. Brucellosis is a systemic infectious disease, endemic in Middle East, Latin America, and Mediterranean countries, which may present manifestations that resemble other diseases posing serious problems of differential diagnosis. Some hallmarks of Brucellosis may mimic a spondyloarthritis flare. In this paper, authors present a clinical case of brucellosis occurring in a patient with spondyloarthritis. Clinical symptoms initially mimicked exacerbation of spondyloarthritis.

  6. Thymic Langerhans cell histiocytosis mimicking lymphoma.

    PubMed

    Yağci, Begül; Varan, Ali; Uner, Aysegül; Akyüz, Canan; Büyükpamukçu, Münevver

    2008-12-01

    Langerhans cell histiocytosis (LCH) is a rare disorder characterized by clonal expansion of antigen presenting Langerhans cells. Different clinical features can be seen according to the involved organs and systems. Multisystem disease with organ dysfunction is more common in infants, whereas single system disease is usually observed in older children. The disease can affect any system or organ throughout the body. Thymus is a rarely involvement site reported in LCH and usually is accompanied by skin, bone or lung disease. Here we report a 12-year-old male with thymic involvement by LCH clinically mimicking lymphoma.

  7. Post-pancreatitis Fat Necrosis Mimicking Carcinomatosis.

    PubMed

    Smith, Joshua P; Arnoletti, J Pablo; Varadarajulu, Shyam; Morgan, Desiree E

    2008-01-01

    Acute pancreatitis can result in retroperitoneal fat necrosis, typically occurring in the peripancreatic region, with extension into the transverse mesocolon, omentum and mesenteric root. When evaluated with contrast enhanced computed tomography (CECT), acute peripancreatic post necrotic collections typically become lower in attenuation over time, and often appear as homogeneous fluid collections. Saponification as a complication of fat necrosis in patients with acute pancreatitis is a well recognized clinical entity. While retroperitonal fat necrosis is commonly seen on CECT, saponification is not a prominent imaging feature. We present a case of acute pancreatitis complicated by extensive saponification of fat throughout the retroperitoneum and peritoneal lining, mimicking carcinomatosis.

  8. Severe emphysematous pyelonephritis mimicking intestinal obstruction.

    PubMed

    Sun, Ji Ning; Zhang, Bao Long; Yu, Hai Yan; Wang, Bin

    2015-12-01

    Emphysematous pyelonephritis is a severe necrotizing infection characterized by the presence of gas and/or fluid in the renal parenchyma, collecting system, or perirenal tissues. Emphysematous pyelonephritis with approximately 15 cm air-fluid level, diffused ureteral involvement, and the accumulation of gas in liver and peritoneal cavity is very rare. Here, we reported a severe emphysematous pyelonephritis with multiple huge air-fluid level mimicking intestinal obstruction and with the accumulation of gas in liver and ureter in computed tomography imaging. The patient was successfully managed by percutaneous nephrostomy combined with medical treatment.

  9. Chondroblastoma of the acromion mimicking fibrous dysplasia.

    PubMed

    Gebert, Carsten; Hardes, Jendrik; Streitbürger, Arne; Vieth, Volker; Bürger, Horst; Winkelmann, Winfried; Gosheger, Georg

    2004-12-01

    The authors report the case of a 65-year-old man who presented with an expansive osteolytic lesion in the right acromion, mimicking cystic fibrous dysplasia. Magnetic resonance imaging showed a lesion with intermediate-signal intensity on T1-weighted images and a high-signal intensity on fat suppressed T2-weighted images. The biopsy led to the diagnosis of chondroblastoma. This tumour is rare in flat bones, and may mimic other benign or malignant lesions. It is therefore essential to perform a biopsy in order to obtain a definite diagnosis. The acromion was excised, and replaced with an iliac crest graft.

  10. Intradural Extramedullary Tuberculoma Mimicking En Plaque Meningioma

    PubMed Central

    Shim, Dae Moo; Kim, Tae Kyun; Chae, Soo Uk

    2010-01-01

    A 24-year-old man with tuberculosis meningitis developed acute paraplegia and sensory disturbances 5 weeks after receiving conventional antituberculous therapy. Magnetic resonance imaging revealed an intradural extramedullary long segmental mass mimicking en plaque meningioma at the T2-T6 vertebrae levels. Prompt surgical decompression was performed. A histology examination of the mass revealed a tuberculoma. After surgery, the patient showed improved motor power and a normal bladder function. Intradural extramedullary tuberculoma of the spinal cord is rare complication of tuberculosis meningitis, which can occur as a response to conventional antituberculous therapy. PMID:21119945

  11. Pulmonary tumour microembolism clinically mimicking alveolitis

    PubMed Central

    Lo, A W I; Tse, G M K; Chu, W C W; Chan, A B W

    2003-01-01

    A 56 year old man with previously unsuspected recurrence of squamous cell carcinoma of the oesophagus presented with dyspnoea. Bronchoscopy and computed tomography suggested bronchopneumonic changes with an infectious cause. He suffered a rapidly deteriorating course and died despite active treatment, including antibiotics and mechanical ventilation. Necropsy revealed a florid pulmonary tumour microembolism mimicking alveolitis. No bronchopneumonia was seen. The emboli arose from loosely attached tumour vegetations in the tricuspid valve. In a patient with known malignancy, tumour microembolism should be considered as an uncommon cause of rapid respiratory failure, refractory to antibiotic treatment. PMID:14600135

  12. From Research Question to Conducting a Randomized Controlled Trial on Continuous Antibiotic Prophylaxis in Prenatal Hydronephrosis: A Rational Stepwise Process.

    PubMed

    Braga, Luis H; Easterbrook, Bethany; Jegatheeswaran, Kizanee; Lorenzo, Armando J

    2016-01-01

    Continuous antibiotic prophylaxis (CAP) use to prevent urinary tract infections (UTI) in infants with prenatal hydronephrosis (HN) remains controversial. Lack of consensus guidelines and diverse practice patterns for postnatal management of HN highlight the dire need for higher level of evidence studies. Herein, we aim to describe the steps from developing a well-defined research question to execute a multicentered randomized controlled trial (RCT) to address the issue of CAP use in patients with prenatal HN. The steps involved were (1) choosing the proper research question, (2) survey of practice patterns and establishing clinical equipoise, (3) systematic review of the literature, (4) reviewing own practice, (5) longitudinal prospective study, (6) pilot study, (7) cost-utility analysis, and (8) definitive RCT (clinical trials registry number: NCT01140516). An update of our previous systematic review was conducted using two electronic databases and gray literature from 2010 to 2015. Eligibility criteria included studies of children <2 years old with postnatally confirmed prenatal HN, receiving CAP or not, and reporting on development of UTIs, capturing information on voiding cystourethrogram result and HN grade. Full-text screening was conducted by two independent reviewers. UTI rates in patients with high-grade HN were compared across different study designs. Finally, blinded comparative analysis of UTI rates between placebo and treatment groups was carried out using chi-square test. UTI rates in patients with high-grade HN by their respective study design were: 25% for systematic review, 20% for retrospective study, 21% for prospective and pilot studies, and 13% for the definitive RCT thus far. Regardless of the type of study design, patients with hydroureteronephrosis had significantly higher (threefold to sixfold) UTI rates than those with isolated HN. Our updated systematic review yielded 486 citations, of which 9 (n = 1987 infants) observational

  13. Clinical and Histologic Mimickers of Celiac Disease.

    PubMed

    Kamboj, Amrit K; Oxentenko, Amy S

    2017-08-17

    Celiac disease is an autoimmune disorder of the small bowel, classically associated with diarrhea, abdominal pain, and malabsorption. The diagnosis of celiac disease is made when there are compatible clinical features, supportive serologic markers, representative histology from the small bowel, and response to a gluten-free diet. Histologic findings associated with celiac disease include intraepithelial lymphocytosis, crypt hyperplasia, villous atrophy, and a chronic inflammatory cell infiltrate in the lamina propria. It is important to recognize and diagnose celiac disease, as strict adherence to a gluten-free diet can lead to resolution of clinical and histologic manifestations of the disease. However, many other entities can present with clinical and/or histologic features of celiac disease. In this review article, we highlight key clinical and histologic mimickers of celiac disease. The evaluation of a patient with serologically negative enteropathy necessitates a carefully elicited history and detailed review by a pathologist. Medications can mimic celiac disease and should be considered in all patients with a serologically negative enteropathy. Many mimickers of celiac disease have clues to the underlying diagnosis, and many have a targeted therapy. It is necessary to provide patients with a correct diagnosis rather than subject them to a lifetime of an unnecessary gluten-free diet.

  14. Doxycycline-induced ulceration mimicking esophageal cancer

    PubMed Central

    Tahan, Veysel; Sayrak, Hakan; Bayar, Nevzat; Erer, Burak; Tahan, Gulgun; Dane, Faysal

    2008-01-01

    Introduction Doxycycline-induced esophageal ulcer patients are mostly young persons with no history of esophageal dysfunction. Heartburn, midsternal pain and dysphagia are the most common symptoms. It has generally a benign course. The present case is the first report of doxycycline-induced extensive ulcerations, mimicking esophageal cancer in two esophageal segments alongside, in the literature. Case presentation This report describes a 16-year-old Caucasian girl who, while taking doxycycline capsules100 mg twice a day for acne vulgaris for 3 months, developed these symptoms. An upper endoscopy revealed multiple circumferential deep ulcerations surrounding fragile, irregular, hyperemic and hypertrophic mucosa at the level of the mid-esophagus and concomitantly in the lower esophageal sphincter. The lesions were biopsied to exclude esophageal carcinoma because of the suspicious appearance in the endoscopic examination. The histopathological examination, haematoxylin and eosin stained sections showed ulceration with a mixed inflammatory infiltrate. Doxycycline was discontinued and she was given sucralfate 1 g qid and omeprazole 20 mg bid orally. All symptoms of the patient were resolved on the third day of the treatment. After 4 weeks of the therapy, an upper endoscopic control examination demonstrated normal findings. Conclusion The present case has been an uncommon presentation of doxycycline-induced extensive ulcerations, mimicking esophageal cancer in two esophageal segments, concomitantly. Even the lesions were biopsied to exclude esophageal carcinoma. A modification on the behavior of taking drugs can prevent these unpleasant complications. PMID:18778470

  15. Inflammatory Myofibroblastic Tumor Mimicking Apical Periodontitis.

    PubMed

    Adachi, Makoto; Kiho, Kazuki; Sekine, Genta; Ohta, Takahisa; Matsubara, Makoto; Yoshida, Takakazu; Katsumata, Akitoshi; Tanuma, Jun-ichi; Sumitomo, Shinichiro

    2015-12-01

    Inflammatory myofibroblastic tumors (IMTs) are rare. IMTs of the head and neck occur in all age groups, from neonates to old age, with the highest incidence occurring in childhood and early adulthood. An IMT has been defined as a histologically distinctive lesion of uncertain behavior. This article describes an unusual case of IMT mimicking apical periodontitis in the mandible of a 42-year-old man. At first presentation, the patient showed spontaneous pain and percussion pain at teeth #28 to 30, which continued after initial endodontic treatment. Panoramic radiography revealed a radiolucent lesion at the site. Cone-beam computed tomographic imaging showed osteolytic lesions, suggesting an aggressive neoplasm requiring incisional biopsy. Histopathological examination indicated an IMT. The lesion was removed en bloc under general anesthesia, and the patient manifested no clinical evidence of recurrence for 24 months. Lesions of nonendodontic origin should be included in the differential diagnosis of apical periodontitis. Every available diagnostic tool should be used to confirm the diagnosis. Cone-beam computed tomographic imaging is very helpful for differential diagnosis in IMTs mimicking apical periodontitis.

  16. Nonlinearity parameter for tissue-mimicking materials.

    PubMed

    Dong, F; Madsen, E L; MacDonald, M C; Zagzebski, J A

    1999-06-01

    A finite amplitude insert-substitution method has been used to determine the ultrasonic nonlinearity parameter B/A of nine versions of water-based, macroscopically uniform ultrasonically tissue-mimicking (TM) nonfat and fat materials. In this method, the amplitude of the second harmonic following transmission through degassed distilled water with known B/A (B/A = 5.2) and the amplitude of the second harmonic following transmission through the unknown sample are measured. The ratio of these amplitudes allows calculation of the B/A of the sample. Measured B/A values of the nonfat materials range from 5.6 to 6.6. These values compare favorably with published values for nonfat soft tissues. In contrast, the measured B/A values for two tissue-mimicking fat materials are 9.8 and 11.1; these two values represent the low and high end of B/A for most fresh fatty tissues. For comparison, B/A was measured for two commonly available uniform materials, corn oil and ethylene glycol, and the results are in good agreement with published values.

  17. Breast cancer cell behaviors on staged tumorigenesis-mimicking matrices derived from tumor cells at various malignant stages

    SciTech Connect

    Hoshiba, Takashi; Tanaka, Masaru

    2013-09-20

    Highlights: •Models mimicking ECM in tumor with different malignancy were prepared. •Cancer cell proliferation was suppressed on benign tumor ECM. •Benign tumor cell proliferation was suppressed on cancerous ECM. •Chemoresistance of cancer cell was enhanced on cancerous ECM. -- Abstract: Extracellular matrix (ECM) has been focused to understand tumor progression in addition to the genetic mutation of cancer cells. Here, we prepared “staged tumorigenesis-mimicking matrices” which mimic in vivo ECM in tumor tissue at each malignant stage to understand the roles of ECM in tumor progression. Breast tumor cells, MDA-MB-231 (invasive), MCF-7 (non-invasive), and MCF-10A (benign) cells, were cultured to form their own ECM beneath the cells and formed ECM was prepared as staged tumorigenesis-mimicking matrices by decellularization treatment. Cells showed weak attachment on the matrices derived from MDA-MB-231 cancer cells. The proliferations of MDA-MB-231 and MCF-7 was promoted on the matrices derived from MDA-MB-231 cancer cells whereas MCF-10A cell proliferation was not promoted. MCF-10A cell proliferation was promoted on the matrices derived from MCF-10A cells. Chemoresistance of MDA-MB-231 cells against 5-fluorouracil increased on only matrices derived from MDA-MB-231 cells. Our results showed that the cells showed different behaviors on staged tumorigenesis-mimicking matrices according to the malignancy of cell sources for ECM preparation. Therefore, staged tumorigenesis-mimicking matrices might be a useful in vitro ECM models to investigate the roles of ECM in tumor progression.

  18. High-altitude cerebral oedema mimicking stroke

    PubMed Central

    Yanamandra, Uday; Gupta, Amul; Patyal, Sagarika; Varma, Prem Prakash

    2014-01-01

    High-altitude cerebral oedema (HACO) is the most fatal high-altitude illness seen by rural physicians practising in high-altitude areas. HACO presents clinically with cerebellar ataxia, features of raised intracranial pressure (ICP) and coma. Early identification is important as delay in diagnosis can be fatal. We present two cases of HACO presenting with focal deficits mimicking stroke. The first patient presented with left-sided hemiplegia associated with the rapid deterioration in the sensorium. Neuroimaging revealed features suggestive of vasogenic oedema. The second patient presented with monoplegia of the lower limb. Neuroimaging revealed perfusion deficit in anterior cerebral artery territory. Both patients were managed with dexamethasone and they improved dramatically. Clinical picture and neuroimaging closely resembled acute ischaemic stroke in both cases. Thrombolysis in these patients would have been disastrous. Recent travel to high altitude, young age, absence of atherosclerotic risk factors and features of raised ICP concomitantly directed the diagnosis to HACO. PMID:24671373

  19. Orthokeratinised odontogenic cyst mimicking periapical cyst

    PubMed Central

    Rajalakshmi, R; Sreeja, C; Vijayalakshmi, D; Leelarani, V

    2013-01-01

    Orthokeratinised odontogenic cyst (OOC) denotes the odontogenic cyst that microscopically has an orthokeratinised epithelial lining. OOC is characterised by a less-aggressive behaviour and a low rate of recurrence. This report describes a case of OOC involving posterior part of the mandible that mimicked periapical cyst in a 14-year-old boy. The initial clinical diagnosis was given as periapical cyst based on the clinical and radiographical features. Enucleation of the cyst was performed and the specimen was sent for histopathological examination. A definite diagnosis of OOC was made by histopathological examination of the biopsy specimen. This case emphases on including OOC in the differential diagnosis of radiolucencies occurring in the periapical region of non-vital tooth. PMID:24099763

  20. Orthokeratinised odontogenic cyst mimicking periapical cyst.

    PubMed

    Rajalakshmi, R; Sreeja, C; Vijayalakshmi, D; Leelarani, V

    2013-10-07

    Orthokeratinised odontogenic cyst (OOC) denotes the odontogenic cyst that microscopically has an orthokeratinised epithelial lining. OOC is characterised by a less-aggressive behaviour and a low rate of recurrence. This report describes a case of OOC involving posterior part of the mandible that mimicked periapical cyst in a 14-year-old boy. The initial clinical diagnosis was given as periapical cyst based on the clinical and radiographical features. Enucleation of the cyst was performed and the specimen was sent for histopathological examination. A definite diagnosis of OOC was made by histopathological examination of the biopsy specimen. This case emphases on including OOC in the differential diagnosis of radiolucencies occurring in the periapical region of non-vital tooth.

  1. Mature posterior fossa teratoma mimicking dermoid cyst.

    PubMed

    Bohara, Manoj; Yonezawa, Hajime; Karki, Prasanna; Bakhtiar, Yuriz; Hirano, Hirofumi; Kitazono, Ikumi; Matsuyama, Nozomu; Arita, Kazunori

    2013-10-01

    We describe a very rare case of mature posterior fossa teratoma in an adult who presented with clinico-radiological findings consistent with a dermoid cyst. A computed tomography scan showed a hypodense mass in the cistern magna with calcification and a sinus tract in the occipital bone. Magnetic resonance imaging revealed a hypo- to hyperintense mass without contrast enhancement. The intraoperative picture showed a dermal sinus and a cyst containing lipid, keratin and hair. Histopathological examination showed a tumor with components of all the three germ layers; thereby, a diagnosis of mature teratoma was made. The histopathological differentiation between teratoma and dermoid cyst is very valuable for ruling out the presence of immature/malignant or germinomatous components that would require further adjuvant therapies. Thus, we here present a rare case of posterior fossa teratoma mimicking dermoid cyst and emphasize the importance of histopathological differentiation between these entities.

  2. Infant botulism mimicking an acute abdomen.

    PubMed

    Pisanti, R; Vitiello, R; Formicola, S; Pisanti, A

    2009-12-01

    Botulism is the acute, flaccid paralysis caused by a neurotoxin produced by Clostridium botulinum. In the infant, clinical symptoms are usually unspecific such as poor feeding, weak suck, feeble cry, drooling, followed by a symmetric, descending, flaccid paralysis beginning with the cranial nerve musculature. The initial symptoms of the disease are often similar to several diseases and therefore differential diagnosis is very difficult and rarely suspected by the physician. Since 2004 only 22 cases of infant botulism have been reported in Italy. Since most paediatricians are unfamiliar with the clinical manifestations of infant botulism, the diagnosis can be easily missed. Hence the disease may well be underestimated and underreported. We report a clinical case of botulism presenting initially with abdominal distention, thereby mimicking acute abdomen.

  3. Inherited cardiomyopathies mimicking arrhythmogenic right ventricular cardiomyopathy.

    PubMed

    Roberts, Jason D; Veinot, John P; Rutberg, Julie; Gollob, Michael H

    2010-01-01

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) represents an inherited cardiomyopathy that manifests clinically with malignant ventricular arrhythmias, sudden cardiac death, and less commonly heart failure. The condition is characterized by replacement of the myocardium, primarily of the right ventricle, with fibrofatty tissue. Extensive fibrofatty replacement of the myocardium has been previously thought to be pathognomonic of ARVC; however, this report details two other forms of inherited cardiomyopathy, namely hypertrophic cardiomyopathy (HCM) and the PRKAG2 cardiac syndrome, that were found to have significant fibrofatty myocardial replacement at pathologic examination. This report represents the first documentation of inherited cardiomyopathies mimicking ARVC and highlights the concept that other cardiac conditions can be associated with fibrofatty replacement of the myocardium. Copyright 2010 Elsevier Inc. All rights reserved.

  4. Pulmonary artery sarcoma mimicking pulmonary thromboembolism.

    PubMed

    Celik, Gökhan; Ciledağ, Aydin; Yüksel, Cabir; Yenigün, Bülent Mustafa; Kutlay, Hakan; Yazicıoğlu, Levent; Perçinel, Sibel; Kaya, Akin

    2011-01-01

    A 30 years old male patient was referred to our hospital with a diagnosis of pulmonary thromboembolism due to thorax-computerized tomography (CT) angiography, revealing a thrombus totally occluding left main pulmonary artery. The lesion was evaluated as tumoural mass. Positron emission tomography (PET)-CT revealed pathologic uptake at pulmonary artery mass. Due to localization of tumour, left pneumonectomy was performed. The pathological diagnosis revealed to be pulmonary artery sarcoma. The patient was presented because pulmonary artery sarcomas are very rare tumors and can mimick pulmonary thromboembolism. The true prevalence is underestimated as many pulmonary artery sarcomas are misdiagnosed as pulmonary thromboembolism. PET-CT may help to make a differential diagnosis.

  5. Mimicking semi-convection by convective overshooting

    NASA Astrophysics Data System (ADS)

    Caloi, V.; Mazzitelli, I.

    1990-12-01

    This paper investigates the behavior of so called 'semiconvection' (described by Schwarzschild, 1970; Castellani et al., 1971), of stars burning He in a convective core but exibiting an apparent spontaneous capability to partially mix into the core the matter from outside the formal boundaries of the convective region. A simple numerical algorithm based on a small and ad hoc amount of convective overshooting is presented which, if properly tuned, can mimick the effect of semiconvection in the computation of those stellar evolutionary phases in which a convective helium burning core is present. Using this algorithm, the time-consuming numerical procedures involved in the evaluation of the correct chemical profiles at the boundaries of the formally convective He core can be avoided.

  6. A subtle mimicker in emergency department

    PubMed Central

    Angelis, Maria Vittoria De; Giacomo, Roberta Di; Muzio, Antonio Di; Onofrj, Marco; Bonanni, Laura

    2016-01-01

    Abstract Background: Movement disorder emergencies include any movement disorder which develops over hours to days, in which failure to appropriately diagnose and manage can result in patient morbidity or mortality. Movement disorder emergencies include acute dystonia: sustained or intermittent muscle contractions causing abnormal, often repetitive, movements. Acute dystonia is a serious challenge for emergency room doctors and neurologists, because of the high probability of misdiagnosis, due to the presence of several mimickers including partial seizures, meningitis, localized tetanus, serum electrolyte level abnormalities, strychnine poisoning, angioedema, malingering, catatonia, and conversion. Methods: We describe 2 examples, accompanied by videos, of acute drug-induced oro-mandibular dystonia, both subsequent to occasional haloperidol intake. Results: Management and treatment of this movement disorder are often difficult: neuroleptics withdrawal, treatment with benzodiazepines, and anticholinergics are recommended. Conclusion: Alternative treatment options are also discussed. PMID:27741141

  7. Polypoid uterine lesions mimicking endometrial stromal sarcoma.

    PubMed Central

    McCluggage, W G; Alderdice, J M; Walsh, M Y

    1999-01-01

    Two polypoid submucosal uterine lesions were examined histologically and immunohistochemically with monoclonal antibodies to desmin and alpha smooth muscle actin. One case comprised a leiomyoma and the other a polypoid form of adenomyosis. Both polyps had prolapsed through the external cervical os. The lesions had an ulcerated surface with focal areas of marked increased cellularity and pronounced vascularity throughout, such that they mimicked a low grade endometrial stromal sarcoma infiltrating the myometrium. The cellular areas showed diffuse positivity for desmin and alpha smooth muscle actin, confirming them to be of smooth muscle origin. The changes of marked hypercellularity and pronounced vascularity within polypoid submucosal uterine lesions have not been emphasised in published reports up to now. Pathologists should be aware of these morphological features in order to avoid misdiagnosis of such cases as endometrial stromal sarcomas. The changes described here are likely to be secondary to trauma associated with a polypoid lesion prolapsing through the external cervical os. Images PMID:10605413

  8. Phthriasis Palpebrarum Mimicking Lid Eczema and Blepharitis

    PubMed Central

    Turgut, Burak; Kurt, Julide; Çatak, Onur; Demir, Tamer

    2009-01-01

    Phthiriasis palpebrarum (PP) is a rare eyelid infestation caused by phthirus pubis. We report a case of PP mimicking lid eczema and blepharitis. A 68-year-old woman had moderate itching in both eyes. Her initial diagnosis was considered to be lid eczema or blepharitis because of findings similar to exfoliative lesions and color changes in eyelids and to excretions over eyelashes. Careful observation revealed many lice and translucent nits, protuberances and hyperpigmentary changes, and the buried lice in both eyelids. No hyperemia or secretion was observed on the lids and in the conjunctiva in both eyes. The patient was treated with pilocarpine hydrochloride 4% drops. At the end of the first week, no louse or nit was present. Although it was known that PP is a rare cause of blepharoconjunctivitis, it might observe as an isolated infestation of the eyelids and this condition can easily be misdiagnosed as lid eczema and blepharitis. PMID:20339456

  9. Solitary spinal dural syphilis granuloma mimicking a spinal meningioma.

    PubMed

    Zhou, Heng-Jun; Zhan, Ren-Ya; Chen, Man-Tao; Cao, Fei; Zheng, Xiu-Jue

    2014-01-01

    Dural granuloma is extremely rare. To our knowledge, there has no case reported solitary spinal dural syphilis granuloma worldwide so far. Here we report our findings in a 49-year-old woman, who presented with 10-year progressive left lower-limb numbness and two weeks of right lower-limb numbness. Magnetic resonance imaging (MRI) suggested a homogeneous enhanced spindle-shaped lesion, 2.9 × 1.5 cm in size, occupying the spinal intradural extramedullary space, at the level of Thoracic (T)-2/3, which mimicked the appearance of spinal meningioma. The Treponema pallidum particle agglutination (TPPA) test titer of 1:8, and the venereal diseases research laboratory of cerebral spinal fluid (VDRL-CSF) was reactive, so confirmed neurosyphilis was considered. After formal anti-syphilis treatment, posterior laminectomy surgery was performed, and the lesion was completely separated and extirpated. Final histopathologic diagnosis of the lesion was confirmed as chronic granulomatous inflammation, combined with the neurosyphilis history, spinal dural syphilis granuloma was finally diagnosed. Postoperatively, the patient recovered without any further treatment.

  10. Tophaceous gout of the lumbar spine mimicking a spinal meningioma.

    PubMed

    Ribeiro da Cunha, Pedro; Peliz, António Judice; Barbosa, Marcos

    2016-11-05

    Although gout is a common metabolic disorder, it usually affects distal joints of the appendicular skeleton. Axial spine involvement is rare, with only 131 cases reported in the literature. The authors report a rare case of lumbar spinal gout mimicking a spinal meningioma. A 77-year-old man with a history of gout presented with chronic low back pain and progressive paraparesis. Imaging revealed a lumbar spine compressive mass lesion with a dural tail signal. The differential diagnosis was thought to be straightforward favoring a spinal meningioma. Tophaceous gout was never considered. The presence of a dural tail associated with the lesion is an interesting detail of this case, that strongly misguided it and to the best of our knowledge it is the first one reported in the literature. The patient underwent surgery and intra-operative findings were surprisingly different from those expected, revealing a chalky white mass lesion firmly adherent and compressing the dural sac. It was completely excised, leaving the dura intact. Histopathology confirmed the diagnosis of tophaceous gout. The patient was sent to physical therapy and had a complete remission of pain and neurological deficit, regaining his walking capacity. Although spinal gout is rare, it should be considered in the differential diagnosis for patients presenting with symptoms of spinal stenosis, a suspicion of neoplastic lesion of the spine, and a previous history of gout. Early diagnosis can ensure proper and timely medical management, perhaps avoiding neurological compromise and the need for surgery.

  11. Extramedullary Plasmacytoma Mimicking Pancreatic Cancer: An Unusual Presentation

    PubMed Central

    Sciancalepore, Daniela; Musci, Sergio; Fracella, Maria Rosaria; D'Alesio, Grazia; Sportelli, Azzurra; Ingravallo, Giuseppe; Vacca, Angelo

    2016-01-01

    Multiple myeloma is a plasma cell tumor that homes to and expands in the bone marrow and that, despite the new available drugs, remains incurable. Extramedullary plasmacytoma is a not frequent manifestation during the natural history of multiple myeloma and is frequently associated with plasma cell bone marrow infiltration. The most common locations for an EMP include the gastrointestinal tract, pleura, testis, skin, peritoneum, liver, endocrine glands, and lymph nodes. Primary involvement of the gallbladder fossa is exceedingly rare. In this report, we describe a patient with multiple myeloma who achieved a clinical and serological remission after autologous transplant but progressed rapidly at extramedullary site mimicking a second cancer (i.e., pancreatic or biliary cancer). In this case, the extramedullary localization was refractory to standard therapy, differently from bone marrow localization, but responded to lymphoma-like therapy. In this patient (i) the particular site of developing plasmacytoma is the gallbladder fossa, (ii) the timing of onset of this neoplasm is immediately after autologous transplant, and (iii) its disjunction from primary myeloma is that it appears in clinical and serological remission phase which may be confounding during the diagnostic approach simulating a different tumor (solid tumor). PMID:27847663

  12. Idiopathic hypertrophic pachymeningitis mimicking prolactinoma with recurrent vision loss.

    PubMed

    Lok, Julie Y C; Yip, Nelson K F; Chong, Kelvin K L; Li, C L; Young, Alvin L

    2015-08-01

    Idiopathic hypertrophic pachymeningitis is a rare inflammatory condition with diffuse thickening of the dura mater, which may cause a compressive effect or vascular compromise. We report on a 28-year-old Chinese woman with a history of granulomatous mastitis 7 years previously and oligomenorrhoea, headache, blurred vision, and raised prolactin level 2 years previously, that was diagnosed as prolactinoma and treated conservatively with bromocriptine. However, she had recurrent bilateral vision loss when the bromocriptine was stopped. Her symptoms were resolved by high-dose steroid injection but remained steroid-dependent. Serial magnetic resonance imaging scan showed progressive diffuse thickening of the pachymeningitis with disappearance of pituitary apoplexy. Lumbar puncture showed lymphocytosis with no organisms. Open biopsy of the meninges was performed and histology showed features of inflammatory infiltrates and vasculitis. This is an unusual presentation of a rare condition in this age-group, with co-existing granulomatous mastitis and chronic otitis media, and is a diagnostic challenge mimicking pituitary macroadenoma and meningioma in initial magnetic resonance imaging scans.

  13. Retroperitoneal Cystic Malignant Fibrous Histiocytoma Mimicking a Psoas Abscess

    PubMed Central

    Gupta, Madan Mohan; Bahri, Nandini; Watal, Pankaj; Rathod, Ketan; Thaker, Siddarth; Bhandari, Parthiv; Dhamecha, Ketul; Ajudia, Jasmin

    2015-01-01

    Primary neoplasms in the psoas muscle including schwannoma and soft tissue sarcoma with secondary cystic degeneration are rare entities. They are difficult to distinguish from psoas abscess purely based on radiological findings. Malignant fibrous histiocytoma (MFH) in the retroperitoneum is an uncommon entity in contrast to liposarcoma and leiomyosarcoma. Psoas abscess is a common infection in the retroperitoneum, especially in regions where tuberculosis is endemic. In the current case, the patient presented with gradually progressive lower abdominal pain and raised erythrocyte sedimentation rate (ESR), lymphocyte count and sputum positive for acid fast bacilli. There was a presence of previous history of skeletal tuberculosis. Imaging revealed well-defined multilocular cystic lesion involving the left psoas muscle which along with the clinical scenario suggested psoas abscess. However, post-operative biopsy showed the lesion to be a MFH with extensive cystic degeneration. To the best of our knowledge, cystic MFH mimicking an abscess has been previously reported only once in an oncology literature. PMID:26557275

  14. Acute respiratory failure mimicking acute respiratory distress syndrome due to parenchymal infiltration by metastatic melanoma

    PubMed Central

    2013-01-01

    Abstract Malignant melanoma is the most aggressive form of skin cancer and carries a predisposition for metastasis to many different organs. Pulmonary dissemination is common, most often presenting as multiple discrete pulmonary nodules. While a variety of other intrathoracic patterns can occur, diffuse parenchymal infiltration causing acute respiratory failure is an extremely rare manifestation of metastatic disease. We present a case of an otherwise healthy man who developed rapidly progressive respiratory failure mimicking acute respiratory distress syndrome due to melanomatous infiltration of the lung parenchyma and airways. PMID:25006412

  15. Hydroxychloroquine-associated hyperpigmentation mimicking elder abuse.

    PubMed

    Cohen, Philip R

    2013-12-01

    Hydroxychloroquine may result in cutaneous dyschromia. Older individuals who are the victims of elder abuse can present with bruising and resolving ecchymoses. The features of hydroxychloroquine-associated hyperpigmentation are described, the mucosal and skin manifestations of elder abuse are reviewed, and the mucocutaneous mimickers of elder abuse are summarized. An elderly woman being treated with hydroxychloroquine for systemic lupus erythematosus developed drug-associated black and blue pigmentation of her skin. The dyschromia was misinterpreted by her clinician as elder abuse and Adult Protective Services was notified. The family was eventually cleared of suspected elder abuse. A skin biopsy of the patient's dyschromia confirmed the diagnosis of hydroxychloroquine-associated hyperpigmentation. Hyperpigmentation of skin, mucosa, and nails can be observed in patients treated with antimalarials, including hydroxychloroquine. Elder abuse is a significant and underreported problem in seniors. Cutaneous findings can aid in the discovery of physical abuse, sexual abuse, and self-neglect in elderly individuals. However, medication-associated effects, systemic conditions, and accidental external injuries can mimic elder abuse. Therefore, a complete medical history and appropriate laboratory evaluation, including skin biopsy, should be conducted when the diagnosis of elder abuse is suspected.

  16. Mammary analogue secretory carcinoma mimicking salivary adenoma.

    PubMed

    Williams, Lindsay; Chiosea, Simion I

    2013-12-01

    Mammary analogue secretory carcinoma (MASC) is a recently described salivary gland tumor characterized by ETV6 translocation. It appears that prior studies have identified MASC by reviewing salivary gland carcinomas, such as acinic cell carcinoma and adenocarcinoma, not otherwise specified. To address the possibility of MASC mimicking benign salivary neoplasms we reviewed 12 salivary gland (cyst)adenomas diagnosed prior to the discovery of MASC. One encapsulated (cyst)adenoma of the parotid gland demonstrated features of MASC. The diagnosis was confirmed by fluorescence in situ hybridization with an ETV6 break-apart probe. An unusual complex pattern of ETV6 rearrangement with duplication of the telomeric/distal ETV6 probe was identified. This case illustrates that MASC may mimic salivary (cyst)adenomas. To more accurately assess true clinical and morphologic spectrum of MASC, future studies may have to include review of salivary (cyst)adenomas. The differential diagnosis of MASC may have to be expanded to include cases resembling salivary (cyst)adenomas.

  17. Mimicking Melanosomes: Polydopamine Nanoparticles as Artificial Microparasols

    PubMed Central

    2017-01-01

    A primary role of melanin in skin is the prevention of UV-induced nuclear DNA damage to human skin cells, where it serves to screen out harmful UV radiation. Melanin is delivered to keratinocytes in the skin after being excreted as melanosomes from melanocytes. Defects in melanin production in humans can cause diseases, many of which currently lack effective treatments due to their genetic origins (e.g., skin cancer, vitiligo, and albinism). The widespread prevalence of melanin-related diseases and an increasing interest in the performance of various polymeric materials related to melanin necessitates novel synthetic routes for preparing melanin-like materials. In this work, we prepared melanin-like nanoparticles (MelNPs) via spontaneous oxidation of dopamine, as biocompatible, synthetic analogues of naturally occurring melanosomes, and investigated their uptake, transport, distribution, and UV-protective capabilities in human keratinocytes. Critically, we demonstrate that MelNPs are endocytosed, undergo perinuclear aggregation, and form a supranuclear cap, or so-called microparasol in human epidermal keratinocytes (HEKa), mimicking the behavior of natural melananosomes in terms of cellular distribution and the fact that they serve to protect the cells from UV damage. PMID:28691067

  18. [Infestation with Enterobius vermicularis mimicking appendicitis].

    PubMed

    Levens, Afra M A; Schurink, Maarten; Koetse, Harma A; van Baren, Robertine

    2014-01-01

    Gastrointestinal infestation with the parasite Enterobius vermicularis is common in humans and is usually harmless. Anal pruritus is the most characteristic symptom, but the parasites can cause severe abdominal pain mimicking appendicitis. Early recognition can prevent an unnecessary appendectomy. A six-year-old girl reported to the accident and emergency department with pain in the lower right abdominal region. She was admitted and treated for suspected perforated appendix, following physical examination supplemented with an abdominal CT scan. After antibiotic treatment the symptoms disappeared as did the abscess, apart from a minor amount of residual infiltrate. She was then readmitted twice with recurrent abdominal pain without radiological evidence of an abdominal focus. We decided to conduct a diagnostic laparoscopy and an elective appendectomy à froid. During this procedure living worms were found in the appendix. Treatment with the anthelminthicum mebendazol was effective. Gastro-intestinal infestation with E. vermicularis is very common, especially in young children. This infestation is usually harmless, but can mimic appendicitis. This infestation is easily treatable with mebendazol.

  19. Pontine lesions mimicking acute peripheral vestibulopathy

    PubMed Central

    Thomke, F.; Hopf, H. C.

    1999-01-01

    OBJECTIVES—Clinical signs of acute peripheral vestibulopathy (APV) were repeatedly reported with pontine lesions. The clinical relevance of such a mechanism is not known, as most studies were biased by patients with additional clinical signs of brainstem dysfunction.
METHODS—Masseter reflex (MassR), blink reflex (BlinkR), brainstem auditory evoked potentials (BAEPs), and DC electro-oculography (EOG) were tested in 232 consecutive patients with clinical signs of unilateral APV.
RESULTS—Forty five of the 232 patients (19.4%) had at least one electrophysiological abnormality suggesting pontine dysfunction mainly due to possible vertebrobasilar ischaemia (22 patients) and multiple sclerosis (eight patients). MassR abnormalities were seen in 24patients, and EOG abnormalities of saccades and following eye movements occurred in 22 patients. Three patients had BlinkR-R1 abnormalities, and one had delayed BAEP waves IV and V. Clinical improvement was almost always (32 of 34 re-examined patients) associated with improvement or normalisation of at least one electrophysiological abnormality. Brain MRI was done in 25 of the 44 patients and confirmed pontine lesions in six (two infarcts, three inflammations, one tumour).
CONCLUSIONS—Pontine dysfunction was suggested in 45 of 232 consecutive patients with clinical signs of APV on the basis of abnormal electrophysiological findings, and was mainly attributed to brainstem ischaemia and multiple sclerosis. The frequency of pontine lesions mimicking APV is underestimated if based on MRI established lesions only.

 PMID:10084533

  20. Vitamin D Deficiency Rickets Mimicking Pseudohypoparathyroidism

    PubMed Central

    Kurtoğlu, Selim; Yıldız, Aysel; Akın, Mustafa Ali; Kendirici, Mustafa

    2010-01-01

    Vitamin D deficiency rickets (VDDR) is a disorder biochemically characterized by elevated serum alkaline phosphatase (ALP) activity, normal or decreased serum calcium (Ca) and inorganic phosphate concentrations, secondary hyperparathyroidism and decreased serum 25−hydroxyvitamin D (25(OH)D) levels. In stage 1 VDDR, urinary amino acid and phosphate excretion are normal with minimal or no findings of rickets on radiographs. Pseudohypoparathyroidism (PHP) is an inherited disorder characterized by end−organ resistance to parathormone (PTH). VDDR occasionally resembles PHP type 2 in clinical presentation and biochemical features, creating difficulties in the differential diagnosis of these two entities. Here we report an infant diagnosed with VDDR. In addition to inadequate vitamin D intake, usage of antiepileptic drugs (AED) may have led to the worsening of the vitamin D deficiency. The patient presented with a history of febrile convulsions, for which he received phenobarbital treatment. The initial findings of hypocalcemia, hyperphosphatemia and normal tubular reabsorption of phosphate, mimicking PHP 2, responded well to vitamin D and oral Ca treatment with normalization of serum Ca, phosphorus (P), ALP and PTH levels Conflict of interest:None declared. PMID:21274319

  1. Ruptured hepatic abscess mimicking perforated viscus.

    PubMed

    Lai, Yen-Chun; Su, Yu-Jang; Chang, Wen-Han

    2008-11-01

    In the majority of pneumoperitoneum cases we diagnose perforated viscus. We present herein a case of ruptured hepatic abscess mimicking perforated viscus. A 40-year-old man presented to the emergency room with fever and right upper quadrant abdominal pain. The fever had been on/off for a period of 1 month. On physical examination, diffuse abdominal pain with rebounding tenderness was noted. Blood tests showed leukocytosis with left shift, hyperglycemia, and elevated liver function tests. A chest X-ray showed a subdiaphragmatic region air-fluid level, indicating a hepatic abscess. Pneumoperitoneum was also seen. Owing to the status of peritonitis, computed tomography (CT) of the abdomen was performed and revealed an air-containing liver abscess in the right lobe of the liver. Perforation of a hollow organ was also suspected because of the pneumoperitoneum. An emergent laparotomy was immediately performed for the suspicion of a hollow organ perforation. No perforation of the hollow viscus was found. The ruptured hepatic abscess was attributed to the pneumoperitoneum. A blood culture grew Klebsiella pneumoniae four days later, and the same organism was also found in a surgical specimen culture of the abscess. For a ruptured hepatic abscess, surgical intervention with draining of the abscess and cleaning of the abdominal cavity are essential to save patient lives.

  2. Egg white ovalbumin digestion mimicking physiological conditions.

    PubMed

    Martos, Gustavo; Contreras, Patricia; Molina, Elena; López-Fandiño, Rosina

    2010-05-12

    Gastrointestinal digestion of ovalbumin (OVA) was simulated using an in vitro system in two steps, which mimicked digestion in the stomach and duodenum, to assess the effect of different gastric pHs, different concentrations of proteases, and the presence of surfactants, such as phosphatidylcholine (PC) and bile salts (BS). OVA was very resistant to pepsin action at an enzyme/substrate ratio that would resemble a physiological situation (1:20 w/w, 172 units/mg) at pH values equal or above 2. The presence of PC did not change the susceptibility of OVA to proteolysis with pepsin. Fluorescence experiments showed that OVA interacted with PC vesicles, particularly at acidic pH, but it is likely that the protein maintained a high degree of conformational stability, resisting pepsin action. The presence of BS at physiological concentrations considerably increased the proteolysis of OVA by a mixture of pancreatic enzymes. The addition of PC made OVA even more sensitive to proteolytic degradation, suggesting that OVA could associate with the surfactants under duodenal conditions, increasing its exposure to pancreatic proteinases. Immunoreactivity against IgE from sera of allergic patients was retained after in vitro gastric digestion, depending on the reactivity of the sera, but it decreased considerably after in vitro duodenal digestion.

  3. Non-harmful insertion of data mimicking computer network attacks

    DOEpatents

    Neil, Joshua Charles; Kent, Alexander; Hash, Jr, Curtis Lee

    2016-06-21

    Non-harmful data mimicking computer network attacks may be inserted in a computer network. Anomalous real network connections may be generated between a plurality of computing systems in the network. Data mimicking an attack may also be generated. The generated data may be transmitted between the plurality of computing systems using the real network connections and measured to determine whether an attack is detected.

  4. Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae

    PubMed Central

    Kobkitsuksakul, Chai; Jiarakongmun, Pakorn; Chanthanaphak, Ekachat; Singhara Na Ayudya, Sirintara (Pongpech)

    2016-01-01

    PURPOSE The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages. METHODS We retrospectively examined the records of 350 patients who were given provisional diagnoses of carotid cavernous sinus fistulae or cavernous sinus dural AVF in the division of Interventional Neuroradiology, Ramathibodi Hospital, Bangkok between 2008 and 2014. Any patient with cavernous arteriovenous shunt was excluded. RESULTS Of those 350 patients, 10 patients (2.85%) were identified as having noncavernous sinus AVF. The angiographic diagnoses consisted of three anterior condylar (hypoglossal) dural AVF, two traumatic middle meningeal AVF, one lesser sphenoid wing dural AVF, one vertebro-vertebral fistula (VVF), one intraorbital AVF, one direct dural artery to cortical vein dural AVF, and one transverse-sigmoid dural AVF. Six cases (60%) were found to have venous efferent obstruction. CONCLUSION Arteriovenous shunts mimicking the cavernous AVF are rare, with a prevalence of only 2.85% in this series. The clinical presentation mainly depends on venous outflow. The venous outlet of the arteriovenous shunts is influenced by venous afferent-efferent patterns according to the venous anatomy of the central nervous system and the skull base, as well as by architectural disturbance, specifically, obstruction of the venous outflow. PMID:27767958

  5. Mimicking cataract-induced visual dysfunction by means of protein denaturation in egg albumen

    NASA Astrophysics Data System (ADS)

    Mandracchia, B.; Finizio, A.; Ferraro, P.

    2016-03-01

    As the world's population ages, cataract-induced visual dysfunction and blindness is on the increase. This is a significant global problem. The most common symptoms of cataracts are glared and blurred vision. Usually, people with cataract have trouble seeing and reading at distance or in low light and also their color perception is altered. Furthermore, cataract is a sneaky disease as it is usually a very slow but progressive process, which creates adaptation so that patients find it difficult to recognize. All this can be very difficult to explain, so we built and tested an optical device to help doctors giving comprehensive answers to the patients' symptoms. This device allows visualizing how cataract impairs vision mimicking the optical degradation of the crystalline related cataracts. This can be a valuable optical tool for medical education as well as to provide a method to illustrate the patients how cataract progression process will affect their vision.

  6. Atypical Pyoderma Gangrenosum Mimicking an Infectious Process

    PubMed Central

    To, Derek; Wong, Aaron; Montessori, Valentina

    2014-01-01

    We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics. PMID:25024856

  7. Atypical pyoderma gangrenosum mimicking an infectious process.

    PubMed

    To, Derek; Wong, Aaron; Montessori, Valentina

    2014-01-01

    We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics.

  8. Restless legs syndrome mimicking S1 radiculopathy.

    PubMed

    Zambelis, Th; Wolgamuth, B R; Papoutsi, S N; Economou, N T

    2016-01-01

    mimicking several pathological conditions, Restless Legs Syndrome prevalence on general population according to various large epidemiological studies and pathogenic hypotheses on the issue of Restless Legs Syndrome are discussed. Finally, by presenting another possible "RLS-mimic" our aim is to highlight the common misdiagnosis of Restless Legs Syndrome, which can mimic a variety of disorders, some of which are very common, such as an S1 radiculopathy, thus raising concern among doctors of various specialties addressed to by Restless Legs Syndrome sufferers, on the importance of proper diagnosis of the syndrome.

  9. Gemcitabine-induced hemolytic uremic syndrome mimicking scleroderma renal crisis presenting with Raynaud's phenomenon, positive antinuclear antibodies and hypertensive emergency.

    PubMed

    Yamada, Yuichiro; Suzuki, Keisuke; Nobata, Hironobu; Kawai, Hirohisa; Wakamatsu, Ryo; Miura, Naoto; Banno, Shogo; Imai, Hirokazu

    2014-01-01

    A 58-year-old woman who received gemcitabine for advanced gallbladder cancer developed an impaired renal function, thrombocytopenia, Raynaud's phenomenon, digital ischemic changes, a high antinuclear antibody titer and hypertensive emergency that mimicked a scleroderma renal crisis. A kidney biopsy specimen demonstrated onion-skin lesions in the arterioles and small arteries along with ischemic changes in the glomeruli, compatible with a diagnosis of hypertensive emergency (malignant hypertension). The intravenous administration of a calcium channel blocker, the oral administration of an angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker and the transfusion of fresh frozen plasma were effective for treating the thrombocytopenia and progressive kidney dysfunction. Gemcitabine induces hemolytic uremic syndrome with accelerated hypertension and Raynaud's phenomenon, mimicking scleroderma renal crisis.

  10. Extrahepatic bile duct neurilemmoma mimicking Klatskin tumor.

    PubMed

    Kamani, Fereshteh; Dorudinia, Atosa; Goravanchi, Farhood; Rahimi, Farzaneh

    2007-04-01

    Neurilemmoma rarely develops in the biliary tree. Here, we report a 39-year-old Iranian woman with neurilemmoma in the extrahepatic bile duct presenting with progressively deepening jaundice. On the basis of clinical and radiological features, this tumor was initially suspected as Klatskin tumor. Histologically, the tumor was a typical neurilemmoma. Immunostaining showed that tumor cells were strongly and diffusely positive for S-100 protein, which supported the diagnosis of neurilemmoma. Neurilemmoma should be considered in the differential diagnosis of obstructive jaundice.

  11. Munchausen syndrome mimicking psychiatric disease with concomitant genuine physical illness

    PubMed Central

    Almeida, Jaime; da Silva, Joaquim Alves; Xavier, Miguel; Gusmão, Ricardo

    2010-01-01

    Munchausen syndrome is a disorder in which patients intentionally produce symptoms mimicking physical or psychiatric illnesses with the aim to assume the sick role and to gain medical attention. Once a patient receives a Munchausen syndrome diagnosis every complaint made thence tends to be regarded with scepticism by clinical staff. However, it is possible that a bona fide illness, which might be disregarded, may coexist in these patients. We report a case of MS mimicking psychiatric disease with concomitant genuine acute physical illness. Despite the initial doubts about the veracity of the latter, due to its prompt recognition, treatment was successful. PMID:22798096

  12. Pediatric Vesicoureteral Reflux Guidelines Panel Summary Report: Clinical Practice Guidelines for Screening Siblings of Children With Vesicoureteral Reflux and Neonates/Infants With Prenatal Hydronephrosis.

    PubMed

    Skoog, Steven J; Peters, Craig A; Arant, Billy S; Copp, Hillary L; Elder, Jack S; Hudson, R Guy; Khoury, Antoine E; Lorenzo, Armando J; Pohl, Hans G; Shapiro, Ellen; Snodgrass, Warren T; Diaz, Mireya

    2010-09-01

    The American Urological Association established the Vesicoureteral Reflux Guideline Update Committee in July 2005 to update the management of primary vesicoureteral reflux in children guideline. The Panel defined the task into 5 topics pertaining to specific vesicoureteral reflux management issues, which correspond to the management of 3 distinct index patients and the screening of 2 distinct index patients. This report summarizes the existing evidence pertaining to screening of siblings and offspring of index patients with vesicoureteral reflux and infants with prenatal hydronephrosis. From this evidence clinical practice guidelines are developed to manage the clinical scenarios insofar as the data permit. The Panel searched the MEDLINE(R) database from 1994 to 2008 for all relevant articles dealing with the 5 chosen guideline topics. The database was reviewed and each abstract segregated into a specific topic area. Exclusions were case reports, basic science, secondary reflux, review articles and not relevant. The extracted article to be accepted should have assessed a cohort of children, clearly stating the number of children undergoing screening for vesicoureteral reflux. Vesicoureteral reflux should have been diagnosed with a cystogram and renal outcomes assessed by nuclear scintigraphy. The screening articles were extracted into data tables developed to evaluate epidemiological factors, patient and renal outcomes, and results of treatment. The reporting of meta-analysis of observational studies elaborated by the MOOSE group was followed. The extracted data were analyzed and formulated into evidence-based recommendations regarding the screening of siblings and offspring in index cases with vesicoureteral reflux and infants with prenatal hydronephrosis. In screened populations the prevalence of vesicoureteral reflux is 27.4% in siblings and 35.7% in offspring. Prevalence decreases at a rate of 1 screened person every 3 months of age. The prevalence is the same

  13. Annular Lupus Vulgaris Mimicking Tinea Cruris

    PubMed Central

    Heo, Young Soo; Shin, Won Woong; Kim, Yong Ju; Song, Hae Jun

    2010-01-01

    Cutaneous tuberculosis is an infrequent form of extrapulmonary tuberculosis. It is often clinically and histopathologically confused with various cutaneous disorders. A 36-year-old man attended our clinic with slowly progressive, asymptomatic, annular skin lesions on both the thighs and buttocks for 10 years. He consulted with many physicians and was improperly treated with an oral antifungal agent for several months under the diagnosis of tinea cruris, but no resolution of his condition was observed. A diagnosis of lupus vulgaris was made based on the histopathologic examination and the polymerase chain reaction assay. Anti-tuberculosis therapy was administered and the lesions started to regress. PMID:20548922

  14. Unilateral Demodicidosis of Face Mimicking Hansens Disease

    PubMed Central

    Vashisht, Deepak; Singh, Jatinder; Baveja, Sukriti; Tiwari, Rohit; Bhatnagar, Anuj

    2016-01-01

    Demodicosis is a common parasitic infection of the hair follicles and the pilosebaceous unit by the Demodex mites viz. Demodex folliculorum and Demodex brevis. Infection by this parasite is common among immunocompromised and elderly. We report a case of facial Demodicosis which presented like atypical rosacea with a gradually progressing swelling and redness on right side of face which was initially diagnosed as a case of Hansen’s disease. Skin biopsy revealed follicular dilatation with presence of Demodex mite along with intense perifollicular lymphomononuclear infiltrate. Patient was treated with oral tab Ivermectin 12 mg stat along with topical gel metronidazole twice daily to which he responded favourably. PMID:28326184

  15. Endotracheal ectopic parathyroid adenoma mimicking asthma

    PubMed Central

    Özgül, M. Akif; Seyhan, Ekrem Cengiz; Özgül, Güler; Çetinkaya, Erdoğan; Büyükkale, Songul; Ünver, Nurcan; Çakır, Tansel; Sayar, Adnan

    2014-01-01

    Primary benign tumors of the trachea are uncommon. These tumors may cause tracheal occlusion and lead to a misdiagnosis of asthma. Ectopic parathyroid adenoma (EPA) can be seen anywhere between the mandibular angle and the mediastinum. The distal part of the trachea is a rare location for EPA, and EPA obstructing the endotracheal lumen has not been reported in the literature. We herein describe a 52-year-old female with a several-year history of asthma treatment who presented with progressive dyspnea. Computed tomography revealed a mass that was obstructing the tracheal lumen. Total mass excision was performed via endobronchial treatment, and pathologic examination revealed EPA. PMID:26029555

  16. Spinal cord astrocytoma mimicking multifocal myelitis

    PubMed Central

    Neutel, Dulce; Teodoro, Tiago; Coelho, Miguel; Pimentel, José; Albuquerque, Luísa

    2014-01-01

    Introduction Differential diagnosis of acute/subacute intrinsic spinal cord lesions can be challenging. In addition, intramedullary neoplasms typically show gadolinium enhancement, mass effect, and cord expansion. Case report We report a patient with spinal cord and brain stem lesions resembling multifocal myelitis. Magnetic resonance imaging showed no spinal cord enlargement or gadolinium enhancing. Treatment of myelitis was undertaken without stopping the progression of the disease. Biopsy was made and led to a histological diagnosis of astrocytoma. Discussion Astrocytoma must remain as a possible diagnosis of spinal cord lesions, even without typical characteristics of neoplasms. Furthermore, biopsy should always be considered when diagnosis is uncertain. PMID:24621037

  17. Linear Immunoglobulin A dermatosis mimicking Toxic Epidermal Necrolysis: a case report of etanercept treatment.

    PubMed

    Prieto-Barrios, M; Velasco-Tamariz, V; Tous-Romero, F; Burillo-Martinez, S; Zarco-Olivo, C; Rodriguez-Peralto, J L; Ortiz-Romero, P L

    2017-02-21

    A 65-year-old pluripathological woman attended our hospital with a cutaneous eruption of sudden appearance after vancomycin treatment. She presented targetoid lesions affecting approximately 25-30% of her body surface, large erosions, with mucosal lesions and positive Nikolsky sign. Under the initial clinical suspicion of Toxic Epidermal Necrolysis (TEN), and considering recent literature of its successful use in these cases, she was treated with a single dose of anti-Tumor Necrosis Factor (anti-TNF) agent etanercept. Subsequently, the exanthema progression stopped and resolution of the lesions happened in a few days. Later on, histopathology revealed a subepidermal blister with dense neutrophilic infiltrate and linear deposits of IgA on the dermoepidermal junction allowing us to stablish the diagnosis of drug-induced linear immunoglobulin A (IgA) dermatosis mimicking TEN. Linear IgA dermatosis can have severe clinical manifestations, even mimicking TEN, with high mortality, especially the drug-induced cases. We have not found any other report of linear IgA dermatosis treated with etanercept in the English literature. Anti-TNF medications could represent useful therapeutic alternatives in this dermatosis. This article is protected by copyright. All rights reserved.

  18. Bronchial Aneurysms Mimicking Aortic Aneurysms: Endovascular Treatment in Two Patients

    SciTech Connect

    Vernhet, Helene; Bousquet, Claudine; Jean, Betty; Lesnik, Alvian; Durand, Gerard; Giron, Jacques; Senac, Jean Paul

    1999-05-15

    Bronchial artery dilatation and aneurysm formation is a potential complication of local inflammation, especially in bronchiectasis. When the bronchial artery has an ectopic origin from the inferior segment of the aortic arch, aneurysms may mimick aortic aneurysms. Despite this particular location, endovascular treatment is possible. We report two such aneurysms that were successfully embolized with steel coils.

  19. Cutaneous lymphoid hyperplasia mimicking cutaneous lymphoma in a hyperthyroid cat

    PubMed Central

    Snead, Elisabeth; Kerr, Moira; MacDonald, Valerie

    2013-01-01

    A 12-year-old neutered male domestic shorthair cat presented for chronic, localized, swelling and crusting of the left upper lip, weight loss, sporadic vomiting, and focal alopecia between the scapulae was diagnosed with hyperthyroidism and regional eosinophilic lymphadenitis. Treatment with methimazole exacerbated an underlying hypersensitivity disorder leading to marked generalized lymphadenopathy that histologically mimicked lymphoma. PMID:24155419

  20. Retroperitoneal bronchogenic cyst mimicking hydatid liver: a case report.

    PubMed

    Parray, Fazl Q; Sherwani, Afak Yusuf; Dangroo, Sajad Ahmad; Bisati, Rafia Aziz; Malik, Nighat Shaffi

    2012-01-01

    Bronchogenic cysts frequently occur in the mediastinum. They may be rarely encountered in the abdomen and retroperitoneum. Bronchogenic cysts can in fact mimic hydatid cysts. We report a case of retroperitoneal bronchogenic cyst below the right hemidiaphragm mimicking a hydatid cyst of the liver in a 30-year-old female.

  1. Retroperitoneal Bronchogenic Cyst Mimicking Hydatid Liver: A Case Report

    PubMed Central

    Parray, Fazl Q.; Sherwani, Afak Yusuf; Dangroo, Sajad Ahmad; Bisati, Rafia Aziz; Malik, Nighat Shaffi

    2012-01-01

    Bronchogenic cysts frequently occur in the mediastinum. They may be rarely encountered in the abdomen and retroperitoneum. Bronchogenic cysts can in fact mimic hydatid cysts. We report a case of retroperitoneal bronchogenic cyst below the right hemidiaphragm mimicking a hydatid cyst of the liver in a 30-year-old female. PMID:22606600

  2. Organic diseases mimicking acral lick dermatitis in six dogs.

    PubMed

    Denerolle, Philippe; White, Stephen D; Taylor, Tara S; Vandenabeele, Sophie I J

    2007-01-01

    Acral lick dermatitis ("lick granuloma") in dogs is often thought to have a behavioral etiology. However, other diseases may cause lesions on the distal legs, mimicking acral lick dermatitis. In this report, six dogs were presented with acral lick dermatitis-like lesions from different underlying causes-namely lymphoma, an orthopedic pin, deep pyoderma, mast cell tumor, leishmaniasis, and (presumptive) sporotrichosis.

  3. [Ectopic pancreas mimicking advanced gastric malignancy--case report].

    PubMed

    Zawada, Iwona; Lewosiuk, Agnieszka; Hnatyszyn, Krzysztof; Patalan, Michał; Woyke, Stanisław; Kostyrka, Roman; Marlicz, Krzysztof; Starzyńska, Teresa

    2012-04-01

    Ectopic pancreas is the most common type of ectopic tissue in gastrointestinal tract. It is typically asymptomatic, presenting as a small submucosal lesion in prepyloric region of stomach. The diagnosis is usually incidental, during gastroscopy. The patient with symptomatic heterotropic pancreas, mimicking gastric malignancy was described.

  4. Headache attributed to unruptured saccular aneurysm, mimicking hemicrania continua.

    PubMed

    Vikelis, Michail; Xifaras, Michail; Magoufis, Georgios; Gekas, Georgios; Mitsikostas, Dimos Dimitrios

    2005-06-01

    Unruptured cerebral arterial aneurysms most often remain asymptomatic, but they may cause headache or other symptoms or signs. We describe herewith a case of headache attributed to an unruptured internal carotid artery aneurysm, clearly mimicking the phenotype of hemicrania continua. Potential pathophysiological explanations and recommendations for recognition of similar cases are discussed.

  5. Cutaneous lymphoid hyperplasia mimicking cutaneous lymphoma in a hyperthyroid cat.

    PubMed

    Snead, Elisabeth; Kerr, Moira; Macdonald, Valerie

    2013-10-01

    A 12-year-old neutered male domestic shorthair cat presented for chronic, localized, swelling and crusting of the left upper lip, weight loss, sporadic vomiting, and focal alopecia between the scapulae was diagnosed with hyperthyroidism and regional eosinophilic lymphadenitis. Treatment with methimazole exacerbated an underlying hypersensitivity disorder leading to marked generalized lymphadenopathy that histologically mimicked lymphoma.

  6. Trichophyton Schoenleinii-induced widespread tinea corporis mimicking parapsoriasis.

    PubMed

    Mansouri, P; Farshi, S; Khosravi, A R; Naraghi, Z S; Chalangari, R

    2012-06-01

    We report a case of extensive tinea corporis in an 80-year-old woman on her forearms, thighs, legs, buttocks and trunk, mimicking parapsoriasis due to Trichophyton schoenleinii, without scalp involvement. Diagnosis of Trichophyton schoenleinii was confirmed by microscopy and mycological culture specimens.

  7. Histoplasmosis mimicking primary lung cancer or pulmonary metastases *,**

    PubMed Central

    Bello, Aline Gehlen Dall; Severo, Cecilia Bittencourt; Guazzelli, Luciana Silva; Oliveira, Flavio Mattos; Hochhegger, Bruno; Severo, Luiz Carlos

    2013-01-01

    OBJECTIVE: To describe the main clinical and radiological characteristics of patients with histoplasmosis mimicking lung cancer. METHODS: This was a retrospective descriptive study based on the analysis of the medical records of the 294 patients diagnosed with histoplasmosis between 1977 and 2011 at the Mycology Laboratory of the Santa Casa Sisters of Mercy Hospital of Porto Alegre in the city of Porto Alegre, Brazil. The diagnosis of histoplasmosis was established by culture, histopathological examination, or immunodiffusion testing (identification of M or H precipitation bands). After identifying the patients with macroscopic lesions, as well as radiological and CT findings consistent with malignancy, we divided the patients into two groups: those with a history of cancer and presenting with lesions mimicking metastases (HC group); and those with no such history but also presenting with lesions mimicking metastases (NHC group). RESULTS: Of the 294 patients diagnosed with histoplasmosis, 15 had presented with lesions mimicking primary neoplasia or metastases (9 and 6 in the HC and NHC groups, respectively). The age of the patients ranged from 13 to 67 years (median, 44 years). Of the 15 patients, 14 (93%) presented with pulmonary lesions at the time of hospitalization. CONCLUSIONS: The clinical and radiological syndrome of neoplastic disease is not confined to malignancy, and granulomatous infectious diseases must therefore be considered in the differential diagnosis. PMID:23503487

  8. Rectal diverticulitis mimicking rectal carcinoma with intestinal obstruction: case report.

    PubMed

    Özçelik, Ümit; Bircan, Hüseyin Yüce; Eren, Eryiğit; Demiralay, Ebru; Işıklar, İclal; Demirağ, Alp; Moray, Gökhan

    2015-01-01

    Although diverticular disease of the colon is common, the occurrence of rectal diverticula is extremely rare with only sporadic reports in the literature since 1911. Symptomatic rectal diverticula are seen even less frequently, and surgical intervention is needed for only complicated cases. Here we report the case of a 63-year-old woman presenting with rectal diverticulitis mimicking rectal carcinoma with intestinal obstruction.

  9. Diffuse Large B Cell Lymphoma Mimicking Granulomatosis with Polyangiitis

    PubMed Central

    Horowitz, Netanel; Ben-Itzhak, Ofer; Braun-Moscovici, Yolanda

    2016-01-01

    In a patient with systemic multiorgan disease with overlapping features, the differential diagnosis included infectious diseases, malignancies, and systemic autoimmune or inflammatory diseases. We present an unusual case of a young male with B cell lymphoma who presented with symptoms mimicking systemic vasculitis and review the existing literature. PMID:27293945

  10. The cutaneous manifestations and common mimickers of physical child abuse.

    PubMed

    Mudd, Shawna S; Findlay, Jeanne S

    2004-01-01

    The cutaneous manifestations of physical child abuse are some of the most common and easily recognized forms of injury. To make an accurate assessment and diagnosis, it is important to differentiate between inflicted cutaneous injuries and mimickers of physical abuse. Likewise, an understanding of reporting guidelines helps guide practitioners in their decision making.

  11. Giant cell myocarditis mimicking idiopathic fascicular ventricular tachycardia.

    PubMed

    Weidenbach, Michael; Springer, Tina; Daehnert, Ingo; Klingel, Karin; Doll, Susanne; Janousek, Jan

    2008-02-01

    We report an adolescent with giant cell myocarditis (GCM) mimicking tachycardia-induced cardiomyopathy. His electrocardiogram (ECG) was typical for an incessant form of fascicular ventricular tachycardia. The patient rapidly deteriorated and required support using extracorporeal membrane oxygenation (ECMO). Biopsy revealed GCM with massive myocyte necrosis. He was successfully heart transplanted 6 days after admission.

  12. Mechanisms for attenuation in cancellous-bone-mimicking phantoms.

    PubMed

    Wear, Keith A

    2008-11-01

    Broadband ultrasound attenuation (BUA) in cancellous bone is useful for prediction of osteoporotic fracture risk, but its causes are not well understood. To investigate attenuation mechanisms, 9 cancellous-bone-mimicking phantoms containing nylon filaments (simulating bone trabeculae) embedded within soft-tissue-mimicking fluid (simulating marrow) were interrogated. The measurements of frequency-dependent attenuation coefficient had 3 separable components: 1) a linear (with frequency) component attributable to absorption in the soft-tissue-mimicking fluid, 2) a quasilinear (with frequency) component, which may include absorption in and longitudinal-shear mode conversion by the nylon filaments, and 3) a nonlinear (with frequency) component, which may be attributable to longitudinal-longitudinal scattering by the nylon filaments. The slope of total linear (with frequency) attenuation coefficient (sum of components #1 and #2) versus frequency was found to increase linearly with volume fraction, consistent with reported measurements on cancellous bone. Backscatter coefficient measurements in the 9 phantoms supported the claim that the nonlinear (with frequency) component of attenuation coefficient (component #3) was closely associated with longitudinal-longitudinal scattering. This work represents the first experimental separation of these 3 components of attenuation in cancellous bone-mimicking phantoms.

  13. Mimicking shear zones: An example from Wadi Filk, Jordan

    NASA Astrophysics Data System (ADS)

    Meyer, Sven Erik; Passchier, Cees; Jarrar, Ghaleb H.; Ghanem, Hind; Yaseen, Najel

    2017-05-01

    Ductile shear zones can develop in at least two ways: (1) a nucleus can grow laterally by free propagation into undeformed host rock, like most faults or joints; (2) the zone may nucleate and grow on or in a planar discontinuity and mimick its orientation. Most small-scale ductile shear zones are mimicking zones, but large-scale ductile shear zones could be free-propagating. The Wadi Filk mylonite zone in Jordan is a two km long, ten meter wide mylonite zone flanked by ultramylonite zones, developed in undeformed Neoproterozoic porphyritic monzogranite. Since mineral and major element composition of mylonite and monzogranite are identical, the structure seems to have formed by free propagation. Only detailed observations of the microstructure and trace element chemistry of the mylonite indicate that it is mimicking a precursor rhyolitic dyke. The Wadi Filk mylonite zone shows that even km-scale ductile shear zones can be mimicking dykes. Fine-grained chilled margins of dykes can act as a nucleus of ultramylonite formation.

  14. Osteoid osteoma of the radial styloid mimicking de quervain tenosynovitis.

    PubMed

    Chloros, George D; Themistocleous, George S; Papagelopoulos, Panayiotis J; Khaldi, Lubna; Efstathopoulos, Dimitrios G; Soucacos, Panayotis N

    2007-10-01

    A very unusual location of osteoid osteoma arising in the radial styloid is presented, which strongly mimicked de Quervain tenosynovitis, thereby resulting in the patient undergoing an additional unnecessary operation and a substantial delay of more than 2 years in diagnosis.

  15. Borderline tuberculoid leprosy mimicking mycosis fungoides.

    PubMed

    Rodríguez-Acosta, Elva Dalia; Esquivel-Pedraza, Lilly; Saeb-Lima, Marcela; Arenas-Guzmán, Roberto; Granados-Arriola, Julio; Domínguez-Cherit, Judith

    2013-01-01

    A 65-year-old unemployed man, originally from Michoacán and currently living in Toluca, state of Mexico, presented for medical consultation for disseminated dermatosis in all body segments. The condition was limited to the head and neck, was bilateral and symmetrical, and was characterized by infiltrated and confluent erythematous-edematous plates of diverse diameter covering 90% of the upper and lower extremities (Figure 1). The ailment had 2 years' evolution and a progressive course. The patient was diagnosed in private practice as having atopic dermatitis. After exacerbation of symptoms, he was treated with deflazacort and hydroxychloroquine with no improvement. Results from lesion biopsies revealed sarcoidal granulomas and the patient was therefore referred to the dermatology department at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán for further study and treatment with the presumptive diagnosis of mycosis fungoides vs sarcoidosis.

  16. Spinal cord infarction mimicking ischemic heart disease.

    PubMed

    Lee, Dae Won; Choi, Yoon Hee

    2017-06-01

    Spinal cord infarction is a rare condition and is easily misdiagnosed owing to its initial non-specific manifestation. We report a case of a 77-year-old man who presented with chest pain and upper back pain initially, and was misdiagnosed with a myocardial infarction. Four hours after admission, he complained of numbness in his entire left leg below the knee, with rapid deterioration of neurological symptoms. After 9 hours, loss of sensation progressed up to the T4 dermatome, strength of both lower extremities deteriorated to grade 0, and decrease in anal tone and deep tendon reflex was observed. Initial magnetic resonance imaging findings were normal; however, a signal change occurred 3 days after symptom onset. When patients present with acute chest pain and neurologic symptoms, the possibility of ischemic cardiac disease as well as any neurological manifestations must be investigated. Emergency physicians must remember the value of serial physical examinations.

  17. A case of solely lung-involved IgG4-related disease mimicking tuberculosis.

    PubMed

    Tan, Hongyi; Li, Haitao; Hu, Yongbing; Niu, Ruichao; Pan, Pinhua; Hu, Chengping

    2015-01-01

    IgG4-related disease (IgG4-RD) is a chronic progressive autoimmune disease. Solely lung involved IgG4-RD is extremely rare. Herein, we reported a case of IgG4-related disease as mimicking tuberculosis. A 52-year-old male patient was admitted due to cough and hemoptysis for two months and fever for 1 month. The pre-admission diagnosis in another hospital was secondary pulmonary tuberculosis, but the quadruple anti-tuberculosis therapy was ineffective and the disease condition continued to deteriorate. The percutaneous lung biopsy was carried out after admission and the pathological diagnosis was IgG4-related disease. The patient's disease condition was improved following hormonal therapy.

  18. Fasting-Mimicking Diet Reduces HO-1 to Promote T Cell-Mediated Tumor Cytotoxicity.

    PubMed

    Di Biase, Stefano; Lee, Changhan; Brandhorst, Sebastian; Manes, Brianna; Buono, Roberta; Cheng, Chia-Wei; Cacciottolo, Mafalda; Martin-Montalvo, Alejandro; de Cabo, Rafael; Wei, Min; Morgan, Todd E; Longo, Valter D

    2016-07-11

    Immune-based interventions are promising strategies to achieve long-term cancer-free survival. Fasting was previously shown to differentially sensitize tumors to chemotherapy while protecting normal cells, including hematopoietic stem and immune cells, from its toxic side effects. Here, we show that the combination of chemotherapy and a fasting-mimicking diet (FMD) increases the levels of bone marrow common lymphoid progenitor cells and cytotoxic CD8(+) tumor-infiltrating lymphocytes (TILs), leading to a major delay in breast cancer and melanoma progression. In breast tumors, this effect is partially mediated by the downregulation of the stress-responsive enzyme heme oxygenase-1 (HO-1). These data indicate that FMD cycles combined with chemotherapy can enhance T cell-dependent targeted killing of cancer cells both by stimulating the hematopoietic system and by enhancing CD8(+)-dependent tumor cytotoxicity.

  19. Light chain multiple myeloma presenting with spinal plasmacytoma: Unusual radiological appearance mimicking giant cell tumor.

    PubMed

    Satija, Bhawna; Gupta, Rajat; Kumar, Sanyal; Chandoke, Raj

    2015-01-01

    Plasmacytoma, an initial presentation of multiple myeloma, is extremely rare and an unusual cause of spinal cord compression in a young male. A 35-year-old man presented with complaints of progressive weakness and tingling of bilateral lower limbs, severe backache for 3 months, and bladder and bowel incontinence for 1 week duration. Imaging demonstrated lytic destruction of 10 th and 11 th dorsal vertebrae with large soft tissue component and compression of the spinal cord. Biopsy was performed under computed tomography guidance and the histopathology demonstrated presence of plasmacytoma. Serum electrophoresis and bone marrow examination confirmed the diagnosis of light chain multiple myeloma. Though the magnetic resonance imaging the appearance of spinal plasmacytoma is nonspecific, a minibrain appearance has been considered pathognomonic. This case is reported for the unusual radiological appearance of this entity mimicking giant cell tumor.

  20. A Case of Acute Motor Axonal Neuropathy Mimicking Brain Death and Review of the Literature.

    PubMed

    Ravikumar, Sandhya; Poysophon, Poysophon; Poblete, Roy; Kim-Tenser, May

    2016-01-01

    We describe a case report of fulminant Guillain-Barré syndrome (GBS) mimicking brain death. A previously healthy 60-year-old male was admitted to the neurointensive care unit after developing rapidly progressive weakness and respiratory failure. On presentation, the patient was found to have absent brainstem and spinal cord reflexes resembling that of brain death. Acute motor axonal neuropathy, a subtype of GBS, was diagnosed by cerebrospinal fluid and nerve conduction velocity testing. An electroencephalogram showed that the patient had normal, appropriately reactive brain function. Transcranial Doppler (TCD) ultrasound showed appropriate blood flow to the brain. GBS rarely presents with weakness so severe as to mimic brain death. This article provides a review of similar literature. This case demonstrates the importance of performing a proper brain death examination, which includes evaluation for irreversible cerebral injury, exclusion of any confounding conditions, and performance of tests such as electroencephalography and TCDs when uncertainty exists about the reliability of the clinical exam.

  1. Asymmetric Acute Motor Axonal Neuropathy With Unilateral Tongue Swelling Mimicking Stroke.

    PubMed

    Chi, Man Sum; Ng, Shi Hon; Chan, Lok Yiu

    2016-11-01

    A 60-year-old man presented with acute onset of left hemiparesis and left hypoglossal nerve palsy with ipsilateral tongue swelling. He then progressed to tetraparesis in a few days. Cerebrospinal fluid showed cell protein dissociation. A nerve conduction study showed motor axonal neuropathy with sensory sparing. A subsequent blood test revealed anti-GD1b IgG antibody positivity. He was diagnosed to have acute motor axonal neuropathy (AMAN) and treated with a course of intravenous immunoglobulin with slow improvement. This is probably the first AMAN with asymmetrical presentation mimicking stroke reported in the literature in detail. The anti-GD1b IgG antibody is also not commonly associated with AMAN.

  2. Cervical dystonia mimicking dropped-head syndrome after radiotherapy for laryngeal carcinoma.

    PubMed

    Astudillo, Leonardo; Hollington, L; Game, X; Benyoucef, A; Boladeras, A M; Delisle, M B; Simonetta-Moreau, M

    2003-12-01

    We report a case of cervical dystonia mimicking dropped-head syndrome (DHS) in a 57-year-old man treated for laryngeal carcinoma by radiotherapy (74.4 Gy) 3 months before. Cervical computerized tomographic scan and magnetic resonance imaging (MRI) did not find any muscle fat changes but found a high-intensity signal on T2 weighted images in the cervical spinal cord. Clinical and electromyographic findings were consistent with cervical dystonia. A trapezius biopsy was normal. Spontaneous remission of the dystonia was observed for 1 month whereas the laryngeal carcinoma progressed. The link between cervical dystonia and radiotherapy might be acute radiation-induced damage to the cervical spinal cord.

  3. Infant acute myocarditis mimicking acute myocardial infarction

    PubMed Central

    Tilouche, Samia; Masmoudi, Tasnim; Sahnoun, Maha; Chkirbène, Youssef; Mestiri, Sarra; Boughamoura, Lamia; Ben Dhiab, Mohamed; Souguir, Mohamed Kamel

    2016-01-01

    Myocarditis is an inflammatory disease of the myocardium with heterogeneous clinical manifestations and progression. In clinical practice, although there are many methods of diagnosis of acute myocarditis, the diagnosis remains an embarrassing dilemma for clinicians. The authors report the case of 9-month-old infant who was brought to the Pediatric Emergency Department with sudden onset dyspnea. Examination disclosed heart failure and resuscitation was undertaken. The electrocardiogram showed an ST segment elevation in the anterolateral leads with a mirror image. Cardiac enzyme tests revealed a significant elevation of troponin and creatine phosphokinase levels. A diagnosis of acute myocardial infarction was made, and heparin therapy was prescribed. The infant died on the third day after admission with cardiogenic shock. The autopsy showed dilatation of the ventricles and massive edema of the lungs. Histological examinations of myocardium samples revealed the presence of a marked lymphocytic infiltrate dissociating myocardiocytes. Death was attributed to acute myocarditis. The authors call attention to the difficulties of differential diagnosis between acute myocarditis and acute myocardial infarction especially in children, and to the important therapeutic implications of a correct diagnosis. PMID:28210569

  4. Occipital Falcine Anaplastic Hemangiopericytoma Mimicking Meningioma

    PubMed Central

    Kanesen, Davendran; Kandasamy, Regunath; Idris, Zamzuri

    2016-01-01

    The rarity of hemangiopericytoma (HPC) and its controversial histological classification result in its frequent misdiagnosis and thus make the treatment quite challenging. It is often difficult to distinguish these tumors from meningiomas based on clinical features and radiological findings. This is a case report of a man, diagnosed clinically and radiologically as meningioma, which turned out to be anaplastic HPC on histological examination. A 30-year-old man presented with 3 months of progressively worsening of headache and blurring of vision. Clinical examination revealed the right homonymous hemianopia with reduced visual acuity and papilledema bilaterally. Magnetic resonance imaging revealed a multilobulated and heterogenous extraaxial lesion attached to the occipital falx. It measured 9.0 cm (AP) × 5.5 cm (W) × 5.8 cm (CC) and expands bilaterally with major bulk on the left. An occipital craniotomy followed by a subtotal tumor excision was only achieved due to profuse bleeding intraoperatively. Histopathology confirmed an anaplastic HPC (WHO Grade 3). The importance of differentiation between HPCs and meningiomas cannot be overemphasized. A preoperative correct diagnosis is difficult, but it is important that it should be made. Multilobulated (mushroom appearance), prominent internal signal voids, relatively narrow dural attachment, and lytic destruction without calcifications are useful findings to distinguish HPCs from meningiomas. PMID:28163517

  5. Occipital Falcine Anaplastic Hemangiopericytoma Mimicking Meningioma.

    PubMed

    Kanesen, Davendran; Kandasamy, Regunath; Idris, Zamzuri

    2016-12-01

    The rarity of hemangiopericytoma (HPC) and its controversial histological classification result in its frequent misdiagnosis and thus make the treatment quite challenging. It is often difficult to distinguish these tumors from meningiomas based on clinical features and radiological findings. This is a case report of a man, diagnosed clinically and radiologically as meningioma, which turned out to be anaplastic HPC on histological examination. A 30-year-old man presented with 3 months of progressively worsening of headache and blurring of vision. Clinical examination revealed the right homonymous hemianopia with reduced visual acuity and papilledema bilaterally. Magnetic resonance imaging revealed a multilobulated and heterogenous extraaxial lesion attached to the occipital falx. It measured 9.0 cm (AP) × 5.5 cm (W) × 5.8 cm (CC) and expands bilaterally with major bulk on the left. An occipital craniotomy followed by a subtotal tumor excision was only achieved due to profuse bleeding intraoperatively. Histopathology confirmed an anaplastic HPC (WHO Grade 3). The importance of differentiation between HPCs and meningiomas cannot be overemphasized. A preoperative correct diagnosis is difficult, but it is important that it should be made. Multilobulated (mushroom appearance), prominent internal signal voids, relatively narrow dural attachment, and lytic destruction without calcifications are useful findings to distinguish HPCs from meningiomas.

  6. Hydronephrosis due to pelviureteric junction narrowing: Utility of urinary enzymes to predict the need for surgical management and follow-up

    PubMed Central

    Rathod, Kirtikumar J.; Samujh, Ram; Agarwal, Sumeet; Kanojia, Ravi Prakash; Sharma, Ujjawal; Prasad, Rajendra

    2012-01-01

    Aim: To study the role of urinary enzymes N-acetyl-β-glucosaminidase (NAG), alkaline phosphatase (AKP) and gamma glutamyl transferase (GGT) in the diagnosis and follow-up of patients with suspected pelviureteric junction obstruction (PUJO). Materials and Methods: A total of 70 patients, 29 managed conservatively (group A) and 41 managed by pyeloplasty (group B), were studied prospectively. A serial measurement of urinary enzymes NAG, AKP and GGT level was performed in both the groups. The mean levels of these urinary enzymes were compared between the two groups and among the patients of the same group at presentation as well as during follow-up. Results: There was a significant fall in the mean AKP level in patients managed conservatively at 8 months of follow-up. Similarly, in the operated group, there was a significant fall in the AKP levels at both 3 months and 8 months of follow-up. The mean level of GGT also showed a significant fall after 3 months of surgery but did not show further significant change at 8 months after surgery. The mean levels of NAG and GGT in the conservatively managed group were significantly low compared with that of patients requiring pyeloplasty at presentation as well as in the follow-up. The mean level of AKP was significantly low in the conservatively managed group when compared with the patients requiring surgery, but did not differ significantly in both the follow-ups after surgery. Conclusions: The level of urinary enzymes NAG, AKP and GGT are significantly high in the patients with hydronephrosis (HDN) requiring pyeloplasty when compared with the patients managed conservatively. The level of AKP significantly falls after pyeloplasty in the patients of HDN due to PUJO. There is a negative correlation with the preoperative level of enzyme NAG with split renal function in the patients of HDN requiring pyeloplasty. PMID:22279355

  7. Renal vein thrombosis mimicking urinary calculus: a dilemma of diagnosis.

    PubMed

    Wang, Yimin; Chen, Shanwen; Wang, Wei; Liu, Jianyong; Jin, Baiye

    2015-07-02

    Renal vein thrombosis (RVT) with flank pain, and hematuria, is often mistaken with renal colic originating from ureteric or renal calculus. Especially in young and otherwise healthy patients, clinicians are easily misled by clinical presentation and calcified RVT. A 38-year-old woman presented with flank pain and hematuria suggestive of renal calculus on ultrasound. She underwent extracorporeal shock wave lithotripsy that failed, leading to the recommendation that percutaneous lithotomy was necessary to remove the renal calculus. In preoperative view of the unusual shape of the calculus without hydronephrosis, noncontrast computed tomography was taken and demonstrated left ureteric calculus. However computed tomography angiography revealed, to our surprise, a calcified RVT that was initially thought to be a urinary calculus. This case shows that a calcified RVT might mimic a urinary calculus on conventional ultrasonography and ureteric calculus on noncontrast computed tomography. Subsequent computed tomography angiography disclosed that a calcified RVT caused the imaging findings, thus creating a potentially dangerous clinical pitfall. Hence, it is suggested that the possibility of a RVT needs to be considered in the differential diagnosis whenever one detects an uncommon shape for a urinary calculus.

  8. 18F-FDG PET/CT demonstrating primary bone lymphoma of the extremities mimicking an inflammatory peripheral arthropathy.

    PubMed

    Tachibana, Ayano; Robinson, Richard J; Patel, Chirag N

    2015-02-01

    A 66-year-old woman presents with progressive bilateral swelling of her fingers, elbows, and toes. Initially thought to represent an inflammatory peripheral arthropathy, the patient underwent rheumatology review, but subsequent tissue biopsy confirmed diffuse large B-cell lymphoma. Results of bone marrow biopsy and staging CT were negative. F-FDG PET/CT demonstrates FDG-avid bony and adjacent soft tissue disease limited to the extremities with an excellent metabolic response to primary chemotherapy. This is a rare case of primary bone lymphoma limited to the extremities mimicking an inflammatory peripheral arthropathy.

  9. Rational Design of Pathogen-Mimicking Amphiphilic Materials as Nanoadjuvants

    NASA Astrophysics Data System (ADS)

    Ulery, Bret D.; Petersen, Latrisha K.; Phanse, Yashdeep; Kong, Chang Sun; Broderick, Scott R.; Kumar, Devender; Ramer-Tait, Amanda E.; Carrillo-Conde, Brenda; Rajan, Krishna; Wannemuehler, Michael J.; Bellaire, Bryan H.; Metzger, Dennis W.; Narasimhan, Balaji

    2011-12-01

    An opportunity exists today for cross-cutting research utilizing advances in materials science, immunology, microbial pathogenesis, and computational analysis to effectively design the next generation of adjuvants and vaccines. This study integrates these advances into a bottom-up approach for the molecular design of nanoadjuvants capable of mimicking the immune response induced by a natural infection but without the toxic side effects. Biodegradable amphiphilic polyanhydrides possess the unique ability to mimic pathogens and pathogen associated molecular patterns with respect to persisting within and activating immune cells, respectively. The molecular properties responsible for the pathogen-mimicking abilities of these materials have been identified. The value of using polyanhydride nanovaccines was demonstrated by the induction of long-lived protection against a lethal challenge of Yersinia pestis following a single administration ten months earlier. This approach has the tantalizing potential to catalyze the development of next generation vaccines against diseases caused by emerging and re-emerging pathogens.

  10. A patient with plaque type morphea mimicking systemic lupus erythematosus.

    PubMed

    Wardhana; Datau, E A

    2015-04-01

    Morphea is an uncommon connective tissue disease with the most prominent feature being thickening or fibrosis of the dermal without internal organ involvement. It is also known as a part of localized scleroderma. Based on clinical presentation and depth of tissue involvement, morphea is classified into several forms, and about two thirds of adults with morphea have plaque type. Overproduction of collagen production by fibroblast is the cause of abnormality in morphea, and the hyperactivity mechanism of fibroblast is still unknown, although there are several mechanisms already proposed. Plaque type morphea is actually a benign and self limited. Plaque type morphea that mimicking systemic lupus erythematosus in clinical appearance, such as alopecia and oral mucosal ulcers, is uncommon. A case of plaque type morphea mimicking systemic lupus erythematosus in a 20 year old woman was discussed. The patient was treated with local and systemic immunosuppressant and antioxydant. The patient's condition is improved without any significant side effects.

  11. The stiffening of arteries by the tissue-mimicking gelatin.

    PubMed

    Zhang, Xiaoming; Greenleaf, James F

    2006-08-01

    Pulse wave velocity (PWV) is widely used for estimating the stiffness of an artery. PWV is measured by the time of travel of the "foot" of the pressure wave over a known distance. This technique has a low time resolution and is an average measurement of artery stiffness between the two measuring sites. The elastic modulus of the artery can be estimated with PWV, but the surrounding tissue effects are not considered. In this paper an external short pulse wave is generated noninvasively in the arterial wall by the radiation force of ultrasound. The pulse wave velocity in the artery is measured by a scanning technique with high-time resolution. The effect of tissue-mimicking gelatin on the artery is analyzed by measuring the wave velocity of the artery without and embedded in gelatin. It is found that the tissue-mimicking gelatin significantly stiffens the rubber tube and the artery if they are embedded in gelatin.

  12. An exposimetry system using tissue-mimicking liquid.

    PubMed

    Stiles, Timothy A; Madsen, Ernest L; Frank, Gary R

    2008-01-01

    Acoustic output measurements of diagnostic ultrasound scanners are currently performed in water and derated to approximate in situ values. The derating scheme ignores nonlinear propagation of sound waves and has been shown in previous numerical and experimental studies to tend to underestimate relevant pressure and intensity values in tissue mimicking media. This work describes an alternative method, which uses a tissue-mimicking liquid with attenuation coefficient slope of 0.3 dB/cm/MHz, speed of sound of 1,540 m/s and nonlinearity parameter B/A of 7.5. The acoustic properties of this liquid are stable for at least 2 y after production. Initial results using a single M-mode configuration are presented. These results confirm that derating can significantly underestimate the pulse intensity integral and peak rarefactional pressure.

  13. Testicular Schistosomiasis Mimicking Malignancy in a Child: A Case Report.

    PubMed

    Ekenze, Sebastian O; Modekwe, Victor O; Nzegwu, Martin A; Ekpemo, Samuel C; Ezomike, Uchechukwu O

    2015-08-01

    Schistosomiasis is an important communicable disease in the developing world. However, testicular schistosomiasis is an extremely rare condition. We report a case of testicular schistosomiasis mimicking testicular tumour in a 13 year old who presented with huge unilateral testicular mass. The dilemma encountered in the diagnosis and treatment of this child is presented to highlight the need for high index of suspicion of this pathology in children with testicular mass presenting from schistosomiasis-endemic areas.

  14. Mimicking biological functionality with polymers for biomedical applications

    NASA Astrophysics Data System (ADS)

    Green, Jordan J.; Elisseeff, Jennifer H.

    2016-12-01

    The vast opportunities for biomaterials design and functionality enabled by mimicking nature continue to stretch the limits of imagination. As both biological understanding and engineering capabilities develop, more sophisticated biomedical materials can be synthesized that have multifaceted chemical, biological and physical characteristics designed to achieve specific therapeutic goals. Mimicry is being used in the design of polymers for biomedical applications that are required locally in tissues, systemically throughout the body, and at the interface with tissues.

  15. Intracranial subdural empyema mimicking a recurrent chronic subdural hematoma

    PubMed Central

    Doan, Ninh; Patel, Mohit; Nguyen, Ha Son; Mountoure, Andrew; Shabani, Saman; Gelsomino, Michael; Janich, Karl; Kurpad, Shekar

    2016-01-01

    Intracranial subdural empyema (ISDE) is a life-threatening condition. The risk for ISDE increases in patients that have undergone prior intracranial procedures. The non-specificity in its clinical presentation often makes ISDE difficult to diagnose. Here, we present a rare case of ISDE mimicking a recurrent chronic subdural hematoma, emphasizing the significance of obtaining early magnetic resonance images of the brain for early diagnosis and treatment to achieve the optimal outcome. PMID:27651110

  16. Localized IgG4-related Cholecystitis Mimicking Gallbladder Cancer.

    PubMed

    Inoue, Tadahisa; Okumura, Fumihiro; Mizushima, Takashi; Nishie, Hirotada; Iwasaki, Hiroyasu; Anbe, Kaiki; Ozeki, Takanori; Kachi, Kenta; Fukusada, Shigeki; Suzuki, Yuta; Watanabe, Kazuko; Sano, Hitoshi

    2015-01-01

    We encountered a case of localized IgG4-cholecystitis mimicking gallbladder cancer with focal/segmental type1 autoimmune pancreatitis (AIP). In this case, we were unable to exclude a diagnosis of gallbladder cancer and thus performed radical cholecystectomy. Type1 AIP is often associated with gallbladder lesions, accompanied by generally diffuse, circumferential thickening of the gallbladder wall. Although localized IgG4-related cholecystitis is extremely rare, differentiating this condition from gallbladder cancer is often very difficult.

  17. Mimicking Classical Conditioning Based on a Single Flexible Memristor.

    PubMed

    Wu, Chaoxing; Kim, Tae Whan; Guo, Tailiang; Li, Fushan; Lee, Dea Uk; Yang, J Joshua

    2017-03-01

    The mimicking of classical conditioning, including acquisition, extinction, recovery, and generalization, can be efficiently achieved by using a single flexible memristor. In particular, the experiment of Pavlov's dog is successfully demonstrated. This demonstration paves the way for reproducing advanced neural processes and provides a frontier approach to the design of artificial-intelligence systems with dramatically reduced complexity. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. A giant ancient schwannoma mimicking an adnexal mass

    PubMed Central

    Karaköse, Oktay; Pülat, Hüseyin; Oğuz, Serhat; Zihni, İsmail; Özçelik, Kazım Çağlar; Yalta, Tülin Deniz; Eken, Hüseyin

    2016-01-01

    Abstract Introduction: Ancient schwannoma is a rare tumor of the peripheral nerve sheath. As degenerative properties are defined histologically, it can be wrongly interpreted as malignant. Case presentation: The case presented here is of a giant ancient schwannoma with a pelvic retroperitoneal location, which was mimicking an adnexal mass. Conclusion: In the rarely seen cases in the retroperitoneum, it may reach very large dimensions. PMID:27472696

  19. Reactive arthritis mimicking inflammatory bowel disease arthritis: a challenging diagnosis.

    PubMed

    Trabulo, D; Mangualde, J; Cremers, I; Oliveira, A P

    2014-01-01

    Reactive arthritis comprises a subgroup of infection-associated arthritis which occurs after genitourinary or gastrointestinal tract infection in genetically susceptible hosts. Studies have proposed Salmonella, Shigella or Yersinia infection as the microorganisms responsible for the post-dysenteric form. The human leukocyte antigen (HLA)-B27 is a well recognised best-known predisposing factor. We report a case of HLA-B27-associated reactive arthritis after Salmonella goldcoast enteritis, mimicking inflammatory bowel disease arthritis.

  20. Osteofibrous dysplasia of clavicle clinically mimicking chronic osteomyelitis

    PubMed Central

    Gopinathan, Nirmal Raj; Prakash, Mahesh; Saibaba, Balaji; Das, Ashim

    2016-01-01

    Osteofibrous dysplasia or ossifying fibroma is an uncommon benign fibro-osseous lesion of childhood, commonly described in the maxilla and the mandible. Among long bones, it usually presents in the tibia as a painless swelling or anterior bowing. Ossifying fibroma of clavicle has never been reported in English literature, to the best of our knowledge. Here, we would like to present an unusual case of osteofibrous dysplasia of clavicle clinically mimicking chronic osteomyelitis. PMID:27413281

  1. Regional bone change in intramuscular haemangioma mimicking primary bone tumour.

    PubMed

    Shikhare, Sumer; Chacko, Julio K; Chuah, Khoon L

    2015-04-01

    Intramuscular haemangiomas are benign soft-tissue tumours, commonly located in the extremities. We present a right-leg intramuscular haemangioma with florid periosteal reaction in adjacent tibia, mimicking a primary bone tumour. Plain radiograph and magnetic resonance imaging features are illustrated with the surgical and histopathological findings. Radiologists need to be familiar with reactive bone changes secondary to deep-seated intramuscular haemangiomas to avoid potential misdiagnosis.

  2. Addison's Disease Mimicking as Acute Pancreatitis: A Case Report.

    PubMed

    Chaudhuri, Sayani; Rao, Karthik N; Patil, Navin; Ommurugan, Balaji; Varghese, George

    2017-04-01

    Over past two decades there has been significant improvement in medical field in elucidating the underlying pathophysiology and genetics of Addison's disease. Adrenal insufficiency (Addison's disease) is a rare disease with an incidence of 0.8/100,000 cases. The diagnosis may be delayed if the clinical presentation mimics a gastrointestinal disorder or psychiatric illness. We report a case of Addison's disease presenting as acute pain in abdomen mimicking clinical presentation of acute pancreatitis.

  3. Heparin-Mimicking Polymers: Synthesis and Biological Applications.

    PubMed

    Paluck, Samantha J; Nguyen, Thi H; Maynard, Heather D

    2016-11-14

    Heparin is a naturally occurring, highly sulfated polysaccharide that plays a critical role in a range of different biological processes. Therapeutically, it is mostly commonly used as an injectable solution as an anticoagulant for a variety of indications, although it has also been employed in other forms such as coatings on various biomedical devices. Due to the diverse functions of this polysaccharide in the body, including anticoagulation, tissue regeneration, anti-inflammation, and protein stabilization, and drawbacks of its use, analogous heparin-mimicking materials are also widely studied for therapeutic applications. This review focuses on one type of these materials, namely, synthetic heparin-mimicking polymers. Utilization of these polymers provides significant benefits compared to heparin, including enhancing therapeutic efficacy and reducing side effects as a result of fine-tuning heparin-binding motifs and other molecular characteristics. The major types of the various polymers are summarized, as well as their applications. Because development of a broader range of heparin-mimicking materials would further expand the impact of these polymers in the treatment of various diseases, future directions are also discussed.

  4. Dengue fever mimicking acute appendicitis: A case report.

    PubMed

    McFarlane, M E C; Plummer, J M; Leake, P A; Powell, L; Chand, V; Chung, S; Tulloch, K

    2013-01-01

    Dengue fever is an acute viral disease, which usually presents as a mild febrile illness. Patients with severe disease present with dengue haemorrhagic fever or dengue toxic shock syndrome. Rarely, it presents with abdominal symptoms mimicking acute appendicitis. We present a case of a male patient presenting with right iliac fossa pain and suspected acute appendicitis that was later diagnosed with dengue fever following a negative appendicectomy. A 13-year old male patient presented with fever, localized right-sided abdominal pain and vomiting. Abdominal ultrasound was not helpful and appendicectomy was performed due to worsening abdominal signs and an elevated temperature. A normal appendix with enlarged mesenteric nodes was found at surgery. Complete blood count showed thrombocytopenia with leucopenia. Dengue fever was now suspected and confirmed by IgM enzyme-linked immunosorbent assay against dengue virus. This unusual presentation of dengue fever mimicking acute appendicitis should be suspected during viral outbreaks and in patients with atypical symptoms and cytopenias on blood evaluation in order to prevent unnecessary surgery. This case highlights the occurrence of abdominal symptoms and complications that may accompany dengue fever. Early recognition of dengue fever mimicking acute appendicitis will avoid non-therapeutic operation and the diagnosis may be aided by blood investigations indicating a leucopenia, which is uncommon in patients with suppurative acute appendicitis. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Heparin-Mimicking Polymers: Synthesis and Biological Applications

    PubMed Central

    2016-01-01

    Heparin is a naturally occurring, highly sulfated polysaccharide that plays a critical role in a range of different biological processes. Therapeutically, it is mostly commonly used as an injectable solution as an anticoagulant for a variety of indications, although it has also been employed in other forms such as coatings on various biomedical devices. Due to the diverse functions of this polysaccharide in the body, including anticoagulation, tissue regeneration, anti-inflammation, and protein stabilization, and drawbacks of its use, analogous heparin-mimicking materials are also widely studied for therapeutic applications. This review focuses on one type of these materials, namely, synthetic heparin-mimicking polymers. Utilization of these polymers provides significant benefits compared to heparin, including enhancing therapeutic efficacy and reducing side effects as a result of fine-tuning heparin-binding motifs and other molecular characteristics. The major types of the various polymers are summarized, as well as their applications. Because development of a broader range of heparin-mimicking materials would further expand the impact of these polymers in the treatment of various diseases, future directions are also discussed. PMID:27739666

  6. Novel tissue mimicking materials for high frequency breast ultrasound phantoms.

    PubMed

    Cannon, Louise M; Fagan, Andrew J; Browne, Jacinta E

    2011-01-01

    The development and acoustical characterisation of a range of novel agar-based tissue mimicking material (TMMs) for use in clinically relevant, quality assurance (QA) and anthropomorphic breast phantoms are presented. The novel agar-based TMMs described in this study are based on a comprehensive, systematic variation of the ingredients in the International Electrotechnical Commission (IEC) TMM. A novel, solid fat-mimicking material was also developed and acoustically characterised. Acoustical characterisation was carried out using an in-house scanning acoustic macroscope at low (7.5 MHz) and high frequencies (20 MHz), using the pulse-echo insertion technique. The speeds of sound range from 1490 to 1570 m. s(-1), attenuation coefficients range from 0.1 to 0.9 dB. cm(‑1). MHz(-1) and relative backscatter ranges from 0 to -20 dB. It was determined that tissues can be mimicked in terms of independently controllable speeds of sound and attenuation coefficients. These properties make these novel TMMs suitable for use in clinically relevant QA and anthropomorphic phantoms and would potentially be useful for other high frequency applications such as intravascular and small animal imaging. Copyright © 2011 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  7. Recent Progress of Microfluidics in Translational Applications.

    PubMed

    Liu, Zongbin; Han, Xin; Qin, Lidong

    2016-04-20

    Microfluidics, featuring microfabricated structures, is a technology for manipulating fluids at the micrometer scale. The small dimension and flexibility of microfluidic systems are ideal for mimicking molecular and cellular microenvironment, and show great potential in translational research and development. Here, the recent progress of microfluidics in biological and biomedical applications, including molecular analysis, cellular analysis, and chip-based material delivery and biomimetic design is presented. The potential future developments in the translational microfluidics field are also discussed.

  8. Recent Progress of Microfluidics in Translational Applications

    PubMed Central

    Liu, Zongbin; Han, Xin

    2016-01-01

    Microfluidics, featuring microfabricated structures, is a technology for manipulating fluids at the micrometer scale. The small dimension and flexibility of microfluidic systems are ideal for mimicking molecular and cellular microenvironment, and show great potential in translational research and development. Here, the recent progress of microfluidics in biological and biomedical applications, including molecular analysis, cellular analysis, and chip-based material delivery and biomimetic design is presented. The potential future developments in the translational microfluidics field are also discussed. PMID:27091777

  9. Male Fertility Is Reduced by Chronic Intermittent Hypoxia Mimicking Sleep Apnea in Mice

    PubMed Central

    Torres, Marta; Laguna-Barraza, Ricardo; Dalmases, Mireia; Calle, Alexandra; Pericuesta, Eva; Montserrat, Josep M.; Navajas, Daniel; Gutierrez-Adan, Alfonso; Farré, Ramon

    2014-01-01

    Study Objectives: Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia and oxidative stress. However, it is unknown whether intermittent hypoxia mimicking OSA modifies male fertility. We tested the hypothesis that male fertility is reduced by chronic intermittent hypoxia mimicking OSA in a mouse model. Design: Case-control comparison in a murine model. Setting: University research laboratory. Participants: Eighteen F1 (C57BL/6xCBA) male mice. Interventions: Mice were subjected to a pattern of periodic hypoxia (20 sec at 5% O2 followed by 40 sec of room air) 6 h/day for 60 days or normoxia. After this period, mice performed a mating trial to determine effective fertility by assessing the number of pregnant females and fetuses. Measurements and Results: After euthanasia, oxidative stress in testes was assessed by measuring the expression of glutathione peroxidase 1 (Gpx1) and superoxide dismutase-1 (Sod1) by reverse-transcription polymerase chain reaction. Sperm motility was determined by Integrated Semen Analysis System (ISAS). Intermittent hypoxia significantly increased testicular oxidative stress, showing a reduction in the expression of Gpx1 and Sod1 by 38.9% and 34.4%, respectively, as compared with normoxia (P < 0.05). Progressive sperm motility was significantly reduced from 27.0 ± 6.4% in normoxia to 12.8 ± 1.8% in the intermittent hypoxia group (P = 0.04). The proportion of pregnant females and number of fetuses per mating was significantly lower in the intermittent hypoxia group (0.33 ± 0.10 and 2.45 ± 0.73, respectively) than in normoxic controls (0.72 ± 0.16 and 5.80 ± 1.24, respectively). Conclusions: These results suggest that the intermittent hypoxia associated with obstructive sleep apnea (OSA) could induce fertility reduction in male patients with this sleep breathing disorder. Citation: Torres M, Laguna-Barraza R, Dalmases M, Calle A, Pericuesta E, Montserrat JM, Navajas D, Gutierrez-Adan A, Farré R. Male fertility is

  10. Preliminary study on the differentiation between parapelvic cyst and hydronephrosis with non-calculous using only pre-contrast dual-energy spectral CT scans.

    PubMed

    Han, Dong; Ma, Guangming; Wei, Lequn; Ren, Chenglong; Zhou, Jieli; Shen, Chen; He, Taiping

    2017-05-01

    To investigate the value of using the quantitative parameters from only the pre-contrast dual-energy spectral CT imaging for distinguishing between parapelvic cyst and hydronephrosis with non-calculous (HNC). This retrospective study was approved by the institutional review board. 28 patients with parapelvic cyst and 24 patients with HNC who underwent standard pre-contrast and multiphase contrast-enhanced dual-energy spectral CT imaging were retrospectively identified. The parapelvic cyst and HNC were identified using the contrast-enhanced scans, and their CT number in the 70-keV monochromatic images, effective atomic number (Zeff), iodine concentration (IC) and water concentration in the pre-contrast images were measured. The slope of the spectral curve (λ) was calculated. The difference in the measurements between parapelvic cyst and HNC was statistically analyzed using SPSS(®) v. 19.0 (IBM Corp., New York, NY; formerly SPSS Inc., Chicago, IL) statistical software. Receiver-operating characteristic analysis was performed to assess the diagnostic performance. The CT numbers in the 70-keV images, Zeff and IC values were statistically different between parapelvic cyst and HNC (all p < 0.05). The sensitivity, specificity and accuracy of these parameters for distinguishing between parapelvic cyst and HNC were 89.2%, 73.3% and 82.1%; 86.5%, 43.3% and 67.2%; 91.9%, 40.0% and 68.7%; and 64.9%, 73.3% and 83.6%, respectively, and the combined specificity was 92.9%. There was no statistical difference in λ between the two groups (p > 0.05). The quantitative parameters obtained in the pre-contrast dual-energy spectral CT imaging may be used to differentiate between parapelvic cyst and HNC. Advances in knowledge: The pre-contrast dual-energy spectral CT scans may be used to screen parapelvic cysts for patients who are asymptomatic, thereby avoiding contrast-enhanced CT or CT urography examination for these patients to reduce ionizing radiation dose and contrast

  11. Degree of hydronephrosis predicts adverse pathological features and worse oncologic outcomes in patients with high-grade urothelial carcinoma of the upper urinary tract.

    PubMed

    Chung, Paul H; Krabbe, Laura-Maria; Darwish, Oussama M; Westerman, Mary E; Bagrodia, Aditya; Gayed, Bishoy A; Haddad, Ahmed Q; Kapur, Payal; Sagalowsky, Arthur I; Lotan, Yair; Margulis, Vitaly

    2014-10-01

    To evaluate degree of hydronephrosis (HN) as a surrogate for adverse pathological features and oncologic outcomes in patients with high-grade (HG) and low-grade (LG) upper tract urothelial carcinomas (UTUCs). We retrospectively reviewed 141 patients with localized UTUCs that underwent extirpative surgery at a tertiary referral center. Preoperative imaging was used to evaluate presence and degree of ipsilateral HN. We evaluated degree of HN (none/mild vs. moderate/severe), pathological findings, and oncologic outcomes. HG UTUC was present in 113 (80%) patients, muscle-invasive disease (≥pT2) in 49 (35%), and non-organ-confined disease (≥pT3) in 41 (29%). At a median follow-up of 34 months, 49 (35%) patients experienced intravesical recurrence, 28 (20%) developed local/systemic recurrence, and 24 (17%) died of UTUC. HN was graded as none/mild in 77 (55%) patients and moderate/severe in 64 (45%). In patients with HG UTUC, but not LG, degree of HN was associated with advanced pathological stage (P<0.001), positive lymph nodes (P = 0.01), local/systemic recurrence-free survival (hazard ratio [HR] = 5.5, P = 0.02), and cancer-specific survival (HR = 5.2, P = 0.02). On multivariable analysis of preoperative factors, degree of HN in patients with HG UTUC was associated with muscle invasion (HR = 9.3; 95% CI: 3.08-28.32; P<0.001), non-organ-confined disease (HR = 4.5; 95% CI: 1.66-12.06; P = 0.003), local/systemic recurrence-free survival (HR = 2.5; 95% CI: 1.07-5.64; P = 0.04), and cancer-specific survival (HR = 2.6; 95% CI: 1.05-6.22; P = 0.04). Degree of HN can serve as a surrogate for advanced disease and predict worse oncologic outcomes in HG UTUC. Degree of HN was not predictive of intravesical or local/systemic recurrence in LG UTUC. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Male fertility is reduced by chronic intermittent hypoxia mimicking sleep apnea in mice.

    PubMed

    Torres, Marta; Laguna-Barraza, Ricardo; Dalmases, Mireia; Calle, Alexandra; Pericuesta, Eva; Montserrat, Josep M; Navajas, Daniel; Gutierrez-Adan, Alfonso; Farré, Ramon

    2014-11-01

    Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia and oxidative stress. However, it is unknown whether intermittent hypoxia mimicking OSA modifies male fertility. We tested the hypothesis that male fertility is reduced by chronic intermittent hypoxia mimicking OSA in a mouse model. Case-control comparison in a murine model. University research laboratory. Eighteen F1 (C57BL/6xCBA) male mice. Mice were subjected to a pattern of periodic hypoxia (20 sec at 5% O2 followed by 40 sec of room air) 6 h/day for 60 days or normoxia. After this period, mice performed a mating trial to determine effective fertility by assessing the number of pregnant females and fetuses. After euthanasia, oxidative stress in testes was assessed by measuring the expression of glutathione peroxidase 1 (Gpx1) and superoxide dismutase-1 (Sod1) by reverse-transcription polymerase chain reaction. Sperm motility was determined by Integrated Semen Analysis System (ISAS). Intermittent hypoxia significantly increased testicular oxidative stress, showing a reduction in the expression of Gpx1 and Sod1 by 38.9% and 34.4%, respectively, as compared with normoxia (P < 0.05). Progressive sperm motility was significantly reduced from 27.0 ± 6.4% in normoxia to 12.8 ± 1.8% in the intermittent hypoxia group (P = 0.04). The proportion of pregnant females and number of fetuses per mating was significantly lower in the intermittent hypoxia group (0.33 ± 0.10 and 2.45 ± 0.73, respectively) than in normoxic controls (0.72 ± 0.16 and 5.80 ± 1.24, respectively). These results suggest that the intermittent hypoxia associated with obstructive sleep apnea (OSA) could induce fertility reduction in male patients with this sleep breathing disorder.

  13. Quantifying temperature changes in tissue-mimicking fluid phantoms using optical coherence tomography and envelope statistics

    NASA Astrophysics Data System (ADS)

    Seevaratnam, Subaagari; Bains, Amitpal; Farid, Mashal; Farhat, Golnaz; Kolios, Michael; Standish, Beau A.

    2014-02-01

    Several therapies make use of a hypo or hyperthermia tissue environment to induce cell death in both benign and malignant tumors. Current progression in optical technologies, such as optical coherence tomography (OCT) and fiber Bragg gratings (FBG) sensors, could potentially provide viable information to explore the response of tissue when these temperature induced treatments are implemented. Studies were conducted with tissue-mimicking phantoms fabricated with polystyrene microspheres and glycerin to observe any relationship between the pixel intensities of the OCT images and their concurring envelope statistics. OCT images of the monitored region of interest were taken at 5°C intervals from 25°C to 60°C. Four probability distribution functions (PDF), Rician, Rayleigh, Normal and Generalized Gamma were used to investigate OCT envelope statistics as the temperature was altered. Using the Kolmogrov-Smirnov goodness of fit test, it was determined that the Generalized Gamma was the best fit. The scaling and shape parameters associated with the Generalized Gamma PDF were used to quantify the OCT envelope data to identify temperature changes within the tissue mimicking media. The Generalized Gamma PDF was verified as the best fit based on the Kolmogorov-Smirnov (K-S) test correlation factor being less than 0.05 (p = 0.0158). In addition to the PDFs, the OCT speckle decorrelation at varying temperature were also measured and quantified to detect the microspheres response to temperature changes. Initial results are very promising with future research focused on extending this methodology to monitor relative temperature changes in tissue during therapy. Clinical utility can be achieved if these optical techniques are used to evaluate the temperature-derived biological response of tissue and provide a feedback mechanism to improve procedural efficiency.

  14. Development of thin skin mimicking bilayer solid tissue phantoms for optical spectroscopic studies

    PubMed Central

    Nivetha, K. Bala; Sujatha, N.

    2017-01-01

    In vivo spectroscopic measurements have the proven potential to provide important insight about the changes in tissue during the development of malignancies and thus help to diagnose tissue pathologies. Extraction of intrinsic data in the presence of varying amounts of scatterers and absorbers offers great challenges in the development of such techniques to the clinical level. Fabrication of optical phantoms, tailored to the biochemical as well as morphological features of the target tissue, can help to generate a spectral database for a given optical spectral measurement system. Such databases, along with appropriate pattern matching algorithms, could be integrated with in vivo measurements for any desired quantitative analysis of the target tissue. This paper addresses the fabrication of such soft, photo stable, thin bilayer phantoms, mimicking skin tissue in layer dimensions and optical properties. The performance evaluation of the fabricated set of phantoms is carried out using a portable fluorescence spectral measurement system. The alterations in flavin adenine dinucleotide (FAD)–a tissue fluorophore that provides important information about dysplastic progressions in tissues associated with cancer development based on changes in emission spectra–fluorescence with varied concentrations of absorbers and scatterers present in the phantom are analyzed and the results are presented. Alterations in the emission intensity, shift in emission wavelength and broadening of the emission spectrum were found to be potential markers in the assessment of biochemical changes that occur during the progression of dysplasia. PMID:28717562

  15. Various Tumor-Mimicking Lesions in the Musculoskeletal System: Causes and Diagnostic Approach

    PubMed Central

    Kim, Sue Yon; Ryu, Kyung Nam; Jin, Wook; Park, So Young

    2011-01-01

    Tumor-mimicking lesions in the musculoskeletal system can be defined as lesions mistaken as tumors due to the presence of palpation upon physical examination or a tumor-like appearance upon radiological examination. Moreover, tumor-mimicking lesions show diverse etiologies and anatomic locations. We illustrated the various tumor-mimicking lesions involving bone and soft tissue. In this review, the tumor-mimicking lesions were classified into those based on clinical examination and those based on radiological examination in musculoskeletal radiology. Awareness of the various causes of tumor-mimicking lesions, correctly obtaining clinical information, and the proper selection of imaging modality are important for the differentiation of tumor-mimicking lesions from true neoplasms. PMID:21430940

  16. Characterization of Transverse Isotropy in Compressed Tissue Mimicking Phantoms

    PubMed Central

    Urban, Matthew W.; Lopera, Manuela; Aristizabal, Sara; Amador, Carolina; Nenadic, Ivan; Kinnick, Randall R.; Weston, Alexander D.; Qiang, Bo; Zhang, Xiaoming; Greenleaf, James F.

    2015-01-01

    Tissues such as skeletal muscle and kidneys have well-defined structure that affects the measurements of mechanical properties. As an approach to characterize the material properties of these tissues, different groups have assumed that they are transversely isotropic (TI) and measure the shear wave velocity as it varies with angle with respect to the structural architecture of the organ. To refine measurements in these organs, it is desirable to have tissue mimicking phantoms that exhibit similar anisotropic characteristics. Some approaches involve embedding fibers into a material matrix. However, if a homogeneous solid is under compression due to a static stress, an acoustoelastic effect can manifest which makes the measured wave velocities change with the compression stress. We propose to exploit this characteristic to demonstrate that stressed tissue mimicking phantoms can be characterized as a TI material. We tested six phantoms made with different concentrations of gelatin and agar. Stress was applied by the weight of a water container centered on top of a plate on top of the phantom. A linear array transducer and a V-1 Verasonics system were used to induce and measure shear waves in the phantoms. The shear wave motion was measured using a compound plane wave imaging technique. Autocorrelation was applied to the received in-phase/quadrature data. The shear wave velocity, c, was estimated using a Radon transform method. The transducer was mounted on a rotating stage so measurements were made every 10° over a range of 0–360°, where the stress is applied along 0–180° direction. The shear moduli were estimated. A TI model was fit to the data and the fractional anisotropy was evaluated. This approach can be used to explore many configurations of transverse isotropy with the same phantom, simply by applying stress to the tissue mimicking phantom. PMID:26067038

  17. Lepra Reaction with Lucio Phenomenon Mimicking Cutaneous Vasculitis

    PubMed Central

    Misra, Durga Prasanna; Parida, Jyoti Ranjan; Chowdhury, Abhra Chandra; Pani, Krushna Chandra; Kumari, Niraj; Krishnani, Narendra

    2014-01-01

    Leprosy is a disease typically found in the tropics. Patients with leprosy can have varying presentation with constitutional symptoms, joint pains, skin nodules, and rarely a vasculitis-like picture with skin ulcers and neuropathy. We present a young lady who presented with the rare manifestation of skin infarcts mimicking cutaneous vasculitis, diagnosed on histopathology to have Lucio phenomenon on a background of lepromatous leprosy. With increasing migration and widespread use of biologic response modifiers, clinicians all over the world need to be aware of various presentations of leprosy as well as needing to keep an open mind while considering the differential diagnoses of vasculitis. PMID:25580317

  18. Lepra reaction with lucio phenomenon mimicking cutaneous vasculitis.

    PubMed

    Misra, Durga Prasanna; Parida, Jyoti Ranjan; Chowdhury, Abhra Chandra; Pani, Krushna Chandra; Kumari, Niraj; Krishnani, Narendra; Agarwal, Vikas

    2014-01-01

    Leprosy is a disease typically found in the tropics. Patients with leprosy can have varying presentation with constitutional symptoms, joint pains, skin nodules, and rarely a vasculitis-like picture with skin ulcers and neuropathy. We present a young lady who presented with the rare manifestation of skin infarcts mimicking cutaneous vasculitis, diagnosed on histopathology to have Lucio phenomenon on a background of lepromatous leprosy. With increasing migration and widespread use of biologic response modifiers, clinicians all over the world need to be aware of various presentations of leprosy as well as needing to keep an open mind while considering the differential diagnoses of vasculitis.

  19. Simple bone cyst of mandible mimicking periapical cyst

    PubMed Central

    HS, Charan Babu; Rai, Bhagawan Das; Nair, Manju A.; Astekar, Madhusudan S.

    2012-01-01

    Simple bone cysts (SBC) are pseudocysts occurring less commonly in the maxillofacial region. The uncertain and unclear etiopathogenesis led to numerous synonyms to refer this particular cyst. These cysts are devoid of an epithelial lining and are usually empty or contain blood or straw-colored fluid. In jaws initially it mimics a periapical cyst and later can lead to cortical bone expansion warranting for radical approach, which is seldom required. SBC is predominantly diagnosed in first two decades of life. Here we report a case of solitary bone cyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient. PMID:24765458

  20. Simple bone cyst of mandible mimicking periapical cyst.

    PubMed

    Hs, Charan Babu; Rai, Bhagawan Das; Nair, Manju A; Astekar, Madhusudan S

    2012-05-29

    Simple bone cysts (SBC) are pseudocysts occurring less commonly in the maxillofacial region. The uncertain and unclear etiopathogenesis led to numerous synonyms to refer this particular cyst. These cysts are devoid of an epithelial lining and are usually empty or contain blood or straw-colored fluid. In jaws initially it mimics a periapical cyst and later can lead to cortical bone expansion warranting for radical approach, which is seldom required. SBC is predominantly diagnosed in first two decades of life. Here we report a case of solitary bone cyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient.

  1. Primary oral leishmaniasis mimicking oral cancer: a case report.

    PubMed

    Celentano, A; Ruoppo, E; Mansueto, G; Mignogna, M D

    2015-04-01

    Primary mucosal leishmaniasis is a rare infectious disease, particularly in immunocompetent patients. We present a 50-year-old patient with a 6-week history of a painful lesion of the left buccal mucosa that mimicked cancer. The exophytic lesion looked invasive, and we took an incisional biopsy specimen to exclude cancer. The diagnosis of leishmaniasis was unexpected, and the patient was successfully treated with amphotericin B for five weeks. After five months the patient had a visceral recurrence. Chronic exophytic and ulcerated mucosal lesions that do not heal within 3-4 weeks should be regarded as the first signs of oral cancer, but primary oral leishmaniasis can easily mimic it.

  2. Iliacus pyomyositis mimicking septic arthritis of the hip joint.

    PubMed

    Chen W-S; Wan Y-L

    1996-01-01

    The iliacus muscle is closely associated with the psoas muscle, femoral nerve, hip joint, pelvic and intraabdominal structures; thus, its disorders may present as lower abdominal pain, hip pain, or femoral neuropathy. Iliacus pyomyositis, a primary bacterial infection of the skeletal muscle not secondary to a contiguous skin, bone, or soft-tissue infection, presenting as hip pain, femoral neuropathy, and sympathetic effusion of the hip joint in an 8-year-old boy mimicked septic arthritis of the hip joint. Computed tomography was helpful in delineating the accurate location of the lesion. Surgical drainage and appropriate antibiotic therapy led to complete resolution and full functional recovery.

  3. Steroid-responsive Hashimoto encephalopathy mimicking Creutzfeldt-Jakob disease.

    PubMed

    Santoro, Domenico; Colombo, Irene; Ghione, Isabella; Peverelli, Lorenzo; Bresolin, Nereo; Sciacco, Monica; Prelle, Alessandro

    2011-08-01

    Hashimoto's encephalopathy (HE) is a rare neurological disorder with a heterogeneous group of neurological symptoms associated with high titres of anti-thyroid antibodies. Clinical manifestations may include encephalopathic features such as seizures, behavioural and psychiatric manifestations, movement disorders and coma. The objective of this presentation is to describe a patient with this rare and controversial clinical syndrome mimicking Creutzfeldt-Jakob disease, associated with a Hashimoto euthyroid thyroiditis and with a significant response to high dose intravenous prednisone. The responsiveness of this syndrome to steroids suggests that this disorder involves immune pathogenic mechanisms, as previous reviews reported.

  4. Superficial Fibromatosis Mimicking Glomus Tumor of the Second Toe

    PubMed Central

    Jo, Hyang Jeong; Kim, Gang Deuk; Kim, Yeung Jin; Choi, Deok Hwa; Park, Jae In

    2015-01-01

    Various types of tumor can occur in the subungual space, including glomus tumors, subungual exostosis, hemangioma, epidermal cysts, and malignant tumors. While fibromatosis can occur at various sites throughout the body, it is very rarely seen in the toe. Here, we are the first to report a case of superficial fibromatosis mimicking a glomus tumor in the subungual space of the second toe. The presentation of this condition shows the possibility of encountering uncommon superficial fibromatosis in the distal phalanx of the toe, and suggests that superficial fibromatosis should be included in the differential diagnosis of a glomus tumor in the toe. PMID:26330970

  5. Subarachnoid haemorrhage mimicking transient ST-segment elevation myocardial infarction.

    PubMed

    Lai, C-H; Juan, Y-H; Chang, S-L; Lee, W-L; How, C-K; Hsu, T-F

    2015-08-01

    Patients often present to the emergency department with loss of consciousness. The differential diagnosis of such condition may be difficult because of limited clinical information. The authors present a case of subarachnoid haemorrhage (SAH) with initial electrocardiographic (ECG) finding mimicking ST-segment elevation myocardial infarction (STEMI), which was confirmed to resolve in a follow-up study. Accurate and timely diagnosis of SAH-related ST-segment elevation was important, as the therapeutic strategy for SAH is completely different from that for STEMI. If the clinicians do not have other tools for diagnosis, the follow-up ECG may help us make a most possible diagnosis.

  6. Brucellosis mimicking Henoch-Schönlein purpura.

    PubMed

    Massasso, David; Gibson, Kathryn

    2007-06-04

    A young male immigrant from Syria with a vasculitic-appearing leg rash, asymmetrical polyarthritis, microscopic haematuria, and raised inflammatory markers was provisionally diagnosed with Henoch-Schönlein purpura. Skin biopsy showed leukocytoclastic vasculitis. Low-grade fevers persisted despite non-steroidal anti-inflammatory therapy, and Brucella sp. was subsequently grown from both blood and synovial fluid aspirates. Further tests gave positive results for B. abortus, and triple antibiotic therapy produced a rapid clinical response. Cutaneous vasculitis has rarely been described in brucellosis, and this is the first report in the English medical literature of brucellosis mimicking Henoch-Schönlein purpura.

  7. Subcutaneous Phaeohyphomycosis Due to Pyrenochaeta romeroi Mimicking a Synovial Cyst

    PubMed Central

    Dinh, Aurélien; Levy, Bruno; Bouchand, Frédérique; Davido, Benjamin; Duran, Clara; Cristi, Marin; Felter, Adrien; Salomon, Jérôme; Ait Ammar, Nawel

    2016-01-01

    Opportunistic subcutaneous fungal infections are increasing nowadays due to the growing number of medical conditions causing immunosuppression, especially organ transplant. The incidence rate of subcutaneous phaeohyphomycosis is very low. Most studies found are case reports. They showed a wide variation of clinical presentations. Pyrenochaeta romeroi, a fungus from the Dematiaceae group is a saprophyte found in soil and plants and a possible causative agent of phaeohyphomycosis. We present a rare case of subcutaneous phaeohyphomycosis caused by P. romeroi mimicking a synovial cyst in a diabetic patient. PMID:27630637

  8. Aggressive Indeterminate Dendritic Cell Tumor Mimicking Scalp Angiosarcoma.

    PubMed

    Li, Yun; Wang, Ting-Ting; Zhang, Zi-Hui; Wang, Lin

    2017-10-01

    Indeterminate dendritic cell tumor (IDCT) is a proliferation of CD1a+, S100+ and langerin- histiocytes with a generally benign course. Here, we describe a case of a 90-year-old male who developed skin lesions on his scalp mimicking angiosarcoma and lymphadenopathy. He died six months after the onset of skin lesions despite of months' radiotherapy. Pathological examination ruled out scalp angiosarcoma and showed a high Ki-67 index. The appearance of skin lesions and lymphadenopathy led to challenges in diagnosis and the development of a treatment plan.

  9. Intimal Sarcoma of the Descending Aorta Mimicking Aortitis

    PubMed Central

    Pucci, Angela; De Martino, Andrea; Levantino, Maurizio; Berchiolli, Raffaella; Basolo, Fulvio; Bortolotti, Uberto

    2016-01-01

    We describe a 74-year-old male patient with an intimal sarcoma of the descending aorta mimicking aortitis. The patient presented with lower back pain, fever, and increased C-reactive protein, erythrocyte sedimentation rate, and immunoglobulin G4 (IgG4) serum levels, together with Staphylococcus epidermidis-positive blood cultures. These findings, together with evidence of a 49-mm pseudoaneurysm of the descending thoracic aorta, caused us to suspect aortitis. However, postoperative histology and immunohistochemistry demonstrated the presence of an intimal aortic sarcoma. At the 8-month follow-up, local recurrence of the neoplasm and lung metastases were noted. PMID:28097198

  10. Klebsiella pneumoniae pharyngitis mimicking malignancy: a diagnostic dilemma.

    PubMed

    Yeh, C-F; Li, W-Y; Hsu, Y-B

    2014-12-01

    Acute pharyngitis is a common disease. However, acute pharyngitis caused by Klebsiella pneumoniae with a gross appearance mimicking hypopharyngeal malignancy has never previously been reported. We report the case of a 57-year-old man with a right hypopharyngeal tumor which was disclosed by fiberoptic laryngoscopy and computed tomography scan. However, both the frozen and final pathologies showed no evidence of malignant cells, and a bacterial culture revealed the growth of K. pneumoniae. The hypopharyngeal lesion completely regressed after 2 weeks of antibiotic treatment. Clinicians should perform biopsy along with tissue culture for tumor-like lesions because infectious agents can lead to lesions with malignancy-like appearance.

  11. A case of generalized ostraceous psoriasis mimicking dermatitis neglecta.

    PubMed

    Nascimento, Bianca Angelina Macêdo do; Carvalho, Alessandra Haber; Dias, Carolina Moraes; Lage, Thaiane Lima; Carneiro, Clívia Maria Oliveira; Bittencourt, Maraya de Jesus Semblano

    2015-01-01

    Lithium has been implicated in the exacerbation of pre-existing psoriasis, in the induction of psoriasis on previously uninvolved skin of psoriasis patients, and in the triggering of psoriasis for the first time in patients without a personal or family history. Lithium-induced psoriasis (and its resistance to treatment) is one of the major reasons for noncompliance in patients treated with lithium. We describe a male patient who developed generalized ostraceous psoriasis whose clinical appearance mimicked dermatitis neglecta, 10 months after starting therapy with lithium.

  12. Hepatitis A infection mimicking adult onset Still's disease.

    PubMed

    Sridharan, S; Mossad, S; Hoffman, G

    2000-07-01

    Fever, rash, and arthritis may be components of the prodrome of viral hepatitis. In the absence of jaundice and abnormal liver function tests, this form of polyarthritis is easily confused with primary autoimmune diseases. Whereas the association of systemic illness with musculoskeletal symptoms and numerous viral infections is well known, such an association with hepatitis A has only been rarely reported. We describe a case of hepatitis A infection mimicking adult onset Still's disease, and review the pathogenesis and differential diagnosis of Still's disease and the extraarticular manifestations of hepatitis.

  13. Subacute combined degeneration mimicking traumatic spinal cord injury.

    PubMed

    Paul, Ian; Reichard, R Ross

    2009-03-01

    Subacute combined degeneration (SCD) of the spinal cord is the most common neurologic manifestation of vitamin B12 (cobalamin) deficiency and is usually secondary to autoimmune gastritis, but may also be seen in malnutrition syndromes such as chronic alcoholism, strict vegetarianism, gastrectomy, and also in nitrous oxide abuse. Although traumatic spinal cord injury is routinely encountered in the medical examiner's office, medical causes of spinal cord abnormalities such as SCD should be considered in the appropriate clinical setting. We report a case of alcohol-associated SCD mimicking traumatic spinal cord injury.

  14. Endometriosis after surgical menopause mimicking pelvic malignancy: surgeons' predicament.

    PubMed

    Bhat, Rani A; Teo, Melissa; Bhat, Akhil Krishnanand

    2014-05-01

    Prevalence of persistent endometriosis in women after menopause without any hormonal replacement therapy is very rare. This is a case of a woman with previous history of total hysterectomy and bilateral salpingo-oophorectomy for endometriosis who presented with hemoperitoneum, vaginal bleeding, pelvic mass, and pulmonary thromboembolism mimicking as rectovaginal septum carcinoma. This is the first case report with a unique mode of presentation wherein the patient presented with hemoperitoneum requiring emergency embolization of the vessel to stabilize the patient. She underwent en bloc resection of the tumor with high anterior resection of the rectum. Histopathology confirmed endometriosis.

  15. Endometriosis After Surgical Menopause Mimicking Pelvic Malignancy: Surgeons’ Predicament

    PubMed Central

    Bhat, Rani A.; Teo, Melissa; Bhat, Akhil Krishnanand

    2014-01-01

    Prevalence of persistent endometriosis in women after menopause without any hormonal replacement therapy is very rare. This is a case of a woman with previous history of total hysterectomy and bilateral salpingo-oophorectomy for endometriosis who presented with hemoperitoneum, vaginal bleeding, pelvic mass, and pulmonary thromboembolism mimicking as rectovaginal septum carcinoma. This is the first case report with a unique mode of presentation wherein the patient presented with hemoperitoneum requiring emergency embolization of the vessel to stabilize the patient. She underwent en bloc resection of the tumor with high anterior resection of the rectum. Histopathology confirmed endometriosis. PMID:24936277

  16. A case of generalized ostraceous psoriasis mimicking dermatitis neglecta*

    PubMed Central

    do Nascimento, Bianca Angelina Macêdo; Carvalho, Alessandra Haber; Dias, Carolina Moraes; Lage, Thaiane Lima; Carneiro, Clívia Maria Oliveira; Bittencourt, Maraya de Jesus Semblano

    2015-01-01

    Lithium has been implicated in the exacerbation of pre-existing psoriasis, in the induction of psoriasis on previously uninvolved skin of psoriasis patients, and in the triggering of psoriasis for the first time in patients without a personal or family history. Lithium-induced psoriasis (and its resistance to treatment) is one of the major reasons for noncompliance in patients treated with lithium. We describe a male patient who developed generalized ostraceous psoriasis whose clinical appearance mimicked dermatitis neglecta, 10 months after starting therapy with lithium. PMID:26312715

  17. Anisotropic microstructured poly(vinyl alcohol) tissue-mimicking phantoms.

    PubMed

    Dawson, Andrew; Harris, Paul; Gouws, Gideon

    2010-07-01

    Novel microstructured PVA phantoms mimicking fibrous tissues have been developed using a simple freeze-casting process. Scanning electron micrographs reveal highly anisotropic microstructure with dimensions of the order of 5 to 100 microm. Characterization of an example phantom revealed acoustic properties consistent with those found in fibrous tissues. At 20 MHz, the velocity measured parallel to the microstructure orientation of 1555 ms(-1) was significantly greater than that perpendicular to the microstructure of 1537 ms(-1). The attenuation coefficient was measured to be 5 dBxmm(-1) and proportional to the 1.6 power of frequency, which is in good agreement with that for normal human myocardium.

  18. Giant submandibular gland duct sialolith mimicking an impacted canine tooth

    PubMed Central

    Bhullar, Ramandeep Singh; Dhawan, Amit; Bhullar, Kanwalpreet; Malhotra, Sonia

    2015-01-01

    Sialolithiasis is the most common disease affecting the salivary glands and accounts for 80% of salivary gland disorders. Chronic sialolithiasis promotes stone formation. Size of the salivary stones may range from 0.1 mm to 30 mm or be even bigger. Those salivary stones, the size of which exceeds 15 mm in any one dimension or 1 g in weight are classified as giant sialoliths. Giant sialoliths of the submandibular gland duct are rarely reported. Here, we report a case of a giant sialolith of the submandibular gland duct mimicking an impacted mandibular canine tooth on routine radiographic examination and its surgical management through an intraoral approach. PMID:26668461

  19. Tissue-Mimicking Materials Using Segmented Polyurethane Gel and Their Acoustic Properties

    NASA Astrophysics Data System (ADS)

    Yoshida, Tomoji; Tanaka, Kouhei; Kondo, Toshio; Yasukawa, Kazuhiro; Miyamoto, Nobuaki; Taniguchi, Masahiko; Shikinami, Yasuo

    2012-07-01

    Accurate testing of an instrument by phantoms requires a tissue-mimicking material that has the acoustic velocity and density defined in the International Electrotechnical Commission (IEC) standard, and furthermore the tissue-mimicking material must be stable over time. To achieve the tissue-mimicking materials with the desired acoustic velocity and density defined in the IEC standard, new materials have been developed. The form of tissue-mimicking materials reported comprised polystyrene and poly(methyl methacrylate) (PMMA) particles dispersed in segmented polyurethane gel. They were stable over a period of 40 days and the changes in weight and acoustic velocity did not exceed 0.5%.

  20. Multiorgan Involvement of Chemotherapy-Induced Sarcoidosis Mimicking Progression of Lymphoma on FDG PET/CT.

    PubMed

    Sanan, Prateek; Lu, Yang

    2017-09-01

    A 35-year-old woman with biopsy-proven recurrent Hodgkin lymphoma in the neck lymph nodes received salvage chemotherapy of brentuximab/insulin growth factor-methotrexate. Although the patient continued doing well clinically with no constitutional symptoms or significant laboratory abnormalities following the second recurrence, subsequent FDG PET CT examinations over the next 2 years revealed multiple new FDG-avid foci including lymph nodes above/below the diaphragm, liver, spleen, lungs, and bone. An alternate diagnosis of chemotherapy-induced sarcoidosis was suggested and confirmed on both bone marrow and right inguinal node biopsy.

  1. Characterization of various tissue mimicking materials for medical ultrasound imaging

    NASA Astrophysics Data System (ADS)

    Thouvenot, Audrey; Poepping, Tamie; Peters, Terry M.; Chen, Elvis C. S.

    2016-04-01

    Tissue mimicking materials are physical constructs exhibiting certain desired properties, which are used in machine calibration, medical imaging research, surgical planning, training, and simulation. For medical ultrasound, those specific properties include acoustic propagation speed and attenuation coefficient over the diagnostic frequency range. We investigated the acoustic characteristics of polyvinyl chloride (PVC) plastisol, polydimethylsiloxane (PDMS), and isopropanol using a time-of-light technique, where a pulse was passed through a sample of known thickness contained in a water bath. The propagation speed in PVC is approximately 1400ms-1 depending on the exact chemical composition, with the attenuation coefficient ranging from 0:35 dB cm-1 at 1MHz to 10:57 dB cm-1 at 9 MHz. The propagation speed in PDMS is in the range of 1100ms-1, with an attenuation coefficient of 1:28 dB cm-1 at 1MHz to 21:22 dB cm-1 at 9 MHz. At room temperature (22 °C), a mixture of water-isopropanol (7:25% isopropanol by volume) exhibits a propagation speed of 1540ms-1, making it an excellent and inexpensive tissue-mimicking liquid for medical ultrasound imaging.

  2. Circumscribed choroidal haemangioma mimicking chronic central serous chorioretinopathy.

    PubMed

    Rahman, W; Horgan, N; Hungerford, J

    2013-03-01

    We describe a rare case of bilateral circumscribed choroidal haemangioma in an otherwise healthy male, which mimicked chronic central serous chorioretinopathy (CSCR). A 52-year-old Asian man presented with a one-year history of visual decline in his left eye. The vision in the right eye had been reduced for 15 years. Visual acuity was 6/60 in the right eye and 6/18 in the left eye. Fundus examination of the right eye revealed an area of discoloration with overlying retinal pigment epithelial changes in the macula and evidence of prior surrounding argon laser photocoagulation. The left macula showed a raised choroidal lesion with overlying retinal pigment epithelial changes and associated subretinal fluid. This appearance illustrates how chronic retinal pigment epithelial alterations associated with longstanding subretinal fluid exudation from circumscribed choroidal haemangiomas may mimick the appearance of chronic central serous chorioretinopathy. B-scan ultrasonography, fluorescein angiography, indocyanine green angiography and optical coherence tomography helped to establish the diagnosis. The active lesion in the left eye was treated with verteporfin photodynamic therapy with improvement in vision.

  3. Tissue-mimicking phantoms for photoacoustic and ultrasonic imaging

    PubMed Central

    Cook, Jason R.; Bouchard, Richard R.; Emelianov, Stanislav Y.

    2011-01-01

    In both photoacoustic (PA) and ultrasonic (US) imaging, overall image quality is influenced by the optical and acoustical properties of the medium. Consequently, with the increased use of combined PA and US (PAUS) imaging in preclinical and clinical applications, the ability to provide phantoms that are capable of mimicking desired properties of soft tissues is critical. To this end, gelatin-based phantoms were constructed with various additives to provide realistic acoustic and optical properties. Forty-micron, spherical silica particles were used to induce acoustic scattering, Intralipid® 20% IV fat emulsion was employed to enhance optical scattering and ultrasonic attenuation, while India Ink, Direct Red 81, and Evans blue dyes were utilized to achieve optical absorption typical of soft tissues. The following parameters were then measured in each phantom formulation: speed of sound, acoustic attenuation (from 6 to 22 MHz), acoustic backscatter coefficient (from 6 to 22 MHz), optical absorption (from 400 nm to 1300 nm), and optical scattering (from 400 nm to 1300 nm). Results from these measurements were then compared to similar measurements, which are offered by the literature, for various soft tissue types. Based on these comparisons, it was shown that a reasonably accurate tissue-mimicking phantom could be constructed using a gelatin base with the aforementioned additives. Thus, it is possible to construct a phantom that mimics specific tissue acoustical and/or optical properties for the purpose of PAUS imaging studies. PMID:22076278

  4. Spontaneous motor entrainment to music in multiple vocal mimicking species.

    PubMed

    Schachner, Adena; Brady, Timothy F; Pepperberg, Irene M; Hauser, Marc D

    2009-05-26

    The human capacity for music consists of certain core phenomena, including the tendency to entrain, or align movement, to an external auditory pulse [1-3]. This ability, fundamental both for music production and for coordinated dance, has been repeatedly highlighted as uniquely human [4-11]. However, it has recently been hypothesized that entrainment evolved as a by-product of vocal mimicry, generating the strong prediction that only vocal mimicking animals may be able to entrain [12, 13]. Here we provide comparative data demonstrating the existence of two proficient vocal mimicking nonhuman animals (parrots) that entrain to music, spontaneously producing synchronized movements resembling human dance. We also provide an extensive comparative data set from a global video database systematically analyzed for evidence of entrainment in hundreds of species both capable and incapable of vocal mimicry. Despite the higher representation of vocal nonmimics in the database and comparable exposure of mimics and nonmimics to humans and music, only vocal mimics showed evidence of entrainment. We conclude that entrainment is not unique to humans and that the distribution of entrainment across species supports the hypothesis that entrainment evolved as a by-product of selection for vocal mimicry.

  5. Acute chylous ascites mimicking acute appendicitis in a patient with pancreatitis.

    PubMed

    Smith, Emily K; Ek, Edmund; Croagh, Daniel; Spain, Lavinia A; Farrell, Stephen

    2009-10-14

    We report a case of acute chylous peritonitis mimicking acute appendicitis in a man with acute on chronic pancreatitis. Pancreatitis, both acute and chronic, causing the development of acute chylous ascites and peritonitis has rarely been reported in the English literature. This is the fourth published case of acute chylous ascites mimicking acute appendicitis in the literature.

  6. Intussusception of Rectosigmoid Colon Cancer Mimicking a Pedunculated Tumor

    PubMed Central

    Saigusa, Susumu; Ohi, Masaki; Imaoka, Hiroki; Shimura, Tadanobu; Inoue, Yasuhiro; Kusunoki, Masato

    2014-01-01

    Intussusception in adults is a rare phenomenon involving the colon in approximately 20% of cases. A 65-year-old man was hospitalized with anorexia, anemia, dehydration, and melena. Digital rectal examination revealed a palpable mass approximately 5 cm from the anal verge. The mass moved between the rectosigmoid colon and the rectum below the peritoneal reflection during radiographic examinations and during sigmoidoscopy. We strongly suspected a rectosigmoid pedunculated tumor and performed a low anterior resection. Intraoperatively we observed intussusception of the rectosigmoid colon with easy manual reduction. The tumor was palpable in the rectosigmoid colon. The postoperative course was uneventful. This case illustrates intussusception of a rectosigmoid type 1 colon adenocarcinoma mimicking a pedunculated tumor. PMID:24963434

  7. Sarcoidosis mimicking a venous ulcer: a case report.

    PubMed

    Joshi, Smita S; Romanelli, Paolo; Kirsner, Robert S

    2009-11-01

    Sarcoidosis--a chronic, multisystem disease of unknown etiology characterized by noncaseating granulomas--may cause ulcerative lesions, particularly in African American women. A case of ulcerative sarcoidosis mimicking a venous ulcer is presented. The patient is a 44-year-old African American hypertensive, obese woman with a nonhealing medially based lower leg ulcer of 3 years' duration clinically consistent with a venous ulcer. The ulcer did not heal with compression therapy and pentoxifylline. Subsequent biopsies showed granulomatous inflammation consistent with sarcoidosis. When intralesional triamcinolone was added to compression therapy, the ulcer resolved after 3 months. Given its propensity toward formation on the lower extremities and ulcerative and atrophic appearance, ulcerative sarcoidosis should be considered in the differential diagnosis of a venous ulcer refractory to standard therapy, especially in African American women.

  8. Optofluidic phantom mimicking optical properties of porcine livers

    PubMed Central

    Long, Ruiqi; King, Travis; Akl, Tony; Ericson, M. Nance; Wilson, Mark; Coté, Gerard L.; McShane, Michael J.

    2011-01-01

    One strategy for assessing efficacy of a liver transplant is to monitor perfusion and oxygenation after transplantation. An implantable optical sensor is being developed to overcome inadequacies of current monitoring approaches. To facilitate sensor design while minimizing animal use, a polydimethylsiloxane (PDMS)-based liver phantom was developed to mimic the optical properties of porcine liver in the 630-1000 nm wavelength range and the anatomical geometry of liver parenchyma. Using soft lithography to construct microfluidic channels in pigmented elastomer enabled the 2D approximation of hexagonal liver lobules with 15mm sinusoidal channels, which will allow perfusion with blood-mimicking fluids to facilitate the development of the liver perfusion and oxygenation monitoring system. PMID:21750766

  9. An Adolescent Patient with Scabies Mimicking Gottron Papules.

    PubMed

    Yoshinaga, Eiji; Oiso, Naoki; Kawara, Shigeru; Kawada, Akira

    2009-01-13

    Atypical features of scabies occur in infants and children and patients with prolonged use of corticosteroids or immunosuppression. We report a non-immunosuppressed 15-year-old female case of scabies showing scaly reddish papules over the proximal interphalangeal joints mimicking Gottron papules in classic dermatomyositis. Periungal erythema was also seen. Four months' topical corticosteroids from previous clinics had been used. Dermoscopic findings were consistent with typical pictures of scabies. Scraping of hand crusts demonstrated scabies mites and ova. Skin lesions of the patient were cured with oral ivermectin and topical 10% crotamiton. This case suggests that a lesion resembling Gottron papules may be added to the panel of unusual presentations of scabies.

  10. An Adolescent Patient with Scabies Mimicking Gottron Papules

    PubMed Central

    Yoshinaga, Eiji; Oiso, Naoki; Kawara, Shigeru; Kawada, Akira

    2010-01-01

    Atypical features of scabies occur in infants and children and patients with prolonged use of corticosteroids or immunosuppression. We report a non-immunosuppressed 15-year-old female case of scabies showing scaly reddish papules over the proximal interphalangeal joints mimicking Gottron papules in classic dermatomyositis. Periungal erythema was also seen. Four months’ topical corticosteroids from previous clinics had been used. Dermoscopic findings were consistent with typical pictures of scabies. Scraping of hand crusts demonstrated scabies mites and ova. Skin lesions of the patient were cured with oral ivermectin and topical 10% crotamiton. This case suggests that a lesion resembling Gottron papules may be added to the panel of unusual presentations of scabies. PMID:21173918

  11. Dense Deposit Disease Mimicking a Renal Small Vessel Vasculitis

    PubMed Central

    Singh, Lavleen; Bhardwaj, Swati; Sinha, Aditi; Bagga, Arvind; Dinda, Amit

    2016-01-01

    Dense deposit disease is caused by fluid-phase dysregulation of the alternative complement pathway and frequently deviates from the classic membranoproliferative pattern of injury on light microscopy. Other patterns of injury described for dense deposit disease include mesangioproliferative, acute proliferative/exudative, and crescentic GN. Regardless of the histologic pattern, C3 glomerulopathy, which includes dense deposit disease and C3 GN, is defined by immunofluorescence intensity of C3c two or more orders of magnitude greater than any other immune reactant (on a 0–3 scale). Ultrastructural appearances distinguish dense deposit disease and C3 GN. Focal and segmental necrotizing glomerular lesions with crescents, mimicking a small vessel vasculitis such as ANCA-associated GN, are a very rare manifestation of dense deposit disease. We describe our experience with this unusual histologic presentation and distinct clinical course of dense deposit disease, discuss the pitfalls in diagnosis, examine differential diagnoses, and review the relevant literature. PMID:26361799

  12. Subungual onycholemmal cyst of the toenail mimicking subungual melanoma.

    PubMed

    Busquets, Joanna; Banala, Mounica; Campanelli, Carmen; Sahu, Joya; Lee, Jason B

    2016-08-01

    This report highlights a rare case of a woman with horizontal ridging and tenderness of the right great toenail associated with dyspigmentation of 5 years' duration. Histopathology revealed a cystic structure with an epithelial lining mostly reminiscent of an isthmus-catagen cyst admixed with the presence of both an intermittent, focal granular layer and an eosinophilic cuticle surrounding pink, laminated keratin, most consistent with a diagnosis of subungual onycholemmal cyst (SOC). It is a rare and distinctive nail abnormality occurring in the dermis of the nail bed. We present a case of an SOC in the toenail mimicking subungual malignant melanoma, which may be an underrecognized and common entity that must be considered when discussing tumors of the nail unit, especially subungual melanoma.

  13. Somatostatin-secreting Pheochromocytoma Mimicking Insulin-dependent Diabetes Mellitus

    PubMed Central

    Hirai, Hiroyuki; Midorikawa, Sanae; Suzuki, Shinichi; Sasano, Hironobu; Watanabe, Tsuyoshi; Satoh, Hiroaki

    2016-01-01

    We herein present the findings of a 42-year-old woman with either adrenal pheochromocytoma or intraadrenal paraganglioma that simultaneously secreted somatostatin, thus mimicking insulin-dependent diabetes mellitus. Pheochromocytoma was clinically diagnosed based on scintigraphy, elevated catecholamine levels, and finally a histopathological analysis of resected specimens. The patient had diabetic ketosis, requiring 40 U insulin for treatment. Following laparoscopic adrenalectomy, insulin therapy was discontinued and the urinary c-peptide levels changed from 5.5-9.0 to 81.3-87.0 μg/day. Histologically, somatostatin immunoreactivity was detected and the somatostatin levels were elevated in the serum-like fluid obtained from the tumor. Clinicians should be aware of the possible occurrence of simultaneous ectopic hormone secretion in patients with pheochromocytoma. PMID:27746437

  14. Somatostatin-secreting Pheochromocytoma Mimicking Insulin-dependent Diabetes Mellitus.

    PubMed

    Hirai, Hiroyuki; Midorikawa, Sanae; Suzuki, Shinichi; Sasano, Hironobu; Watanabe, Tsuyoshi; Satoh, Hiroaki

    We herein present the findings of a 42-year-old woman with either adrenal pheochromocytoma or intraadrenal paraganglioma that simultaneously secreted somatostatin, thus mimicking insulin-dependent diabetes mellitus. Pheochromocytoma was clinically diagnosed based on scintigraphy, elevated catecholamine levels, and finally a histopathological analysis of resected specimens. The patient had diabetic ketosis, requiring 40 U insulin for treatment. Following laparoscopic adrenalectomy, insulin therapy was discontinued and the urinary c-peptide levels changed from 5.5-9.0 to 81.3-87.0 μg/day. Histologically, somatostatin immunoreactivity was detected and the somatostatin levels were elevated in the serum-like fluid obtained from the tumor. Clinicians should be aware of the possible occurrence of simultaneous ectopic hormone secretion in patients with pheochromocytoma.

  15. Recurrent histoplasmosis in AIDS mimicking a colonic carcinoma.

    PubMed

    Aisenberg, G; Marcos, L A; Ogbaa, I

    2009-06-01

    The prevalence rate of lower gastrointestinal bleeding in patients with AIDS is around 2.6%. A 42-year-old woman with AIDS (CD(4) count 9/microL) and recently treated for disseminated histoplasmosis presented to the emergency room with melena, severe anaemia and fever. A colonoscopy showed an umbilicated colonic nodule mimicking a carcinoma of the colon. The biopsy showed intracytoplasmic microorganisms compatible with Histoplasma capsulatum. She had poor compliance to the itraconazole when discharge on previous admission. Despite the fact that colonic histoplasmosis is uncommon, the mortality rate is around 8% and clinicians should be aware of the clinical presentation of histoplasmosis when recur, especially in patients not taking the itraconazole for long-term treatment.

  16. [Amputation neuroma mimicking common bile duct cancer: a case report].

    PubMed

    Koh, Dong Wook; Lee, Woo Jin; Kim, Ji Hoon; Choi, Jun-Il; Kim, Seong Hoon; Hong, Eun Kyung; Park, Joong-Won; Kim, Chang-Min

    2008-07-01

    Amputation neuroma or traumatic neuroma is a tumor-like secondary hyperplasia that may develop after an accidental or surgical trauma. Amputation neuroma of the bile duct has occasionally been reported which occurred in the cystic duct stump late after the cholecystectomy. However, even if the amputation neuroma is suspected in a patient with late-onset jaundice after cholecystectomy, the differential diagnosis from a malignancy is difficult preoperatively. We experienced a case of the amputation neuroma of common bile duct (CBD) developed in a 70-year-old man who presented with a polypoid mass in CBD. He had undergone cholecystectomy 25 years ago and choledochojejunostomy 12 years ago, respectively. We have performed pylorus-preserving pancreatico-duodenectomy (PPPD) under the impression of CBD cancer. He had not been diagnosed of amputation neuroma until having undergone PPPD. We report a case of CBD neuroma mimicking CBD cancer, which was confirmed after PPPD.

  17. Liquid optical phantoms mimicking spectral characteristics of laboratory mouse biotissues

    NASA Astrophysics Data System (ADS)

    Loginova, D. A.; Sergeeva, E. A.; Krainov, A. D.; Agrba, P. D.; Kirillin, M. Yu

    2016-06-01

    Optical phantoms mimicking optical properties of real biotissues in the visible and IR spectral regions are developed based on measurements of the spectral characteristics of ex vivo samples of laboratory mouse biotissues. The phantoms are composed of aqueous solutions of Lipofundin, Indian ink and red ink with different spectral characteristics. The deviations of the measured absorption and scattering coefficients of phantoms in the wavelength range 480 - 580 nm from the corresponding values for real biotissues do not exceed 25% and 2%, respectively. For phantoms in the wavelength region 580 - 880 nm, the deviations of the absorption coefficient do not exceed 40% and the deviations of the scattering coefficient do not exceed 25%. These values, in general, fall within the range of variations for different individual mice of one strain.

  18. Mimicking diffuse supernova antineutrinos with the sun as a source

    SciTech Connect

    Raffelt, G. G.; Rashba, T. I.

    2010-04-15

    Measuring the {nu}-bar{sub e} component of the cosmic diffuse supernova neutrino background (DSNB) is the next ambitious goal for low-energy neutrino astronomy. The largest flux is expected in the lowest accessible energy bin. However, for E {<=} 15 MeV a possible signal can be mimicked by a solar {nu}-bar{sub e} flux that originates from the usual {sup 8}B neutrinos by spin-flavor oscillations. We show that such an interpretation is possible within the allowed range of neutrino electromagnetic transition moments and solar turbulent field strengths and distributions. Therefore, an unambiguous detection of the DSNB requires a significant number of events at E {>=} 15 MeV.

  19. Enterobiasis in ectopic locations mimicking tumor-like lesions.

    PubMed

    Pampiglione, Silvio; Rivasi, Francesco

    2009-01-01

    Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on this subject, lamenting the scarce importance given to this parasitosis in university courses of medical schools and in medical textbooks as it is incorrectly considered "out-of-fashion."

  20. Giant cystic sacral schwannoma mimicking tarlov cyst: a case report.

    PubMed

    Attiah, Mark A; Syre, Peter P; Pierce, John; Belyaeva, Elizaveta; Welch, William C

    2016-05-01

    To present a rare case of a giant schwannoma of the sacrum mimicking a Tarlov cyst. A 58-year-old woman had a 1-year history of low back pain. MRI revealed a large cystic mass in the sacral canal with bony erosion. Radiological diagnosis of Tarlov cyst was made. The patient underwent surgical treatment for the lesion, which revealed a solid mass. Histopathological examination of the tumor confirmed the diagnosis of schwannoma. The postoperative course was uneventful and the patient has had significant improvement in her pain 1 month postoperatively. Giant cystic schwannoma of the sacrum is a very rare diagnosis overlooked by practitioners for more common cystic etiologies, but its treatment is significantly different. Care should be taken to include this diagnosis in a differential for a cystic sacral mass.

  1. Eosinophilic Cystitis Mimicking Bladder Tumour – A Rare Case Report

    PubMed Central

    D, Manimaran; T M, Karthikeyan; M, Sreenivasulu; V R, Mrinalini; V, Gopinath

    2013-01-01

    A 16–year–old male presented with urinary urgency, a frequency of 4 months duration and intermittent gross haematuria which were there since one month. Eosinophilia was noted in complete blood count and CT KUB with contrast showed a filling defect in the right lateral wall, over the vesicoureteric junction. Cystoscopy revealed a sessile mass lesion over right vesico–ureteric junction, with bullous oedema . Rest of the mucosa was normal. Transurethral resection of lesion was performed and histological examination showed features of eosinophilic cystitis. Patient was treated with corticosteroids, antimicrobial agents and antihistaminics and he is recovering well. We are presenting this case for its rare presentation and its possibility of mimicking a bladder tumour. Biopsy of the lesion was diagnostic and an early treatment showed good results. PMID:24298501

  2. Blood-Mimicking Fluid for Testing Ultrasonic Diagnostic Instrument

    NASA Astrophysics Data System (ADS)

    Tanaka, Kouhei; Yoshida, Tomoji; Sato, Kazuishi; Kondo, Toshio; Yasukawa, Kazuhiro; Miyamoto, Nobuaki; Taniguchi, Masahiko

    2012-07-01

    We present a blood-mimicking fluid (BMF) for the Doppler test object of medical diagnostic instruments. Accurate measurement in a flow Doppler test requires a BMF that has the acoustic velocity and density defined in the International Electrotechnical Commission (IEC) standard, and furthermore, they must be stable over time. To formulate a fluid with the desired density and acoustic velocity, we have developed a new fluid made of glycerine and water-soluble silicone oil. The new BMF includes dispersed polystyrene particles as scatterers. The density of the liquid can be adjusted to maintain it at the same value as that of the polystyrene particles, thus ensuring neutral buoyancy of the particles. The MBF was stable over a period of 2 weeks, during which the density and acoustic velocity did not change.

  3. Dense Deposit Disease Mimicking a Renal Small Vessel Vasculitis.

    PubMed

    Singh, Lavleen; Singh, Geetika; Bhardwaj, Swati; Sinha, Aditi; Bagga, Arvind; Dinda, Amit

    2016-01-01

    Dense deposit disease is caused by fluid-phase dysregulation of the alternative complement pathway and frequently deviates from the classic membranoproliferative pattern of injury on light microscopy. Other patterns of injury described for dense deposit disease include mesangioproliferative, acute proliferative/exudative, and crescentic GN. Regardless of the histologic pattern, C3 glomerulopathy, which includes dense deposit disease and C3 GN, is defined by immunofluorescence intensity of C3c two or more orders of magnitude greater than any other immune reactant (on a 0-3 scale). Ultrastructural appearances distinguish dense deposit disease and C3 GN. Focal and segmental necrotizing glomerular lesions with crescents, mimicking a small vessel vasculitis such as ANCA-associated GN, are a very rare manifestation of dense deposit disease. We describe our experience with this unusual histologic presentation and distinct clinical course of dense deposit disease, discuss the pitfalls in diagnosis, examine differential diagnoses, and review the relevant literature.

  4. Isolated angiitis in the hypothalamus mimicking brain tumor.

    PubMed

    Tsutsumi, Satoshi; Ito, Masanori; Yasumoto, Yukimasa; Kaneda, Kazuhiko

    2008-01-01

    A 64-year-old female presented with exaggerating somnolence without contributory medical and lifestyle histories. She was not aware of any preceding infection or headache. Cerebral magnetic resonance imaging demonstrated an isolated enhanced mass in the hypothalamus without meningeal enhancement. Blood and cerebrospinal fluid examinations showed no significant findings except for hypernatremia and hyperprolactinemia. She underwent an open biopsy via the interhemispheric route. Histological examination revealed marked perivascular lymphocytic aggregation with polyclonal immunostaining both for B and T lymphocytes. No findings suggestive of underlying malignancy were recognized. Extensive work-up aiming at systemic vasculitis and lymphoma revealed no signs of extracranial lesion, so the most probable diagnosis was isolated angiitis in the hypothalamus. Angiitis may originate from the hypothalamus and should be considered in the differential diagnosis of hypothalamic lesion mimicking brain tumor on neuroimaging.

  5. An ideal blood mimicking fluid for doppler ultrasound phantoms.

    PubMed

    Samavat, H; Evans, J A

    2006-10-01

    In order to investigate the problems of detecting tumours by ultrasound it is very important to have a portable Doppler flow test object to use as a standardising tool. The flow Doppler test objects are intended to mimic the flow in human arteries. To make the test meaningful, the acoustic properties of the main test object components (tissue and blood mimic) should match closely the properties of the corresponding human tissues, while the tube should ideally have little influence. The blood mimic should also represent the haemodynamic properties of blood. An acceptable flow test object has been designed to closely mimic blood flow in arteries. We have evaluated the properties of three blood mimicking fluid: two have been described recently in the literature, the third is a local design. One of these has emerged as being particularly well matched to the necessary characteristics for in-vitro work.

  6. Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer.

    PubMed

    Białek, Waldemar; Rudzki, Sławomir; Iberszer, Paweł; Wronecki, Lech

    2016-12-01

    Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin.

  7. Surgicel® granuloma mimicking ovarian cancer: A case report

    PubMed Central

    Cormio, Luigi; Cormio, Gennaro; Di Fino, Giuseppe; Scavone, Carmen; Sanguedolce, Francesca; Loizzi, Vera; Carrieri, Giuseppe

    2016-01-01

    Surgicel® is an absorbable sterile mesh composed of oxidized cellulose that is used to control intraoperative capillary or venous bleeding, due to its capacity to bind hemoglobin, thus allowing the formation of an artificial clot. In the present study, a large granuloma mimicking ovarian cancer, which developed following placement of a Surgicel® sponge during a combined pubovaginal sling procedure and cystocele repair, is reported. The aim of the present case report is to emphasize the fact that hemostatic measures should be removed following their use, and to alert surgeons to the risk of using and leaving in situ oxidized cellulose. Furthermore, accurate evaluation of the surgical history of the patient should always be performed prior to attempting surgery. PMID:27446398

  8. Enzyme-Mimicking properties of silicates and other minerals

    NASA Astrophysics Data System (ADS)

    Siegel, B. Z.; Siegel, S. M.

    The adsorptive and/or catalytic properties of clays, silicates in general, and other minerals are well known. More recently, their probable role in prebiotic syntheses of bio-organic compounds has become a matter of record. We demonstrate that, in addition to their role in de novo formation of important biomolecules, clays, micas, fibrous silicates and other minerals mimick the activities of contemporary enzymes including oxidases, esterases, phosphatases and glucosidases. The existence of such capabilities in substances likely to be represented on the surfaces of Earth-like planets may offer a challenge to the technology and design of remote life detection systems which must then distinguish between bona fide biological chemistry and mineral-base pseudometabolism. It also raises questions about the importance of mineral surfaces in post-mortem transformations of organic metabolites in our own biosphere.

  9. A Rare Presentation of Peritoneal Tuberculosis Mimicking Malignancy

    PubMed Central

    Swe, Thein; Naing, Akari Thein; Phyo, Zaw Win; Thwin, Malar

    2016-01-01

    Our search of literature revealed combined elevations of serum cancer antigen 125 levels and rheumatoid factor levels in a patient with peritoneal tuberculosis has rarely been reported. Thus, we describe the case of a 63-year-old female with large abdominal ascites and malignancy was ruled out with biopsy. High levels of serum cancer antigen and rheumatoid factor were noted. Physicians should be aware that tuberculosis infection could induce elevation of rheumatoid factor levels in the absence of rheumatologic symptoms or disease. A high index of suspicion is required because peritoneal tuberculosis is a great mimicker of other abdominal pathology, especially intraabdominal malignancies and can mislead physicians to undergo unnecessary interventions. PMID:27900335

  10. Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer

    PubMed Central

    Rudzki, Sławomir; Iberszer, Paweł; Wronecki, Lech

    2016-01-01

    Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin. PMID:28138411

  11. Mimicking biological stress-strain behaviour with synthetic elastomers.

    PubMed

    Vatankhah-Varnosfaderani, Mohammad; Daniel, William F M; Everhart, Matthew H; Pandya, Ashish A; Liang, Heyi; Matyjaszewski, Krzysztof; Dobrynin, Andrey V; Sheiko, Sergei S

    2017-09-28

    Despite the versatility of synthetic chemistry, certain combinations of mechanical softness, strength, and toughness can be difficult to achieve in a single material. These combinations are, however, commonplace in biological tissues, and are therefore needed for applications such as medical implants, tissue engineering, soft robotics, and wearable electronics. Present materials synthesis strategies are predominantly Edisonian, involving the empirical mixing of assorted monomers, crosslinking schemes, and occluded swelling agents, but this approach yields limited property control. Here we present a general strategy for mimicking the mechanical behaviour of biological materials by precisely encoding their stress-strain curves in solvent-free brush- and comb-like polymer networks (elastomers). The code consists of three independent architectural parameters-network strand length, side-chain length and grafting density. Using prototypical poly(dimethylsiloxane) elastomers, we illustrate how this parametric triplet enables the replication of the strain-stiffening characteristics of jellyfish, lung, and arterial tissues.

  12. Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock.

    PubMed

    Bourcier, Simon; Mongardon, Nicolas; Daviaud, Fabrice; Moachon, Laurence; Arnould, Marc-Antoine; Perruche, Franck; Pène, Frédéric; Cariou, Alain

    2013-01-01

    Shock is a common reason for medical intensive care unit admission, with septic and cardiogenic accounting for most of the etiologies. However, the potential severity of adverse side effects of drugs indicates that any medication should be carefully scrutinized for potential pharmacokinetic and pharmacodynamic interactions that may result. We herein report the case of a life-threatening shock mimicking successively anaphylactic, cardiogenic, and septic shock, which was finally related to disulfiram ethanol reaction. Indeed, disulfiram ethanol reaction is known to provoke unpleasant symptoms through vasodilatation in various organs. However, extreme manifestations of vasodilatory shock may lead to circulatory failure and lactic acidosis. Because of large prevalence of alcoholism and disulfiram medication, emergency physicians and medical specialists should be aware of this life-threatening condition, with its misleading presentation.

  13. Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report

    PubMed Central

    Monteiro, Bárbara Vanessa de Brito; Grempel, Rafael Grotta; Gomes, Daliana Queiroga de Castro; Godoy, Gustavo Pina; Miguel, Márcia Cristina da Costa

    2013-01-01

    Introduction Adenoid cystic carcinoma (ACC) is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site. PMID:25992095

  14. Tissue-mimicking gel phantoms for thermal therapy studies.

    PubMed

    Dabbagh, Ali; Abdullah, Basri Johan Jeet; Ramasindarum, Chanthiriga; Abu Kasim, Noor Hayaty

    2014-10-01

    Tissue-mimicking phantoms that are currently available for routine biomedical applications may not be suitable for high-temperature experiments or calibration of thermal modalities. Therefore, design and fabrication of customized thermal phantoms with tailored properties are necessary for thermal therapy studies. A multitude of thermal phantoms have been developed in liquid, solid, and gel forms to simulate biological tissues in thermal therapy experiments. This article is an attempt to outline the various materials and techniques used to prepare thermal phantoms in the gel state. The relevant thermal, electrical, acoustic, and optical properties of these phantoms are presented in detail and the benefits and shortcomings of each type are discussed. This review could assist the researchers in the selection of appropriate phantom recipes for their in vitro study of thermal modalities and highlight the limitations of current phantom recipes that remain to be addressed in further studies. © The Author(s) 2014.

  15. Oropharyngeal trauma mimicking a first branchial cleft anomaly.

    PubMed

    Larem, Aisha; Sheikh, Rashid; Al Qahtani, Abdulsalam; Khais, Frat; Ganesan, Shanmugam; Haidar, Hassan

    2016-06-01

    We present a unique and challenging case of a remnant foreign body that presented to us in a child disguised as a strongly suspected congenital branchial cleft anomaly. This case entailed oropharyngeal trauma, with a delayed presentation as a retroauricular cyst accompanied by otorrhea that mimicked the classic presentation of an infected first branchial cleft anomaly. During surgical excision of the presumed branchial anomaly, a large wooden stick was found in the tract. The diagnostic and therapeutic obstacles in the management of such cases are highlighted. In addition to exploring the existing literature, we retrospectively analyzed a plausible explanation of the findings of this case. Laryngoscope, 126:E224-E226, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Multi-modality tissue-mimicking phantom for thermal therapy.

    PubMed

    McDonald, Mark; Lochhead, Shanna; Chopra, Rajiv; Bronskill, Michael J

    2004-07-07

    A tissue-mimicking phantom material has been developed for use with thermal therapy devices and techniques. This material has magnetic resonance properties (primarily T2) which change drastically upon thermal coagulation, enabling its use for device characterization and treatment verification using simple T2-weighted imaging techniques. The coagulation temperature of the phantom can be changed from 50-60 degrees C by adjusting the pH from 4.3 to 4.7. The energy absorption properties can be adjusted to match the acoustical and optical properties of tissues. T2 relaxation measurements are provided as a function of temperature, along with T2-weighted MR images to illustrate the visualization of heating patterns. A complete recipe for fabricating phantoms is provided.

  17. Mesenteric lymphangioma mimicking a cystic ovarian mass on imaging.

    PubMed

    Hitzerd, Emilie; van Hamont, Dennis; Pijnenborg, Johanna M A

    2016-02-01

    Pelvic cystic masses are frequently observed in women. Most lesions are benign and of ovarian origin. However, non-ovarian lesions can be easily confused with cystic ovarian masses on imaging, which hampers diagnostic and therapeutic management. In this report, a rare case of mesenteric lymphangioma mimicking an ovarian cystic mass, discovered as an incidental finding on orthopaedic MRI in an adult female, is presented. The report highlights the sometimes difficult diagnostic process of pelvic cystic masses, due to an extensive differential diagnosis and the fact that imaging is often inconclusive. Even though most cystic masses are of ovarian origin, non-ovarian causes can mimic ovarian masses and should be considered as differential diagnoses. Surgical exploration may be necessary to exclude malignant causes. 2016 BMJ Publishing Group Ltd.

  18. A salivary gland adenocarcinoma mimicking a microcystic adnexal carcinoma.

    PubMed

    Basile, John R; Lin, Yi-Ling

    2010-04-01

    The microcystic adnexal carcinoma (MAC) is a rare, slow-growing but locally aggressive neoplasm arising in the midface and lips of middle-aged adults. The MAC is histologically characterized by deeply infiltrating nests and islands of basaloid or squamous cells forming cysts and ductal structures, proliferating in a dense sclerotic stroma and occasionally exhibiting perineural invasion. We describe a salivary gland adenocarcinoma arising in the lower lip, characterized by ductal structures and cords, 3-5 cell layers in thickness, set in a dense fibrous stroma and also invading nerves, thus mimicking a MAC in both its clinical and its histopathologic appearance. The diagnostic dilemma presented by this lesion is discussed, along with a differential diagnosis and brief review of the literature.

  19. Huge uterine-cervical diverticulum mimicking as a cyst.

    PubMed

    Chufal, S; Thapliyal, Naveen; Gupta, Manoj; Pangtey, Nirmal

    2012-01-01

    Here we report an incidental huge uterine-cervical diverticulum from a total abdominal hysterectomy specimen in a perimenopausal woman who presented with acute abdominal pain. The diverticulum was mimicking with various cysts present in the lateral side of the female genital tract. Histopathological examination confirmed this to be a cervical diverticulum with communication to uterine cavity through two different openings. They can attain huge size if left ignored for long duration and present a diagnostic challenge to clinicians, radiologists, as well as pathologists because of its extreme rarity. Therefore, diverticula should also be included as a differential diagnosis. Its histopathological confirmation also highlights that diverticula can present as an acute abdomen, requiring early diagnosis with appropriate timely intervention. Immunohistochemistry CD 10 has also been used to differentiate it from a mesonephric cyst.

  20. Optofluidic phantom mimicking optical properties of porcine livers

    SciTech Connect

    Long, Ruiqi; King, Travis; Akl, Tony; Ericson, Milton Nance; Wilson, Mark A.; Cote, Gerard L.; McShane, Michael J.

    2011-01-01

    One strategy for assessing efficacy of a liver transplant is to monitor perfusion and oxygenation after transplantation. An implantable optical sensor is being developed to overcome inadequacies of current monitoring approaches. To facilitate sensor design while minimizing animal use, a polydimethylsiloxane (PDMS)-based liver phantom was developed to mimic the optical properties of porcine liver in the 630-1000 nm wavelength range and the anatomical geometry of liver parenchyma. Using soft lithography to construct microfluidic channels in pigmented elastomer enabled the 2D approximation of hexagonal liver lobules with 15mm sinusoidal channels, which will allow perfusion with blood-mimicking fluids to facilitate the development of the liver perfusion and oxygenation monitoring system.

  1. Radiation-induced anaplastic ependymoma mimicking a skull base meningioma: A case report

    PubMed Central

    SPALLONE, ALDO; MARCHIONE, PASQUALE; DI CAPUA, MARIO; BELVISI, DANIELE

    2016-01-01

    The present study describes the case of a 63-year-old woman presenting with headache, dizziness and vomiting due to a an ovoid mass in the left pre-bulbar cistern, apparently arising from the lower clivus and the foramen magnum. The clinical history revealed the subtotal removal of a right cerebellar low-grade glioma 15 years previously and subsequent conventional 60-Gy radiotherapy. Notably, following gross total resection, histopathological examination showed microscopic features that resulted in a diagnosis of anaplastic ependymoma. The patient underwent surgery to remove the mass and post-operative chemotherapy with temozolomide. A progressive improvement of neurological signs and symptoms was observed during the postoperative course. At the 6-month follow-up, the patient was free from clinical and radiological recurrence. The unusual features of this rare secondary brain tumor were the extrassial location in the posterior fossa, the unusual age-associated location of the histological subtype and the fact that it closely mimicked a skull-base meningioma. PMID:26893630

  2. A Case of Acute Motor Axonal Neuropathy Mimicking Brain Death and Review of the Literature

    PubMed Central

    Ravikumar, Sandhya; Poysophon, Poysophon; Poblete, Roy; Kim-Tenser, May

    2016-01-01

    We describe a case report of fulminant Guillain–Barré syndrome (GBS) mimicking brain death. A previously healthy 60-year-old male was admitted to the neurointensive care unit after developing rapidly progressive weakness and respiratory failure. On presentation, the patient was found to have absent brainstem and spinal cord reflexes resembling that of brain death. Acute motor axonal neuropathy, a subtype of GBS, was diagnosed by cerebrospinal fluid and nerve conduction velocity testing. An electroencephalogram showed that the patient had normal, appropriately reactive brain function. Transcranial Doppler (TCD) ultrasound showed appropriate blood flow to the brain. GBS rarely presents with weakness so severe as to mimic brain death. This article provides a review of similar literature. This case demonstrates the importance of performing a proper brain death examination, which includes evaluation for irreversible cerebral injury, exclusion of any confounding conditions, and performance of tests such as electroencephalography and TCDs when uncertainty exists about the reliability of the clinical exam. PMID:27199887

  3. Acute inflammatory bowel disease complicating chronic alcoholism and mimicking carcinoid syndrome.

    PubMed

    Ballo, Piercarlo; Dattolo, Pietro; Mangialavori, Giuseppe; Ferro, Giuseppe; Fusco, Francesca; Consalvo, Matteo; Chiodi, Leandro; Pizzarelli, Francesco; Zuppiroli, Alfredo

    2012-05-01

    We report the case of a woman with a history of chronic alcohol abuse who was hospitalized with diarrhea, severe hypokalemia refractory to potassium infusion, nausea, vomiting, abdominal pain, alternations of high blood pressure with phases of hypotension, irritability and increased urinary 5-hydroxyindoleacetic acid and cortisol. Although carcinoid syndrome was hypothesized, abdominal computed tomography and colonoscopy showed non-specific inflammatory bowel disease with severe colic wall thickening, and multiple colic biopsies confirmed non-specific inflammation with no evidence of carcinoid cells. During the following days diarrhea slowly decreased and the patient's condition progressively improved. One year after stopping alcohol consumption, the patient was asymptomatic and serum potassium was normal. Chronic alcohol exposure is known to have several deleterious effects on the intestinal mucosa and can favor and sustain local inflammation. Chronic alcohol intake may also be associated with high blood pressure, behavior disorders, abnormalities in blood pressure regulation with episodes of hypotension during hospitalization due to impaired baroreflex sensitivity in the context of an alcohol withdrawal syndrome, increased urinary 5-hydroxyindoleacetic acid as a result of malabsorption syndrome, and increased urinary cortisol as a result of hypothalamic-pituitary-adrenal axis dysregulation. These considerations, together with the regression of symptoms and normalization of potassium levels after stopping alcohol consumption, suggest the intriguing possibility of a alcohol-related acute inflammatory bowel disease mimicking carcinoid syndrome.

  4. Acute Inflammatory Bowel Disease Complicating Chronic Alcoholism and Mimicking Carcinoid Syndrome

    PubMed Central

    Ballo, Piercarlo; Dattolo, Pietro; Mangialavori, Giuseppe; Ferro, Giuseppe; Fusco, Francesca; Consalvo, Matteo; Chiodi, Leandro; Pizzarelli, Francesco; Zuppiroli, Alfredo

    2012-01-01

    We report the case of a woman with a history of chronic alcohol abuse who was hospitalized with diarrhea, severe hypokalemia refractory to potassium infusion, nausea, vomiting, abdominal pain, alternations of high blood pressure with phases of hypotension, irritability and increased urinary 5-hydroxyindoleacetic acid and cortisol. Although carcinoid syndrome was hypothesized, abdominal computed tomography and colonoscopy showed non-specific inflammatory bowel disease with severe colic wall thickening, and multiple colic biopsies confirmed non-specific inflammation with no evidence of carcinoid cells. During the following days diarrhea slowly decreased and the patient's condition progressively improved. One year after stopping alcohol consumption, the patient was asymptomatic and serum potassium was normal. Chronic alcohol exposure is known to have several deleterious effects on the intestinal mucosa and can favor and sustain local inflammation. Chronic alcohol intake may also be associated with high blood pressure, behavior disorders, abnormalities in blood pressure regulation with episodes of hypotension during hospitalization due to impaired baroreflex sensitivity in the context of an alcohol withdrawal syndrome, increased urinary 5-hydroxyindoleacetic acid as a result of malabsorption syndrome, and increased urinary cortisol as a result of hypothalamic-pituitary-adrenal axis dysregulation. These considerations, together with the regression of symptoms and normalization of potassium levels after stopping alcohol consumption, suggest the intriguing possibility of a alcohol-related acute inflammatory bowel disease mimicking carcinoid syndrome. PMID:22949895

  5. Arteriovenous malformation in temporal lobe presenting as contralateral ocular symptoms mimicking carotid-cavernous fistula.

    PubMed

    Mohd-Tahir, Fadzillah; Siti-Raihan, Ishak; Wan Hazabbah, W H

    2013-01-01

    Aim. To report a rare case of arteriovenous malformation in temporal lobe presenting as contralateral orbital symptoms mimicking carotid-cavernous fistula. Method. Interventional case report. Results. A 31-year-old Malay gentleman presented with 2-month history of painful progressive exophthalmos of his left eye associated with recurrent headache, diplopia, and reduced vision. Ocular examination revealed congestive nonpulsating 7 mm exophthalmos of the left eye with no restriction of movements in all direction. There was diplopia in left lateral gaze. Left IOP was elevated at 29 mmHg. Left eye retinal vessels were slightly dilated and tortuous. CT scan was performed and showed right temporal arteriovenous malformation with a nidus of 3.8 cm × 2.5 cm with right middle cerebral artery as feeding artery. There was dilated left superior ophthalmic vein of 0.9 mm in diameter with enlarged left cavernous sinus. MRA and carotid angiogram confirmed right temporal arteriovenous malformation with no carotid-cavernous fistula. Most of the intracranial drainage was via left cavernous sinus. His signs and symptoms dramatically improved following successful embolisation, completely resolved after one year. Conclusion. Intracranial arteriovenous malformation is rarely presented with primary ocular presentation. Early intervention would salvage the eyes and prevent patients from more disaster morbidity or fatality commonly due to intracranial haemorrhage.

  6. Humans mimicking animals: A cortical hierarchy for human vocal communication sounds

    PubMed Central

    Talkington, William J.; Rapuano, Kristina M.; Hitt, Laura; Frum, Chris A.; Lewis, James W.

    2012-01-01

    Numerous species possess cortical regions that are most sensitive to vocalizations produced by their own kind (conspecifics). In humans, the superior temporal sulci (STS) putatively represent homologous voice-sensitive areas of cortex. However, STS regions have recently been reported to represent auditory experience or “expertise” in general rather than showing exclusive sensitivity to human vocalizations per se. Using functional magnetic resonance imaging and a unique non-stereotypical category of complex human non-verbal vocalizations – human-mimicked versions of animal vocalizations – we found a cortical hierarchy in humans optimized for processing meaningful conspecific utterances. This left-lateralized hierarchy originated near primary auditory cortices and progressed into traditional speech-sensitive areas. These results suggest that the cortical regions supporting vocalization perception are initially organized by sensitivity to the human vocal tract in stages prior to the STS. Additionally, these findings have implications for the developmental time course of conspecific vocalization processing in humans as well as its evolutionary origins. PMID:22674283

  7. A Case of Anti-Glomerular Basement Membrane Glomerulonephritis Complicated by Type 1 Diabetes Mellitus, Mimicking Urinary Tract Infection

    PubMed Central

    Aoki, Yoshihiro; Tanimoto, Izumi; Miyauchi, Yoshihiro; Suzuki, Yoshio; Shiojiri, Toshiaki

    2017-01-01

    Patient: Female, 44 Final Diagnosis: Anti-glomerular basement membrane glomerulonephritis Symptoms: Fever Medication: — Clinical Procedure: — Specialty: Nephrology Objective: Rare co-existance of disease or pathology Background: Type 1 diabetes mellitus (DM) tends to complicate other autoimmune diseases. When considering renal dysfunction in patients with DM, diabetic nephropathy is a likely diagnosis. By contrast, anti-glomerular basement membrane (GBM) glomerulonephritis, an autoimmune disease, is one cause of rapidly progressive glomerulonephritis. Case Report: We report the case of a 44-year-old woman diagnosed with anti-glomerular basement membrane (GBM) glomerulonephritis. The diagnosis was made on the basis of serological test results and pathological findings of a renal biopsy. Five years before admission, she was diagnosed with type 1 DM. At admission, she presented with a fever, chills, nausea, low back pain, and malaise, which were followed by progressive renal dysfunction. The initial presentation mimicked a urinary tract infection, which delayed the correct diagnosis. Conclusions: Our patient’s course strongly suggests that rapidly progressive glomerulonephritis should be considered as an early differential diagnosis in cases of progressive renal dysfunction, especially when accompanied by fever, regardless of the underlying disease. PMID:28344312

  8. Primary scattered multifocal melanocytomas in spinal canal mimicking neurofibromatosis.

    PubMed

    Yang, Chenlong; Fang, Jingyi; Li, Guang; Yang, Jun; Xu, Yulun

    2016-08-01

    Meningeal melanocytoma is an extremely rare pigmented tumor derived from leptomeningeal melanocytes. By and large, it is considered to be a well-differentiated and slow-growing benign lesion. Generally, meningeal melanocytomas are solitary lesions, and the occurrence of the primary multifocal form in the central nervous system is exceedingly rare; it has been previously reported in only six cases. The present report illustrates a 41-year-old woman with primary multifocal meningeal melanocytoma in the spinal canal. Contrary to earlier reports, the tumors presented with a scattered appearance mimicking neurofibromatosis. This study is a case report and review of literature. On admission, the cerebral magnetic resonance images of the patient were normal, whereas the spinal magnetic resonance images showed scattered multifocal nodules mimicking neurofibromatosis. Surgical resection of the responsible lesions was scheduled. In addition to this case presentation, relevant previous reports were reviewed, and the challenging diagnosis, management, and prognosis of meningeal melanocytoma are discussed. Gross total resection of the two largest lesions was achieved, and histopathological examinations confirmed the diagnosis. Despite the benign histopathological findings, the patient had an aggressive clinical course. On follow-up at 18 months after surgery, she succumbed to the disease. Clinicians should be alert to a potential aggressive clinical course of meningeal melanocytoma, despite its benign histopathological nature. Of particular note is multifocality and diffuse leptomeningeal hyperpigmentation, which may suggest a poor prognosis. A combined treatment including surgical resection and adjuvant radiotherapy should be considered, and long-term close follow-up is necessary. Copyright © 2016. Published by Elsevier Inc.

  9. Acoustical characterization of polysaccharide polymers tissue-mimicking materials.

    PubMed

    Cuccaro, Rugiada; Musacchio, Chiara; Giuliano Albo, P Alberto; Troia, Adriano; Lago, Simona

    2015-02-01

    Tissue-mimicking phantoms play a crucial role in medical ultrasound research because they can simulate biological soft tissues. In last years, many types of polymeric tissues have been proposed and characterized from an acoustical and a thermal point of view, but, rarely, a deep discussion about the quality of the measurements, in terms of the uncertainty evaluation, has been reported. In this work, considering the necessity to develop laboratory standards for the measurement of ultrasonic exposure and dose quantities, a detailed description of the experimental apparatuses for the sound speed and the attenuation coefficient measurements is given, focusing the attention on the uncertainty evaluation both of the results and analysis algorithms. In particular, this algorithm reveals a novel empirical relation, fixing a limit to the energy content (therefore limits the number of cycles) of the three parts in which the authors have proposed to divide the acoustical signal. Furthermore, the realisation of multi-components phantoms, Agar and Phytagel based tissue-mimicking gels along with others long chain molecules (dextrane or polyvinyl alcohol) and scattering materials (silicon carbide and kieselguhr) are investigated. This paper reports accurate speed of sound and attenuation coefficient measurements. Speed of sound is measured by a pulse-echo technique in far-field condition, using an optical glass buffer rod; while attenuation coefficient is determined by an insertion technique, using demineralized water as reference material. The experimental sound speed results are subjected to an overall estimated relative uncertainty of about 1.5% and the attenuation coefficient uncertainty is less than 2.5%. For the development of laboratory standards, a detailed analysis of the measurement uncertainty is fundamental to make sample properties comparable. The authors believe this study could represent the right direction to make phantoms characterizations referable and traceable.

  10. Disseminated Mycobacterium marinum Infection With a Destructive Nasal Lesion Mimicking Extranodal NK/T Cell Lymphoma

    PubMed Central

    Asakura, Takanori; Ishii, Makoto; Kikuchi, Taku; Kameyama, Kaori; Namkoong, Ho; Nakata, Noboru; Sugita, Kayoko; Tasaka, Sadatomo; Shimizu, Takayuki; Hoshino, Yoshihiko; Okamoto, Shinichiro; Betsuyaku, Tomoko; Hasegawa, Naoki

    2016-01-01

    Abstract Mycobacterium marinum is a ubiquitous waterborne organism that mainly causes skin infection in immunocompetent patients, and its disseminated infection is rare. Extranodal NK/T cell lymphoma, nasal type (ENKL) usually localizes at the nasal and/or paranasal area, but occasionally disseminates into the skin/soft tissue and gastrointestinal tract. Compromised immunity is a risk factor for developing nontuberculous mycobacterial (NTM) infection and malignant lymphoma, and the 2 diseases may share similar clinical presentation; however, only a few reports have described NTM infection mimicking malignant lymphoma. A 43-year-old Japanese man presented to our hospital complaining of multiple progressive skin nodules and purulent nasal discharge for 3 weeks. He was diagnosed with Crohn disease with refractory enteropathic arthritis and has been treated with anti-tumor necrosis factor alpha agents for 25 years. Fiberoptic nasal examination revealed septal perforation with hemorrhagic mucus and purulent rhinorrhea. Histological examination of the nasal septum revealed the infiltration of atypical medium-to-large-sized cells with erosion. The cells were positive for cytoplasmic CD3, granzyme B, and Epstein–Barr virus-encoded small RNA. Histological examination of the skin nodules and auricle also showed infiltration of atypical lymphocytes. The patient was tentatively diagnosed with ENKL, and chemotherapy was considered. However, the skin lesions decreased in size after discontinuation of immunosuppressive agents and minocycline administration. Two weeks later, nasal septum and lavage fluid and left leg skin cultures were positive for M marinum, and minocycline was discontinued. The skin and the nasal lesions improved after 2 months. To the best of our knowledge, this is the first case of disseminated M marinum infection with a destructive nasal lesion mimicking ENKL. The differentiation between M marinum infection and ENKL is clinically important because

  11. Primary lymphoma of the spleen mimicking simple benign cysts: contrast-enhanced ultrasonography and other imaging findings.

    PubMed

    Ballestri, Stefano; Lonardo, Amedeo; Romagnoli, Dante; Losi, Luisa; Loria, Paola

    2015-04-01

    We report on a case of incidentally detected primary splenic lymphoma mimicking simple benign cysts on abdominal ultrasonography. On contrast-enhanced ultrasonography (CEUS), the lesions showed isoenhancement in the arterial phase with progressive washout and marked hypoenhancement in the parenchymal phase. This pattern enabled us to suspect the malignant nature of the disease, thus preventing a dangerous misdiagnosis. Accordingly, further characterization with other imaging studies (computed tomography, magnetic resonance imaging, and positron emission tomography) was pursued based on CEUS and taking into account the patient's clinical picture and medical history. Collectively, imaging data led us to a diagnosis of suspected primary splenic malignancy, most probably lymphoma, which was histologically confirmed on the surgical specimen after splenectomy.

  12. A new model of retinal photoreceptor cell degeneration induced by a chemical hypoxia-mimicking agent, cobalt chloride.

    PubMed

    Hara, Akira; Niwa, Masayuki; Aoki, Hitomi; Kumada, Masako; Kunisada, Takahiro; Oyama, Takeru; Yamamoto, Tetsuya; Kozawa, Osamu; Mori, Hideki

    2006-09-13

    Retinal photoreceptor cell degeneration was induced by cobalt chloride, a chemical hypoxia-mimicking agent in rodents. Time course and dose-response of photoreceptor cell degeneration in mouse retina after intravitreal injection of cobalt chloride were examined by conventional histological analysis by hematoxylin and eosin staining and in situ terminal dUTP-biotin nick end labeling of DNA fragments (TUNEL) method with the use of paraffin-embedded sections. The dose-response of photoreceptor cell degeneration in rat retina was also examined. Photoreceptor cells progressively degenerated with time and under dose-response relationship. The suitable dose of cobalt chloride for the selective photoreceptor cell degeneration in mice is 10-12 nmol intravitreal injection at the volume of 2 microl. The retinal morphology of the mice 2 weeks after the 10-12 nmol intravitreal injection was similar to that of retinal degeneration in the mutant rd mouse. Retinal damage of total retinal layers was induced by an excessive dose of cobalt chloride. The progression of retinal damage after cobalt chloride injection, measured morphologically, was completed at 1 week. However, nuclear DNA fragmentation, mainly detected at outer nuclear layer by TUNEL, peaked at 48 h after 12 nmol cobalt chloride injection. Thus, the selective photoreceptor cell degeneration induced by cobalt chloride follows DNA fragmentation at outer nuclear layer. The photoreceptor cell degeneration is established optionally by cobalt chloride without use of the retinal degeneration mutant animals. Thus, we have described the development of a new model of retinal photoreceptor cell degeneration induced by a chemical hypoxia-mimicking agent.

  13. Nanofibrous heparin and heparin-mimicking multilayers as highly effective endothelialization and antithrombogenic coatings.

    PubMed

    Nie, Chuanxiong; Ma, Lang; Cheng, Chong; Deng, Jie; Zhao, Changsheng

    2015-03-09

    Combining the advantages of the fibrous nanostructure of carbon nanotubes (CNTs) and the bioactivities of heparin/heparin-mimicking polyanions, functional nanofibrous heparin or heparin-mimicking multilayers were constructed on PVDF membrane with highly promoted endothelialization and antithrombogenic activities. Oxidized CNT (oCNT) was first functionalized with water-soluble chitosan (polycation), then enwrapped with heparin or a typical sulfonated heparin-mimicking polymers (poly(sodium 4-styrenesulfonate-co-sodium methacrylate)) to construct the multilayers. Then, the surface-deposited multilayers were constructed via electrostatic layer-by-layer assembly of the functionalized oCNTs. The scanning electron microscope and atom force microscope images confirmed that the coated multilayers exhibited nanofibrous and porous structure. The live/dead cell staining and cell viability assay results indicated that the coated nanofibrous multilayers had excellent compatibility with endothelial cells. The cell morphology observation further confirmed the promotion ability of surface endothelialization due to the coated heparin/heparin-mimicking multilayers. Further systematical evaluation on blood compatibility revealed that the surface heparin/heparin-mimicking multilayer-coated membranes also had significantly improved blood compatibility including restrained platelet adhesion and activation, prolonged blood clotting times, and inhibited activation of coagulation and complement factors. In summary, the proposed nanofibrous multilayers integrated endothelialization and antithrombogenic properties; meanwhile, the heparin-mimicking coating validated comparable performances as heparin coating. Herein, it is expected that the surface coating of nanofibrous multilayers, especially the facilely constructed heparin-mimicking coating, may have great application potential in biomedical fields.

  14. Right ventricular endomyocardial fibrosis mimicking Ebstein anomaly in a patient with Behçet's disease: case report and review of the literature.

    PubMed

    Buturak, Ali; Saygili, Ozlem; Ulus, Sıla; Kalfa, Melike; Karabulut, Hasan; Alhan, Cem; Dagdelen, Sinan; Aksu, Kenan

    2014-05-01

    Behçet's disease is a multisystemic, chronic inflammatory disorder with diffuse clinical manifestations including the cardiovascular system. Endomyocardial fibrosis is a rarely seen complication of Behçet's disease leading to progressive heart failure. We report a case of right ventricular endomyocardial fibrosis mimicking Ebstein anomaly in a 26-year-old male Turkish patient with Behçet's disease, who had heart failure symptoms. In addition, the previously reported cases of endomyocardial fibrosis complicating Behçet's disease are reviewed in this article.

  15. Study of ultrasound stiffness imaging methods using tissue mimicking phantoms.

    PubMed

    Manickam, Kavitha; Machireddy, Ramasubba Reddy; Seshadri, Suresh

    2014-02-01

    A pilot study was carried out to investigate the performance of ultrasound stiffness imaging methods namely Ultrasound Elastography Imaging (UEI) and Acoustic Radiation Force Impulse (ARFI) Imaging. Specifically their potential for characterizing different classes of solid mass lesions was analyzed using agar based tissue mimicking phantoms. Composite tissue mimicking phantom was prepared with embedded inclusions of varying stiffness from 50 kPa to 450 kPa to represent different stages of cancer. Acoustic properties such as sound speed, attenuation coefficient and acoustic impedance were characterized by pulse echo ultrasound test at 5 MHz frequency and they are ranged from (1564 ± 88 to 1671 ± 124 m/s), (0.6915 ± 0.123 to 0.8268 ± 0.755 db cm(-1)MHz(-1)) and (1.61 × 10(6) ± 0.127 to 1.76 × 10(6) ± 0.045 kg m(-2)s(-1)) respectively. The elastic property Young's Modulus of the prepared samples was measured by conducting quasi static uni axial compression test under a strain rate of 0.5mm/min upto 10 % strain, and the values are from 50 kPa to 450 kPa for a variation of agar concentration from 1.7% to 6.6% by weight. The composite phantoms were imaged by Siemens Acuson S2000 (Siemens, Erlangen, Germany) machine using linear array transducer 9L4 at 8 MHz frequency; strain and displacement images were collected by UEI and ARFI. Shear wave velocity 4.43 ± 0.35 m/s was also measured for high modulus contrast (18 dB) inclusion and X.XX m/s was found for all other inclusions. The images were pre processed and parameters such as Contrast Transfer Efficiency and lateral image profile were computed and reported. The results indicate that both ARFI and UEI represent the abnormalities better than conventional US B mode imaging whereas UEI enhances the underlying modulus contrast into improved strain contrast. The results are corroborated with literature and also with clinical patient images. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Development of Vibrational Culture Model Mimicking Vocal Fold Tissues.

    PubMed

    Kim, Dongjoo; Lim, Jae-Yol; Kwon, Soonjo

    2016-10-01

    The vocal folds (VFs) are connective tissues with complex matrix structures that provide the required mechanical properties for voice generation. VF injury leads to changes in tissue structure and properties, resulting in reduced voice quality. However, injury-induced biochemical changes and repair in scarred VF tissues have not been well characterized to date. To treat scarred VFs, it is essential to understand how physiological characteristics of VFs tissue change in response to external perturbation. In this study, we designed a simple vibrational culture model to mimic vibratory microenvironments observed in vivo. This model consists of a flexible culture plate, three linear actuators, a stereo splitter, and a function generator. Human vocal fold fibroblast (hVFF) monolayers were established on the flexible membrane, to which normal phonatory vibrations were delivered from linear actuators and a function generator. The hVFF monolayers were exposed to the vibrational stresses at a frequency of 205 Hz for 2, 6, and 10 h with maximum displacement of 47.1 μm, followed by a 6 h rest. We then observed the changes in cell morphology, cell viability, and gene expression related to extracellular matrix components. In our dynamic culture device mimicking normal phonatory frequencies, cell proliferation increased and expression of hyaluronic acid synthase 2 was downregulated in response to vibrational stresses. The results presented herein will be useful for evaluating cellular responses following VF injuries in the presence or absence of vibrational stresses.

  17. Mimicking static anisotropic fluid spheres in general relativity

    NASA Astrophysics Data System (ADS)

    Boonserm, Petarpa; Ngampitipan, Tritos; Visser, Matt

    2016-11-01

    We argue that an arbitrary general relativistic static anisotropic fluid sphere, (static and spherically symmetric but with transverse pressure not equal to radial pressure), can nevertheless be successfully mimicked by suitable linear combinations of theoretically attractive and quite simple classical matter: a classical (charged) isotropic perfect fluid, a classical electromagnetic field and a classical (minimally coupled) scalar field. While the most general decomposition is not unique, a preferred minimal decomposition can be constructed that is unique. We show how the classical energy conditions for the anisotropic fluid sphere can be related to energy conditions for the isotropic perfect fluid, electromagnetic field, and scalar field components of the model. Furthermore, we show how this decomposition relates to the distribution of both electric charge density and scalar charge density throughout the model. The generalized TOV equation implies that the perfect fluid component in this model is automatically in internal equilibrium, with pressure forces, electric forces, and scalar forces balancing the gravitational pseudo-force. Consequently, we can build theoretically attractive matter models that can be used to mimic almost any static spherically symmetric spacetime.

  18. Orbital compressed air and petroleum injury mimicking necrotizing fasciitis.

    PubMed

    Mellington, Faye E; Bacon, Annette S; Abu-Bakra, Mohammed A J; Martinez-Devesa, Pablo; Norris, Jonathan H

    2014-09-01

    Orbital injury secondary to petroleum-based products is rare. We report the first case, to our knowledge, of a combined compressed air and chemical orbital injury, which mimicked necrotizing fasciitis. A 58-year-old man was repairing his motorcycle engine when a piston inadvertently fired, discharging compressed air and petroleum-based carburetor cleaner into his left eye. He developed surgical emphysema, skin necrosis, and a chemical cellulitis, causing an orbital compartment syndrome. He was treated initially with antibiotics and subsequently with intravenous steroid and orbital decompression surgery. There was almost complete recovery by 4 weeks postsurgery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Petroleum-based products can cause severe skin irritation and necrosis. Compressed air injury can cause surgical emphysema. When these two mechanisms of injury are combined, the resulting orbitopathy and skin necrosis can mimic necrotizing fasciitis and cause diagnostic confusion. A favorable outcome is achievable with aggressive timely management. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Toxicology Analysis of Tissue-Mimicking Phantom Made From Gelatin

    NASA Astrophysics Data System (ADS)

    Dolbashid, A. S.; Hamzah, N.; Zaman, W. S. W. K.; Mokhtar, M. S.

    2017-06-01

    Skin phantom mimics the biological skin tissues as it have the ability to respond to changes in its environment. The development of tissue-mimicking phantom could contributes towards the reduce usage of animal in cosmetics and pharmacokinetics. In this study, the skin phantoms made from gelatin were tested with four different commonly available cosmetic products to determine the toxicity of each substance. The four substances used were; mercury-based whitening face cream, carcinogenic liquid make-up foundation, paraben-based acne cleanser, and organic lip balm. Toxicity test were performed on all of the phantoms. For toxicity testing, topographical and electrophysiological changes of the phantoms were evaluated. The ability of each respective phantom to react with mild toxic substances and its electrical resistance were analysed in to determine the toxicity of all the phantom models. Four-electrode method along with custom made electrical impedance analyser was used to differentiate electrical resistance between intoxicated phantom and non-intoxicated phantom in this study. Electrical resistance values obtained from the phantom models were significantly higher than the control group. The result obtained suggests the phantom as a promising candidate to be used as alternative for toxicology testing in the future.

  20. Sellar and parasellar intravascular lymphoma mimicking pituitary apoplexy.

    PubMed

    Rizek, Philippe; Seitelbach, Maayan; Alturkustani, Murad; Leung, Andrew; Fraser, J Alexander

    2012-03-01

    Intravascular lymphoma (IVL) is a rare subtype of large-cell non-Hodgkin lymphoma, characterized by proliferation of lymphoma cells within the lumina of small vessels. There are no previously reported cases of IVL involving the pituitary gland presenting with neuro-ophthalmic findings. A 68-year-old female presented with headache, right third nerve palsy, and Horner syndrome. MRI showed a 1.4-cm sellar mass consistent with a pituitary macroadenoma. Two weeks later, despite treatment with dexamethasone, the patient developed complete bilateral ophthalmoplegia and ptosis. Repeat MRI showed invasion of the clivus and cavernous sinuses, and a transsphenoidal pituitary biopsy was undertaken. The preliminary histopathology was consistent with bland pituitary apoplexy, but subsequent examination of an incidentally biopsied nasal polyp revealed endovascular malignant lymphoid cells that, on further scrutiny, were also present in the pituitary tissue. The diagnosis of IVL was confirmed, and the patient had an excellent clinical and radiological response to cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab (CHOP-R) chemotherapy. IVL may involve the pituitary gland, causing sellar mass effect, cavernous sinus infiltration, and pituitary ischemia, mimicking pituitary apoplexy with neuro-ophthalmic features. It can be effectively treated with CHOP-R chemotherapy.

  1. Auditory-motor entrainment in vocal mimicking species

    PubMed Central

    2010-01-01

    We have recently found robust evidence of motor entrainment to auditory stimuli in multiple species of non-human animal, all of which were capable of vocal mimicry. In contrast, the ability remained markedly absent in many closely related species incapable of vocal mimicry. This suggests that vocal mimicry may be a necessary precondition for entrainment. However, within the vocal mimicking species, entrainment appeared non-randomly, suggesting that other components besides vocal mimicry play a role in the capacity and tendency to entrain. Here we discuss potential additional factors involved in entrainment. New survey data show that both male and female parrots are able to entrain, and that the entrainment capacity appears throughout the lifespan. We suggest routes for future study of entrainment, including both developmental studies in species known to entrain and further work to detect entrainment in species not well represented in our dataset. These studies may shed light on additional factors necessary for entrainment in addition to vocal mimicry. PMID:20714417

  2. Adenomatoid odontogenic tumour mimicking a periapical cyst in pregnant woman.

    PubMed

    Bhandari, Neha; Kothari, Mohit

    2010-06-01

    Adenomatoid odontogenic tumours (AOT) are uncommon odontogenic lesions characterized histologi-cally by duct-like structures derived from the epithelial component of the lesion and can be distinctly classified into follicular, extrafollicular and extraosseous variants (Neville BW, Damm DD, Allen CM, et al. Adenomatoid Odontogenic Tumor. A Text Book for Oral and Maxillofacial Pathology, 2(nd) edition, 621-3). Most of these tumours develop in the second or third decade of life and have a distinct predilection for women. The follicular variant accounts for 75% of reported cases (Curran AE, Miller EJ, Murrah VA. Adenomatoid odontogenic tumor presenting as periapical disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:557-60) and is associated with the crown of an impacted tooth, commonly the maxillary canine. We present a rare case of extrafollicular AOT mimicking a periapical cyst that originated in a woman in her first trimester of pregnancy and enlarged rapidly thereafter. The lesion was enucleated and sent for histopathology and immunohistochemistry, which revealed AOT with a cystic component with no dependence on oestrogen or progestrone for its growth. This case of AOT introduces us to the unique variation in its presentation and the difficulty in differentiation from periapical disease of inflammatory origin. Copyright © 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

  3. Red blood cell-mimicking synthetic biomaterial particles.

    PubMed

    Doshi, Nishit; Zahr, Alisar S; Bhaskar, Srijanani; Lahann, Joerg; Mitragotri, Samir

    2009-12-22

    Biomaterials form the basis of current and future biomedical technologies. They are routinely used to design therapeutic carriers, such as nanoparticles, for applications in drug delivery. Current strategies for synthesizing drug delivery carriers are based either on discovery of materials or development of fabrication methods. While synthetic carriers have brought upon numerous advances in drug delivery, they fail to match the sophistication exhibited by innate biological entities. In particular, red blood cells (RBCs), the most ubiquitous cell type in the human blood, constitute highly specialized entities with unique shape, size, mechanical flexibility, and material composition, all of which are optimized for extraordinary biological performance. Inspired by this natural example, we synthesized particles that mimic the key structural and functional features of RBCs. Similar to their natural counterparts, RBC-mimicking particles described here possess the ability to carry oxygen and flow through capillaries smaller than their own diameter. Further, they can also encapsulate drugs and imaging agents. These particles provide a paradigm for the design of drug delivery and imaging carriers, because they combine the functionality of natural RBCs with the broad applicability and versatility of synthetic drug delivery particles.

  4. Mimicking Oxygen delivery and waste removal functions of blood.

    PubMed

    Zhang, Huaifa; Barralet, Jake E

    2017-02-15

    In addition to immunological and wound healing cell and platelet delivery, ion stasis and nutrient supply, blood delivers oxygen to cells and tissues and removes metabolic wastes. For decades researchers have been trying to develop approaches that mimic these two immediately vital functions of blood. Oxygen is crucial for the long-term survival of tissues and cells in vertebrates. Hypoxia (oxygen deficiency) and even at times anoxia (absence of oxygen) can occur during organ preservation, organ and cell transplantation, wound healing, in tumors and engineering of tissues. Different approaches have been developed to deliver oxygen to tissues and cells, including hyperbaric oxygen therapy (HBOT), normobaric hyperoxia therapy (NBOT), using biochemical reactions and electrolysis, employing liquids with high oxygen solubility, administering hemoglobin, myoglobin and red blood cells (RBCs), introducing oxygen-generating agents, using oxygen-carrying microparticles, persufflation, and peritoneal oxygenation. Metabolic waste accumulation is another issue in biological systems when blood flow is insufficient. Metabolic wastes change the microenvironment of cells and tissues, influence the metabolic activities of cells, and ultimately cause cell death. This review examines advances in blood mimicking systems in the field of biomedical engineering in terms of oxygen delivery and metabolic waste removal.

  5. Mimicking the magnetic properties of rare earth elements using superatoms

    PubMed Central

    Cheng, Shi-Bo; Berkdemir, Cuneyt; Castleman, A. W.

    2015-01-01

    Rare earth elements (REs) consist of a very important group in the periodic table that is vital to many modern technologies. The mining process, however, is extremely damaging to the environment, making them low yield and very expensive. Therefore, mimicking the properties of REs in a superatom framework is especially valuable but at the same time, technically challenging and requiring advanced concepts about manipulating properties of atom/molecular complexes. Herein, by using photoelectron imaging spectroscopy, we provide original idea and direct experimental evidence that chosen boron-doped clusters could mimic the magnetic characteristics of REs. Specifically, the neutral LaB and NdB clusters are found to have similar unpaired electrons and magnetic moments as their isovalent REs (namely Nd and Eu, respectively), opening up the great possibility in accomplishing rare earth mimicry. Extension of the superatom concept into the rare earth group not only further shows the power and advance of this concept but also, will stimulate more efforts to explore new superatomic clusters to mimic the chemistry of these heavy atoms, which will be of great importance in designing novel building blocks in the application of cluster-assembled nanomaterials. Additionally, based on these experimental findings, a novel “magic boron” counting rule is proposed to estimate the numbers of unpaired electrons in diatomic LnB clusters. PMID:25848014

  6. Acoustic resolution photoacoustic Doppler velocimetry in blood-mimicking fluids

    PubMed Central

    Brunker, Joanna; Beard, Paul

    2016-01-01

    Photoacoustic Doppler velocimetry provides a major opportunity to overcome limitations of existing blood flow measuring methods. By enabling measurements with high spatial resolution several millimetres deep in tissue, it could probe microvascular blood flow abnormalities characteristic of many different diseases. Although previous work has demonstrated feasibility in solid phantoms, measurements in blood have proved significantly more challenging. This difficulty is commonly attributed to the requirement that the absorber spatial distribution is heterogeneous relative to the minimum detectable acoustic wavelength. By undertaking a rigorous study using blood-mimicking fluid suspensions of 3 μm absorbing microspheres, it was discovered that the perceived heterogeneity is not only limited by the intrinsic detector bandwidth; in addition, bandlimiting due to spatial averaging within the detector field-of-view also reduces perceived heterogeneity and compromises velocity measurement accuracy. These detrimental effects were found to be mitigated by high-pass filtering to select photoacoustic signal components associated with high heterogeneity. Measurement under-reading due to limited light penetration into the flow vessel was also observed. Accurate average velocity measurements were recovered using “range-gating”, which furthermore maps the cross-sectional velocity profile. These insights may help pave the way to deep-tissue non-invasive mapping of microvascular blood flow using photoacoustic methods. PMID:26892989

  7. Hematological Changes Mimicking Myelodysplastic Syndrome Following Treatment for Osteosarcoma.

    PubMed

    Løhmann, Ditte J A; Hasle, Henrik

    2015-04-01

    Therapy-related myelodysplastic syndrome/acute myeloid leukemia (t-MDS/AML) is a feared long-term complication of pediatric cancer. Few osteosarcoma patients develop t-MDS/AML, but the frequency of hematological abnormalities after therapy is unknown. We reviewed biochemistry from osteosarcoma patients up to 3 years posttreatment. All children diagnosed with osteosarcoma at our department from 2006 to 2012 without relapse 1 month posttherapy were included (n=14). Serial blood counts posttherapy were analyzed. The median increase of mean corpuscular volume (MCV) from baseline was 8 fL 6 months posttherapy and remained >5 throughout follow-up. All posttreatment levels of MCV were above 90 fL in 5 patients. Six months posttherapy, the median difference for platelets, white blood count, and absolute neutrophil count had decreased from baseline. They remained under baseline throughout follow-up. Hemoglobin remained stable. Ferritin level was associated with increased MCV. MDS with monosomy 7 was diagnosed in 1 patient. Hypoplastic refractory cytopenia was found in another patient showing spontaneous normalization of hematologic values. More than a third of patients treated for osteosarcoma developed hematological abnormalities mimicking early MDS, but only 1 developed t-MDS/AML. Close hematological monitoring of patients recovering from osteosarcoma is essential and it is worth noting that hematological abnormalities are frequent and may be transitory.

  8. Postictal spectroscopy and imaging findings mimicking brain tumor recurrence.

    PubMed

    Hattingen, Elke; Franz, Kea; Pilatus, Ulrich; Weidauer, Stefan; Lanfermann, Heiner

    2006-07-01

    (1)H magnetic resonance spectroscopic imaging (MRSI) was performed on a patient with an admission diagnosis of recurrent astrocytoma. The patient had undergone surgical resection and radiation therapy for a left occipital astrocytoma WHO grade III 12 years previously, and presented with aphasia, right-sided hemiparesis, and severe headache. Postcontrast T1-weighted images showed cortical enhancement of the left parietotemporal lobe near the post-resection cavity. MRSI revealed a marked increase of trimethylamines (TMA), elevated creatine/creatinephosphate (tCr), and reduced N-acetyl-aspartate (tNAA) in the same brain region. The spectroscopic data were consistent with tumor recurrence. However, the pattern of contrast enhancement on magnetic resonance imaging (MRI), evidence of an epileptic focus on electroencephalography (EEG), and spontaneous regression of the symptoms argued against tumor recurrence. In a 4-week follow-up, the contrast enhancement disappeared on MRI and the EEG abnormalities and neurological symptoms resolved. Follow-up spectroscopic data showed a decrease in TMA compared to normal values. The tCr signal remained elevated but returned to normal values after 5 months. In conclusion, postictal neurological deficits with a temporary increase in TMA and tCr were diagnosed. This is the first report of seizure-induced MRS abnormalities mimicking tumor recurrence. (c) 2006 Wiley-Liss, Inc.

  9. Development and characterization of a brain tumor mimicking fluorescence phantom

    NASA Astrophysics Data System (ADS)

    Haj-Hosseini, Neda; Kistler, Benjamin; Wârdell, Karin

    2014-03-01

    Fluorescence guidance using 5-aminolevulinic acid (5-ALA) for brain tumor resection is a recent technique applied to the highly malignant brain tumors. Five-ALA accumulates as protoporphyrin IX fluorophore in the tumor cells in different concentrations depending on the tumor environment and cell properties. Our group has developed a fluorescence spectroscopy system used with a hand-held probe intra-operatively. The system has shown improvement of fluorescence detection and allows quantification that preliminarily correlates with tumor malignancy grade during surgery. However, quantification of fluorescence is affected by several factors including the initial fluorophore concentration, photobleaching due to operating lamps and attenuation from the blood. Accordingly, an optical phantom was developed to enable controlled fluorescence measurements and evaluation of the system outside of the surgical procedure. The phantom mimicked the optical properties of glioma at the specific fluorescence excitation wavelength when different concentrations of the fluorophore were included in the phantom. To allow evaluation of photobleaching, kinetics of fluorophore molecules in the phantom was restricted by solidifying the phantoms. Moreover, a model for tissue autofluorescence was added. The fluorescence intensity's correlation with fluorophore concentration in addition to the photobleaching properties were investigated in the phantoms and were compared to the clinical data measured on the brain tumor.

  10. Mimicking Neural Stem Cell Niche by Biocompatible Substrates

    PubMed Central

    Regalado-Santiago, Citlalli; Juárez-Aguilar, Enrique; Olivares-Hernández, Juan David; Tamariz, Elisa

    2016-01-01

    Neural stem cells (NSCs) participate in the maintenance, repair, and regeneration of the central nervous system. During development, the primary NSCs are distributed along the ventricular zone of the neural tube, while, in adults, NSCs are mainly restricted to the subependymal layer of the subventricular zone of the lateral ventricles and the subgranular zone of the dentate gyrus in the hippocampus. The circumscribed areas where the NSCs are located contain the secreted proteins and extracellular matrix components that conform their niche. The interplay among the niche elements and NSCs determines the balance between stemness and differentiation, quiescence, and proliferation. The understanding of niche characteristics and how they regulate NSCs activity is critical to building in vitro models that include the relevant components of the in vivo niche and to developing neuroregenerative approaches that consider the extracellular environment of NSCs. This review aims to examine both the current knowledge on neurogenic niche and how it is being used to develop biocompatible substrates for the in vitro and in vivo mimicking of extracellular NSCs conditions. PMID:26880934

  11. Hypoxia-Mimicking Nanofibrous Scaffolds Promote Endogenous Bone Regeneration.

    PubMed

    Yao, Qingqing; Liu, Yangxi; Tao, Jianning; Baumgarten, Keith M; Sun, Hongli

    2016-11-30

    Utilizing biomimetic materials to potentiate endogenous cell growth or signaling is superior to relying on exogenous cells or signals for bone formation. Desferoxamine (DFO), which is a hypoxia-mimetic agent that chelates iron (Fe(3+)), mimics hypoxia to encourage bone healing. However, high cytotoxicity, off-target effects, and the short half-life of DFO have significantly impeded its further applications. We mitigated these side effects by locally immobilizing DFO onto a gelatin nanofibrous (GF) scaffold that retained DFO's ability to chelate Fe(3+). Moreover, DFO-functionalized GF (GF-DFO) scaffolds, which have similar micro/macrostructures to GF scaffolds, not only demonstrated decreased cytotoxicity on both human umbilical vein endothelial cells and human mesenchymal stem cells but also significantly increased vascular endothelial growth factor (VEGF) expression in vitro. Most importantly, in our in vivo experiments on a critical-sized cranial bone defect mouse model, a significant amount of bone was formed in most of the GF-DFO scaffolds after six weeks, while very little new bone was observed in the GF scaffolds. These data suggest that use of a hypoxia-mimicking nanofibrous scaffold is a promising strategy for promoting endogenous bone formation.

  12. Modulated Fluorophore Signal Recovery Buried within Tissue Mimicking Phantoms

    PubMed Central

    Sarkar, Saugata; Fan, Chaoyang; Hsiang, Jung-Cheng; Dickson, Robert M.

    2013-01-01

    Optically modulated fluorescence from ~140nM Cy5 is visualized when embedded up to 6 mm within skin tissue-mimicking phantoms, even in the presence of overwhelming background fluorescence and scatter. Experimental and finite element analysis (FEA)-based computational models yield excellent agreement in signal levels and predict biocompatible temperature changes. Using Synchronously Amplified Fluorescence Image Recovery (SAFIRe), dual laser excitation (primary laser: λ = 594nm, 0.29 kW/cm2; secondary laser: λ = 710nm, 5.9 kW/cm2, intensity-modulated at 100Hz) simultaneously excites fluorescence, and dynamically optically reverses the dark state buildup of primary laser-excited Cy5 molecules. As the modulated secondary laser both directly modulates Cy5 emission and is of lower energy than the collected Cy5 fluorescence, modulated Cy5 fluorescence in phantoms is free of obscuring background emission. The modulated fluorescence emission due to the secondary laser was recovered by Fourier transformation, yielding a specific and unique signature of the introduced fluorophores, with largely background-free detection, at excitation intensities close to the maximum permissible exposure (MPE) for skin. Experimental and computational models agree to within 8%, validating the computational model. As modulated fluorescence depends on the presence of both lasers, depth information as a function of focal position is also readily obtained from recovered modulated signal strength. PMID:23692258

  13. Wernicke's Encephalopathy Mimicking Acute Onset Stroke Diagnosed by CT Perfusion

    PubMed Central

    Advani, Rajiv; Kurz, Kathinka D.; Kurz, Martin W.

    2014-01-01

    Background. Metabolic syndromes such as Wernicke's encephalopathy may present with a sudden neurological deficit, thus mimicking acute onset stroke. Due to current emphasis on rapid admission and treatment of acute stroke patients, there is a significant risk that these stroke mimics may end up being treated with thrombolysis. Rigorous clinical and radiological skills are necessary to correctly identify such metabolic stroke mimics, in order to avoid doing any harm to these patients due to the unnecessary use of thrombolysis. Patient. A 51-year-old Caucasian male was admitted to our hospital with suspicion of an acute stroke due to sudden onset dysarthria and unilateral facial nerve paresis. Clinical examination revealed confusion and dysconjugate gaze. Computed tomography (CT) including a CT perfusion (CTP) scan revealed bilateral thalamic hyperperfusion. The use of both clinical and radiological findings led to correctly diagnosing Wernicke's encephalopathy. Conclusion. The application of CTP as a standard diagnostic tool in acute stroke patients can improve the detection of stroke mimics caused by metabolic syndromes as shown in our case report. PMID:24716022

  14. Multimodal 3D cancer-mimicking optical phantom

    PubMed Central

    Smith, Gennifer T.; Lurie, Kristen L.; Zlatev, Dimitar V.; Liao, Joseph C.; Ellerbee Bowden, Audrey K.

    2016-01-01

    Three-dimensional (3D) organ-mimicking phantoms provide realistic imaging environments for testing various aspects of optical systems, including for evaluating new probe designs, characterizing the diagnostic potential of new technologies, and assessing novel image processing algorithms prior to validation in real tissue. We introduce and characterize the use of a new material, Dragon Skin (Smooth-On Inc.), and fabrication technique, air-brushing, for fabrication of a 3D phantom that mimics the appearance of a real organ under multiple imaging modalities. We demonstrate the utility of the material and technique by fabricating the first 3D, hollow bladder phantom with realistic normal and multi-stage pathology features suitable for endoscopic detection using the gold standard imaging technique, white light cystoscopy (WLC), as well as the complementary imaging modalities of optical coherence tomography and blue light cystoscopy, which are aimed at improving the sensitivity and specificity of WLC to bladder cancer detection. The flexibility of the material and technique used for phantom construction allowed for the representation of a wide range of diseased tissue states, ranging from inflammation (benign) to high-grade cancerous lesions. Such phantoms can serve as important tools for trainee education and evaluation of new endoscopic instrumentation. PMID:26977369

  15. Acoustic resolution photoacoustic Doppler velocimetry in blood-mimicking fluids

    NASA Astrophysics Data System (ADS)

    Brunker, Joanna; Beard, Paul

    2016-02-01

    Photoacoustic Doppler velocimetry provides a major opportunity to overcome limitations of existing blood flow measuring methods. By enabling measurements with high spatial resolution several millimetres deep in tissue, it could probe microvascular blood flow abnormalities characteristic of many different diseases. Although previous work has demonstrated feasibility in solid phantoms, measurements in blood have proved significantly more challenging. This difficulty is commonly attributed to the requirement that the absorber spatial distribution is heterogeneous relative to the minimum detectable acoustic wavelength. By undertaking a rigorous study using blood-mimicking fluid suspensions of 3 μm absorbing microspheres, it was discovered that the perceived heterogeneity is not only limited by the intrinsic detector bandwidth; in addition, bandlimiting due to spatial averaging within the detector field-of-view also reduces perceived heterogeneity and compromises velocity measurement accuracy. These detrimental effects were found to be mitigated by high-pass filtering to select photoacoustic signal components associated with high heterogeneity. Measurement under-reading due to limited light penetration into the flow vessel was also observed. Accurate average velocity measurements were recovered using “range-gating”, which furthermore maps the cross-sectional velocity profile. These insights may help pave the way to deep-tissue non-invasive mapping of microvascular blood flow using photoacoustic methods.

  16. Acoustic resolution photoacoustic Doppler velocimetry in blood-mimicking fluids.

    PubMed

    Brunker, Joanna; Beard, Paul

    2016-02-19

    Photoacoustic Doppler velocimetry provides a major opportunity to overcome limitations of existing blood flow measuring methods. By enabling measurements with high spatial resolution several millimetres deep in tissue, it could probe microvascular blood flow abnormalities characteristic of many different diseases. Although previous work has demonstrated feasibility in solid phantoms, measurements in blood have proved significantly more challenging. This difficulty is commonly attributed to the requirement that the absorber spatial distribution is heterogeneous relative to the minimum detectable acoustic wavelength. By undertaking a rigorous study using blood-mimicking fluid suspensions of 3 μm absorbing microspheres, it was discovered that the perceived heterogeneity is not only limited by the intrinsic detector bandwidth; in addition, bandlimiting due to spatial averaging within the detector field-of-view also reduces perceived heterogeneity and compromises velocity measurement accuracy. These detrimental effects were found to be mitigated by high-pass filtering to select photoacoustic signal components associated with high heterogeneity. Measurement under-reading due to limited light penetration into the flow vessel was also observed. Accurate average velocity measurements were recovered using "range-gating", which furthermore maps the cross-sectional velocity profile. These insights may help pave the way to deep-tissue non-invasive mapping of microvascular blood flow using photoacoustic methods.

  17. Moderately nonlinear ultrasound propagation in blood-mimicking fluid.

    PubMed

    Kharin, Nikolay A; Vince, D Geoffrey

    2004-04-01

    In medical diagnostic ultrasound (US), higher than-in-water nonlinearity of body fluids and tissue usually does not produce strong nonlinearly distorted waves because of the high absorption. The relative influence of absorption and nonlinearity can be characterized by the Gol'dberg number Gamma. There are two limiting cases in nonlinear acoustics: weak waves (Gamma < 1) or strong waves (Gamma > 1). However, at diagnostic frequencies in tissue and body fluids, the nonlinear effects and effects of absorption more likely are comparable (Gol'dberg number Gamma approximately 1). The aim of this work was to study the nonlinear propagation of a moderately nonlinear US second harmonic signal in a blood-mimicking fluid. Quasilinear solutions to the KZK equation are presented, assuming radiation from a flat and geometrically focused circular Gaussian source. The solutions are expressed in a new simplified closed form and are in very good agreement with those of previous studies measuring and modeling Gaussian beams. The solutions also show good agreement with the measurements of the beams produced by commercially available transducers, even without special Gaussian shading.

  18. Biotinidase deficiency mimicking neuromyelitis optica: Initially exhibiting symptoms in adulthood.

    PubMed

    Bottin, Laure; Prud'hon, Sabine; Guey, Stéphanie; Giannesini, Claire; Wolf, Barry; Pindolia, Kirit; Stankoff, Bruno

    2015-10-01

    Children with untreated biotinidase deficiency can experience variable symptoms depending on their age of presentation. Older children and adolescents can exhibit predominant neurological deficits including para- or tetraparesis and vision loss. We report the first case of delayed-onset biotinidase deficiency in a young adult. A 22-year-old man presented with a disabling extensive myelopathy and bilateral optic neuropathy which mimicked the findings of a (seronegative) neuromyelitis optica. Imaging investigations were characterized by an MRI T2 hyper-intensity involving the spinal cord, the optic nerves, the fornix and the mammillar bodies, together with an increased (18)F-FDG uptake on positron emission tomography. He was ultimately shown to have profound biotinidase deficiency due to a novel missense mutation and was partly improved by oral biotin therapy. This individual exemplifies the need to include biotinidase deficiency in the differential diagnosis of patients with extensive myelopathy and/or bilateral optic neuropathy and argues for newborn screening for the disorder. © The Author(s), 2015.

  19. Riboswitch Structure: an Internal Residue Mimicking the Purine Ligand

    SciTech Connect

    Delfosse, V.; Bouchard, P; Bonneau, E; Dagenais, P; Lemay, J; Lafontaine, D; Legault, P

    2009-01-01

    The adenine and guanine riboswitches regulate gene expression in response to their purine ligand. X-ray structures of the aptamer moiety of these riboswitches are characterized by a compact fold in which the ligand forms a Watson-Crick base pair with residue 65. Phylogenetic analyses revealed a strict restriction at position 39 of the aptamer that prevents the G39-C65 and A39-U65 combinations, and mutational studies indicate that aptamers with these sequence combinations are impaired for ligand binding. In order to investigate the rationale for sequence conservation at residue 39, structural characterization of the U65C mutant from Bacillus subtilis pbuE adenine riboswitch aptamer was undertaken. NMR spectroscopy and X-ray crystallography studies demonstrate that the U65C mutant adopts a compact ligand-free structure, in which G39 occupies the ligand-binding site of purine riboswitch aptamers. These studies present a remarkable example of a mutant RNA aptamer that adopts a native-like fold by means of ligand mimicking and explain why this mutant is impaired for ligand binding. Furthermore, this work provides a specific insight into how the natural sequence has evolved through selection of nucleotide identities that contribute to formation of the ligand-bound state, but ensures that the ligand-free state remains in an active conformation.

  20. Synchrony and motor mimicking in chimpanzee observational learning

    PubMed Central

    Fuhrmann, Delia; Ravignani, Andrea; Marshall-Pescini, Sarah; Whiten, Andrew

    2014-01-01

    Cumulative tool-based culture underwrote our species' evolutionary success, and tool-based nut-cracking is one of the strongest candidates for cultural transmission in our closest relatives, chimpanzees. However the social learning processes that may explain both the similarities and differences between the species remain unclear. A previous study of nut-cracking by initially naïve chimpanzees suggested that a learning chimpanzee holding no hammer nevertheless replicated hammering actions it witnessed. This observation has potentially important implications for the nature of the social learning processes and underlying motor coding involved. In the present study, model and observer actions were quantified frame-by-frame and analysed with stringent statistical methods, demonstrating synchrony between the observer's and model's movements, cross-correlation of these movements above chance level and a unidirectional transmission process from model to observer. These results provide the first quantitative evidence for motor mimicking underlain by motor coding in apes, with implications for mirror neuron function. PMID:24923651

  1. Modulated Fluorophore Signal Recovery Buried within Tissue Mimicking Phantoms

    NASA Astrophysics Data System (ADS)

    Sarkar, Saugata; Fan, Chaoyang; Hsiang, Jung-Cheng; Dickson, Robert M.

    2013-10-01

    Optically modulated fluorescence from -140 nM Cy5 is visualized when embedded up to 6 mm within skin tissue mimicking phantoms, even in the presence of overwhelming background fluorescence and scatter. Experimental and finite element analysis (FEA)-based computational models yield excellent agreement in signal levels and predict biocompatible temperature changes. Using synchronously amplified fluorescence image recovery (SAFIRe), dual-laser excitation (primary laser: - = 594 nm, 0.29 kW/cm2; secondary laser: - = 710 nm, 5.9 kW/cm2, intensity-modulated at 100 Hz) simultaneously excites fluorescence and dynamically optically reverses the dark state buildup of primary laser-excited Cy5 molecules. As the modulated secondary laser both directly modulates Cy5 emission and is of lower energy than the collected Cy5 fluorescence, modulated Cy5 fluorescence in phantoms is free of obscuring background emission. The modulated fluorescence emission due to the secondary laser was recovered by Fourier transformation, yielding a specific and unique signature of the introduced fluorophores, with largely background-free detection, at excitation intensities close to the maximum permissible exposure (MPE) for skin. Experimental and computational models agree to within 8%, validating the computational model. As modulated fluorescence depends on the presence of both lasers, depth information as a function of focal position is also readily obtained from recovered modulated signal strength.

  2. Synchrony and motor mimicking in chimpanzee observational learning.

    PubMed

    Fuhrmann, Delia; Ravignani, Andrea; Marshall-Pescini, Sarah; Whiten, Andrew

    2014-06-13

    Cumulative tool-based culture underwrote our species' evolutionary success, and tool-based nut-cracking is one of the strongest candidates for cultural transmission in our closest relatives, chimpanzees. However the social learning processes that may explain both the similarities and differences between the species remain unclear. A previous study of nut-cracking by initially naïve chimpanzees suggested that a learning chimpanzee holding no hammer nevertheless replicated hammering actions it witnessed. This observation has potentially important implications for the nature of the social learning processes and underlying motor coding involved. In the present study, model and observer actions were quantified frame-by-frame and analysed with stringent statistical methods, demonstrating synchrony between the observer's and model's movements, cross-correlation of these movements above chance level and a unidirectional transmission process from model to observer. These results provide the first quantitative evidence for motor mimicking underlain by motor coding in apes, with implications for mirror neuron function.

  3. Preparation of artificial plasma membrane mimicking vesicles with lipid asymmetry.

    PubMed

    Lin, Qingqing; London, Erwin

    2014-01-01

    Lipid asymmetry, the difference in lipid distribution across the lipid bilayer, is one of the most important features of eukaryotic cellular membranes. However, commonly used model membrane vesicles cannot provide control of lipid distribution between inner and outer leaflets. We recently developed methods to prepare asymmetric model membrane vesicles, but facile incorporation of a highly controlled level of cholesterol was not possible. In this study, using hydroxypropyl-α-cyclodextrin based lipid exchange, a simple method was devised to prepare large unilamellar model membrane vesicles that closely resemble mammalian plasma membranes in terms of their lipid composition and asymmetry (sphingomyelin (SM) and/or phosphatidylcholine (PC) outside/phosphatidylethanolamine (PE) and phosphatidylserine (PS) inside), and in which cholesterol content can be readily varied between 0 and 50 mol%. We call these model membranes "artificial plasma membrane mimicking" ("PMm") vesicles. Asymmetry was confirmed by both chemical labeling and measurement of the amount of externally-exposed anionic lipid. These vesicles should be superior and more realistic model membranes for studies of lipid-lipid and lipid-protein interaction in a lipid environment that resembles that of mammalian plasma membranes.

  4. Mimicking the magnetic properties of rare earth elements using superatoms.

    PubMed

    Cheng, Shi-Bo; Berkdemir, Cuneyt; Castleman, A W

    2015-04-21

    Rare earth elements (REs) consist of a very important group in the periodic table that is vital to many modern technologies. The mining process, however, is extremely damaging to the environment, making them low yield and very expensive. Therefore, mimicking the properties of REs in a superatom framework is especially valuable but at the same time, technically challenging and requiring advanced concepts about manipulating properties of atom/molecular complexes. Herein, by using photoelectron imaging spectroscopy, we provide original idea and direct experimental evidence that chosen boron-doped clusters could mimic the magnetic characteristics of REs. Specifically, the neutral LaB and NdB clusters are found to have similar unpaired electrons and magnetic moments as their isovalent REs (namely Nd and Eu, respectively), opening up the great possibility in accomplishing rare earth mimicry. Extension of the superatom concept into the rare earth group not only further shows the power and advance of this concept but also, will stimulate more efforts to explore new superatomic clusters to mimic the chemistry of these heavy atoms, which will be of great importance in designing novel building blocks in the application of cluster-assembled nanomaterials. Additionally, based on these experimental findings, a novel "magic boron" counting rule is proposed to estimate the numbers of unpaired electrons in diatomic LnB clusters.

  5. Evaluation of tissue mimicking quality of tofu for biomedical ultrasound.

    PubMed

    Kim, Yong Tae; Kim, Ho Chul; Inada-Kim, Matthew; Jung, Sung Soo; Yun, Yong Hyeon; Jho, Moon Jae; Sandstrom, Kurt

    2009-03-01

    The tissue mimicking quality of tofu has been evaluated in terms of acoustic properties and acousto/thermal conversion as functions of frequency and diffraction corrected intensity over the 2 MHz to 18 MHz range using three unfocussed transducers with center frequencies of 5 MHz, 10 MHz and 15 MHz. The density and acoustic velocity were close to the American Institute of Ultrasound in Medicine (AIUM) recommended values for the soft tissue, however, the attenuation increases nonlinearly with frequency as alpha = 0.56 x f(1.3). As a result, the temperature rise in tofu due to ultrasound absorption is expressed by the product of the acousto/thermal conversion factor and the attenuation/diffraction corrected acoustic intensity. The decrease of temperature rise with depth measured by embedded thermocouples agrees with the theoretical exponential decrease of the attenuation/diffraction corrected acoustic intensity. The heat capacity per unit mass of tofu is 0.76 cal/g degrees C (equivalent to 3.18 J/g degrees C) of which about 76% is water. The nonlinear frequency dependence of attenuation in tofu as f(1.3) correctly describes the frequency dependence of temperature rise. The present results suggest that tofu may only be used in a limited low MHz range in view of the estimation of temperature rise and penetration depth due to nonlinear frequency dependence of attenuation.

  6. Modulated fluorophore signal recovery buried within tissue mimicking phantoms.

    PubMed

    Sarkar, Saugata; Fan, Chaoyang; Hsiang, Jung-Cheng; Dickson, Robert M

    2013-10-03

    Optically modulated fluorescence from ∼140 nM Cy5 is visualized when embedded up to 6 mm within skin tissue mimicking phantoms, even in the presence of overwhelming background fluorescence and scatter. Experimental and finite element analysis (FEA)-based computational models yield excellent agreement in signal levels and predict biocompatible temperature changes. Using synchronously amplified fluorescence image recovery (SAFIRe), dual-laser excitation (primary laser: λ = 594 nm, 0.29 kW/cm(2); secondary laser: λ = 710 nm, 5.9 kW/cm(2), intensity-modulated at 100 Hz) simultaneously excites fluorescence and dynamically optically reverses the dark state buildup of primary laser-excited Cy5 molecules. As the modulated secondary laser both directly modulates Cy5 emission and is of lower energy than the collected Cy5 fluorescence, modulated Cy5 fluorescence in phantoms is free of obscuring background emission. The modulated fluorescence emission due to the secondary laser was recovered by Fourier transformation, yielding a specific and unique signature of the introduced fluorophores, with largely background-free detection, at excitation intensities close to the maximum permissible exposure (MPE) for skin. Experimental and computational models agree to within 8%, validating the computational model. As modulated fluorescence depends on the presence of both lasers, depth information as a function of focal position is also readily obtained from recovered modulated signal strength.

  7. Angle-resolved spectroscopy: a tissue-mimicking phantom study

    NASA Astrophysics Data System (ADS)

    Zhang, Yan; Vasefi, Fartash; Chamson-Reig, Astrid; Najiminainia, Mohamadreza; Kaminska, Bozena; Carson, Jeffrey J. L.

    2012-03-01

    The Radial Angular Filter Array (RAFA) is a novel optical filter consisting of a radially-distributed series of micromachined channels with a focal length of a few millimeters. The RAFA filters photons passing through the focal point according to the propagation direction and has proven to be capable of collecting the angular distribution and the spectral information of photons simultaneously and non-invasively, which allows angle-resolved spectroscopic measurement of a turbid medium. To explore the feasibility of using this device to characterize the optical abnormalities in human tissues, we tested the performance of an angle-resolved RAFA-based spectroscopy system to detect absorption targets embedded within a tissue-mimicking phantom. The body of the phantom was made of 0.1% IntralipidTM/agarose gel (7 mm in thickness) and the targets were spherical (1.5 mm in radius) and contained 10 μM Indocyanine Green (ICG). The illumination source was a broadband near infrared (NIR) collimated beam. Photons were angularly filtered by the RAFA and spectrally resolved by a pushbroom spectrometer. The experimental results confirmed that the RAFA preferentially filtered photons that carried absorption and scattering information of the embedded targets.

  8. Pulmonary Actinomycosis Mimicking Pulmonary Aspergilloma and a Brief Review of the Literature

    PubMed Central

    Higashi, Yoshitsugu; Nakamura, Shigeki; Ashizawa, Nobuyuki; Oshima, Kazuhiro; Tanaka, Akitaka; Miyazaki, Taiga; Izumikawa, Koichi; Yanagihara, Katsunori; Yamamoto, Yoshihiro; Miyazaki, Yoshitsugu; Mukae, Hiroshi; Kohno, Shigeru

    2017-01-01

    Pulmonary actinomycosis is a rare pulmonary infection that often exhibits unspecific symptoms and radiological findings. We herein report a case of pulmonary actinomycosis that mimicked pulmonary aspergilloma in an immunocompetent patient. PMID:28202870

  9. Bronchogenic/foregut cyst of the ileal mesentery in a child mimicking ovarian mass.

    PubMed

    Markel, Troy A; Lin, Jingmei; Fan, Rong; Billmire, Deborah F

    2013-10-01

    Intraabdominal bronchogenic cysts, a type of foregut cyst, are very rare. We report a case in a 12-year-old female who presented with severe abdominal pain and, in radiology workup, a cystic lesion that mimicked ovarian mass.

  10. Measurement of guided mode wavenumbers in soft tissue-bone mimicking phantoms using ultrasonic axial transmission

    NASA Astrophysics Data System (ADS)

    Chen, Jiangang; Foiret, Josquin; Minonzio, Jean-Gabriel; Talmant, Maryline; Su, Zhongqing; Cheng, Li; Laugier, Pascal

    2012-05-01

    Human soft tissue is an important factor that influences the assessment of human long bones using quantitative ultrasound techniques. To investigate such influence, a series of soft tissue-bone phantoms (a bone-mimicking plate coated with a layer of water, glycerol or silicon rubber) were ultrasonically investigated using a probe with multi-emitter and multi-receiver arrays in an axial transmission configuration. A singular value decomposition signal processing technique was applied to extract the frequency-dependent wavenumbers of several guided modes. The results indicate that the presence of a soft tissue-mimicking layer introduces additional guided modes predicted by a fluid waveguide model. The modes propagating in the bone-mimicking plate covered by the soft-tissue phantom are only slightly modified compared to their counterparts in the free bone-mimicking plate, and they are still predicted by an elastic transverse isotropic two-dimensional waveguide. Altogether these observations suggest that the soft tissue-bone phantoms can be modeled as two independent waveguides. Even in the presence of the overlying soft tissue-mimicking layer, the modes propagating in the bone-mimicking plate can still be extracted and identified. These results suggest that our approach can be applied for the purpose of the characterization of the material and structural properties of cortical bone.

  11. Measurement of guided mode wavenumbers in soft tissue-bone mimicking phantoms using ultrasonic axial transmission.

    PubMed

    Chen, Jiangang; Foiret, Josquin; Minonzio, Jean-Gabriel; Talmant, Maryline; Su, Zhongqing; Cheng, Li; Laugier, Pascal

    2012-05-21

    Human soft tissue is an important factor that influences the assessment of human long bones using quantitative ultrasound techniques. To investigate such influence, a series of soft tissue-bone phantoms (a bone-mimicking plate coated with a layer of water, glycerol or silicon rubber) were ultrasonically investigated using a probe with multi-emitter and multi-receiver arrays in an axial transmission configuration. A singular value decomposition signal processing technique was applied to extract the frequency-dependent wavenumbers of several guided modes. The results indicate that the presence of a soft tissue-mimicking layer introduces additional guided modes predicted by a fluid waveguide model. The modes propagating in the bone-mimicking plate covered by the soft-tissue phantom are only slightly modified compared to their counterparts in the free bone-mimicking plate, and they are still predicted by an elastic transverse isotropic two-dimensional waveguide. Altogether these observations suggest that the soft tissue-bone phantoms can be modeled as two independent waveguides. Even in the presence of the overlying soft tissue-mimicking layer, the modes propagating in the bone-mimicking plate can still be extracted and identified. These results suggest that our approach can be applied for the purpose of the characterization of the material and structural properties of cortical bone.

  12. Auditory Stimuli Mimicking Ambient Sounds Drive Temporal “Delta-Brushes” in Premature Infants

    PubMed Central

    Chipaux, Mathilde; Colonnese, Matthew T.; Mauguen, Audrey; Fellous, Laure; Mokhtari, Mostafa; Lezcano, Oscar; Milh, Mathieu; Dulac, Olivier; Chiron, Catherine; Khazipov, Rustem; Kaminska, Anna

    2013-01-01

    In the premature infant, somatosensory and visual stimuli trigger an immature electroencephalographic (EEG) pattern, “delta-brushes,” in the corresponding sensory cortical areas. Whether auditory stimuli evoke delta-brushes in the premature auditory cortex has not been reported. Here, responses to auditory stimuli were studied in 46 premature infants without neurologic risk aged 31 to 38 postmenstrual weeks (PMW) during routine EEG recording. Stimuli consisted of either low-volume technogenic “clicks” near the background noise level of the neonatal care unit, or a human voice at conversational sound level. Stimuli were administrated pseudo-randomly during quiet and active sleep. In another protocol, the cortical response to a composite stimulus (“click” and voice) was manually triggered during EEG hypoactive periods of quiet sleep. Cortical responses were analyzed by event detection, power frequency analysis and stimulus locked averaging. Before 34 PMW, both voice and “click” stimuli evoked cortical responses with similar frequency-power topographic characteristics, namely a temporal negative slow-wave and rapid oscillations similar to spontaneous delta-brushes. Responses to composite stimuli also showed a maximal frequency-power increase in temporal areas before 35 PMW. From 34 PMW the topography of responses in quiet sleep was different for “click” and voice stimuli: responses to “clicks” became diffuse but responses to voice remained limited to temporal areas. After the age of 35 PMW auditory evoked delta-brushes progressively disappeared and were replaced by a low amplitude response in the same location. Our data show that auditory stimuli mimicking ambient sounds efficiently evoke delta-brushes in temporal areas in the premature infant before 35 PMW. Along with findings in other sensory modalities (visual and somatosensory), these findings suggest that sensory driven delta-brushes represent a ubiquitous feature of the human sensory

  13. Mimicking Photosynthesis with Electrode-Supported Lipid Nanoassemblies.

    PubMed

    Wang, Mingming; Zhan, Wei

    2016-11-15

    as well as their sequential formation on electrodes. Supported on electrodes, these bilayers uniformly afford reliable photocurrent generation and modular system design. (2) Gold-supported hybrid bilayers as a powerful model platform for probing biomembrane-associated photoelectrochemical processes. These hybrid nanostructures consist of one alkanethiol (or substituted alkanethiol) and one lipid monolayer, whose chemical identity and makeup can be separately controlled and modified. Such precise molecular organization and flexible formation, in turn, enable a series of physicochemical parameters key to photosynthetic processes to be explicitly examined and cross-compared. A few such examples, based on donor/acceptor distance and loading, interfacial dipole, and redox level, are included here to illustrate the usefulness and versatility of this system. (3) Mimicking photosynthesis with supercomplexed lipid nanoassemblies. This research effort was motivated to address the low light absorption suffered by single-bilayer based photosynthetic mimics and has yielded a new lipid-based approach to mimicking Nature's way of organizing multiple photosynthetic subunits. Rhodamine and fullerene assembled within these lipid supercomplexes display robust electronic communication. The remarkable possibility of using lipid matrix to further improve photoconversion efficiency is revealed by cholesterol, whose addition triggers exciton formation that promotes faster energy and electron transfer in these lipid nanoassemblies.

  14. Mimicking Nonequilibrium Steady States with Time-Periodic Driving

    NASA Astrophysics Data System (ADS)

    Raz, O.; Subaşı, Y.; Jarzynski, C.

    2016-04-01

    Under static conditions, a system satisfying detailed balance generically relaxes to an equilibrium state in which there are no currents. To generate persistent currents, either detailed balance must be broken or the system must be driven in a time-dependent manner. A stationary system that violates detailed balance evolves to a nonequilibrium steady state (NESS) characterized by fixed currents. Conversely, a system that satisfies instantaneous detailed balance but is driven by the time-periodic variation of external parameters—also known as a stochastic pump (SP)—reaches a periodic state with nonvanishing currents. In both cases, these currents are maintained at the cost of entropy production. Are these two paradigmatic scenarios effectively equivalent? For discrete-state systems, we establish a mapping between nonequilibrium stationary states and stochastic pumps. Given a NESS characterized by a particular set of stationary probabilities, currents, and entropy production rates, we show how to construct a SP with exactly the same (time-averaged) values. The mapping works in the opposite direction as well. These results establish a proof of principle: They show that stochastic pumps are able to mimic the behavior of nonequilibrium steady states, and vice versa, within the theoretical framework of discrete-state stochastic thermodynamics. Nonequilibrium steady states and stochastic pumps are often used to model, respectively, biomolecular motors driven by chemical reactions and artificial molecular machines steered by the variation of external, macroscopic parameters. Our results loosely suggest that anything a biomolecular machine can do, an artificial molecular machine can do equally well. We illustrate this principle by showing that kinetic proofreading, a NESS mechanism that explains the low error rates in biochemical reactions, can be effectively mimicked by a constrained periodic driving.

  15. Fate of pathogenic bacteria in microcosms mimicking human body sites.

    PubMed

    Castellani, Francesco; Ghidini, Valentina; Tafi, Maria Carla; Boaretti, Marzia; Lleo, Maria M

    2013-07-01

    During the infectious process, pathogens may reach anatomical sites where they are exposed to substances interfering with their growth. These substances can include molecules produced by the host, and his resident microbial population, as well as exogenous antibacterial drugs. Suboptimal concentrations of inhibitory molecules and stress conditions found in vivo (high or low temperatures, lack of oxygen, extreme pH) might induce in bacteria the activation of survival mechanisms blocking their division capability but allowing them to stay alive. These "dormant" bacteria can be reactivated in particular circumstances and would be able to express their virulence traits. In this study, it was evaluated the effect of some environmental conditions, such as optimal and suboptimal temperatures, direct light and antibiotic sub-inhibitory concentrations doses of antibiotic, on the human pathogens Escherichia coli and Enterococcus faecalis when incubated in fluids accumulated in the body of patients with different pathologies. It is shown that inoculation in a number of accumulated body fluids and the presence of gentamicin, reliable conditions encountered during pathological states, induce stress-responding strategies enabling bacteria to persist in microcosms mimicking the human body. Significant differences were detected in Gram-negative and Gram-positive species with E. faecalis surviving, as starved or viable but non-culturable forms, in any microcosm and condition tested and E. coli activating a viable but non-culturable state only in some clinical samples. The persistence of bacteria under these conditions, being non-culturable, might explain some recurrent infections without isolation of the causative agent after application of the standard microbiological methods.

  16. Herpes zoster sciatica mimicking lumbar canal stenosis: a case report.

    PubMed

    Koda, Masao; Mannoji, Chikato; Oikawa, Makiko; Murakami, Masazumi; Okamoto, Yuzuru; Kon, Tamiyo; Okawa, Akihiko; Ikeda, Osamu; Yamazaki, Masashi; Furuya, Takeo

    2015-07-29

    Symptom of herpes zoster is sometimes difficult to distinguish from sciatica induced by spinal diseases, including lumbar disc herniation and spinal canal stenosis. Here we report a case of sciatica mimicking lumbar canal stenosis. A 74-year-old Chinese male patient visited our hospital for left-sided sciatic pain upon standing or walking for 5 min of approximately 1 month's duration. At the first visit to our hospital, there were no skin lesions. A magnetic resonance imaging showed spinal canal stenosis between the 4th and 5th lumbar spine. Thus, we diagnosed the patient with sciatica induced by spinal canal stenosis. We considered decompression surgery for the stenosis of 4th and 5th lumbar spine because conservative therapy failed to relieve the patient's symptom. At that time, the patient complained of a skin rash involving his left foot for several days. A vesicular rash and erythema were observed on the dorsal and plantar surfaces of the great toe and lateral malleolus. The patient was diagnosed with herpes zoster in the left 5th lumbar spinal nerve area based on clinical findings, including the characteristics of the pain and vesicular rash and erythema in the 5th lumbar spinal dermatome. The patient was treated with famciclovir (1,500 mg/day) and non-steroidal anti-inflammatory drugs. After 1 week of medication, the skin rash resolved and pain relief was obtained. In conclusion, spinal surgeons should keep in mind herpes zoster infection as one of the possible differential diagnoses of sciatica, even if there is no typical skin rash.

  17. Kawasaki disease mimicking a parapharyngeal abscess: a case report.

    PubMed

    Cai, Qianyun; Luo, Rong; Gan, Jing; Zhang, Li; Qu, Yi; Mu, Dezhi

    2015-05-01

    Parapharyngeal abscess (PPA)-like lesion is a very rare manifestation of Kawasaki disease (KD). Here we report a Chinese case of KD initially mimicking PPA, which is the first one reported in Asia.A 3-year-old male patient presented with fever, drooling, and bilateral painful cervical lymphadenopathy for 3 days. Chest X-ray and echocardiogram were normal. With substantial elevation of white blood count and C-reactive protein, purulent cervical lymphadenitis was considered. Symptoms did not improve after treatment with vancomycin, and the patient further developed trismus and restricted neck movement. Neck CT revealed a 2 × 1.5 cm hypodense lesion in the right parapharyngeal space with peripheral enhancement. PPA was suspected and on the 3rd day following admission, the patient received surgical incision and drainage. One milliliter of serous fluid was drained without bacterial growth on cultures. Fever persisted after surgery. As the clinical course proceeded, additional major signs of KD gradually evolved, and on the 6th day following admission the patient completely fulfilled the diagnostic criteria for KD. Rapid clinical improvement was observed following treatment with high-dose immunoglobulin and aspirin. Due to the parapharyngeal operation, the patient was fed milk through a nasogastric tube for 15 days. His neck incision became infected but healed gradually following dressing change and antibiotic treatment. Currently he remains asymptomatic during regular follow-up and repeated echocardiograms are normal.Both pediatricians and otolaryngologists can learn from this case that KD may initially manifest as PPA. Careful observation for major signs of KD during the clinical course can help to achieve a prompt and correct diagnosis. Thus, unnecessary surgery and cardiac complications of KD may be avoided.

  18. Isolated neurosarcoidosis mimicking multifocal meningiomas: a diagnosis pitfall

    PubMed Central

    Wang, Kun; He, Xiaoying; Wang, Wei; Niu, Huanjiang; Wang, Yirong; Cai, Xiujun; Yang, Shuxu

    2016-01-01

    Abstract Introduction: Neurosarcoidosis accounts for approximately 5% of the sarcoidosis, which develops exclusively in the nervous system and is always difficult to diagnose. We describe a rare case of isolated neurosarcoidosis mimicking as multifocal meningiomas. A 27-year-old male was admitted to our hospital with a history of unconsciousness and convulsion 1 month ago, which was suspected as a seizure. The results showed no abnormalities in complete blood count; serum electrolytes; erythrocyte sedimentation rate and ultrasonography of the liver, pancreas, spleen, kidney and parotid gland, and so on. Chest radiograph and electroencephalogram were also normal. Serum-angiotensin-converting enzyme slightly increased. Normal opening pressure was shown in cerebrospinal fluid sampling, which includes 8/μL white blood cells, 0.93 g/L protein, and 3.03 mmol/L glucose. Enhanced magnetic resonance imaging revealed multifocal enhancement lesions, including left sphenoid wing region, left temporal and bilateral occipitoparietal region, which were suspected as multiple “meningioma”. A left frontotemporal craniotomy was further performed. Both necrotizing and non-necrotizing granulomas were revealed in the pathological specimen, most of which were associated with multinucleated giant cells and macrophages. We could also see the fibrosis and inflammatory reaction in the sample composed of lymphocytes, histiocytes, and plasma cells. Histopathological examination showed that the cells were positive for human CD68 (KP1), CD68 (PGM1), and CD163; however, they were negative for the AF, epithelial membrane antigen, and glial fibrillary acidic protein. Tuberculosis-deoxyribonucleic acid test and special stains for acid-fast bacilli and fungi were negative. The diagnosis was finally made as isolated neurosarcoidosis. Then the patient was treated with additional corticosteroid therapy. Serial imaging examination 4 months later revealed that the lesions extremely decreased

  19. Enhanced Biotransformation of Fluoranthene by Intertidally Derived Cunninghamella elegans under Biofilm-Based and Niche-Mimicking Conditions

    PubMed Central

    Mitra, Sayani; Pramanik, Arnab; Banerjee, Srijoni; Haldar, Saubhik; Gachhui, Ratan

    2013-01-01

    The aims of the investigation were to ascertain if surface attachment of Cunninghamella elegans and niche intertidal conditions provided in a bioreactor influenced biotransformation of fluoranthene by C. elegans. A newly designed polymethylmethacrylate (PMMA) conico-cylindrical flask (CCF) holding eight equidistantly spaced rectangular strips mounted radially on a circular disc allowed comparison of fluoranthene biotransformation between CCFs with a hydrophobic surface (PMMA-CCF) and a hydrophilic glass surface (GS-CCF) and a 500-ml Erlenmeyer flask (EF). Fluoranthene biotransformation was higher by 22-fold, biofilm growth was higher by 3-fold, and cytochrome P450 gene expression was higher by 2.1-fold when C. elegans was cultivated with 2% inoculum as biofilm culture in PMMA-CCF compared to planktonic culture in EF. Biotransformation was enhanced by 7-fold with 10% inoculum. The temporal pattern of biofilm progression based on three-channel fluorescence detection by confocal laser scanning microscopy demonstrated well-developed, stable biofilm with greater colocalization of fluoranthene within extracellular polymeric substances and filaments of the biofilm grown on PMMA in contrast to a glass surface. A bioreactor with discs rotating at 2 revolutions per day affording 6-hourly emersion and immersion mimicked the niche intertidal habitat of C. elegans and supported biofilm formation and transformation of fluoranthene. The amount of transformed metabolite was 3.5-fold, biofilm growth was 3-fold, and cytochrome P450 gene expression was 1.9-fold higher in the process mimicking the intertidal conditions than in a submerged process without disc rotation. In the CCF and reactor, where biofilm formation was comparatively greater, higher concentration of exopolysaccharides allowed increased mobilization of fluoranthene within the biofilm with consequential higher gene expression leading to enhanced volumetric productivity. PMID:24038685

  20. A Case of Cutaneous Leishmaniasis guyanensis Mimicking Otitis Externa.

    PubMed

    Goodrich, Eric S; Sears, Stephen C; Sorrells, Timothy; Radike, James K; Miladi, Anis; Glass, Jonathan S

    2017-07-01

    Cutaneous leishmaniasis typically presents as a painless papule progressing to an ulcer or plaque. In this case study of the ear, the disease manifested as a small painful bump progressing into redness and swelling about the ear with purulent drainage. After multiple oral/intravenous antipseudomonal, antistaphylococcal, and antifungal treatments, there was no improvement. The skin progressed to an erythematous plaque and hemorrhagic ulcer; punch biopsy and speciation revealed Leishmaniasis guyanensis. The patient was switched to a seven-dose course of intravenous L-amphotericin B (visceral leishmaniasis protocol). Within 21 days, pain and edema resolved and the ulcers healed. Three-month follow-up demonstrated no recurrence. Further studies are needed to evaluate the use of L-amphotericin B in Leishmaniasis guyanensis. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  1. Fork-tailed drongos use deceptive mimicked alarm calls to steal food.

    PubMed

    Flower, Tom

    2011-05-22

    Despite the prevalence of vocal mimicry in animals, few functions for this behaviour have been shown. I propose a novel hypothesis that false mimicked alarm calls could be used deceptively to scare other species and steal their food. Studies have previously suggested that animals use their own species-specific alarm calls to steal food. However none have shown conclusively that these false alarms are deceptive, or that mimicked alarm calls are used in this manner. Here, I show that wild fork-tailed drongos (Dicrurus adsimilis) make both drongo-specific and mimicked false alarm calls when watching target species handling food, in response to which targets flee to cover abandoning their food. The drongo-specific and mimicked calls made in false alarms were structurally indistinguishable from calls made during true alarms at predators by drongos and other species. Furthermore, I demonstrate by playback experiments that two of these species, meerkats (Suricata suricatta) and pied babblers (Turdoides bicolor), are deceived by both drongo-specific and mimicked false alarm calls. These results provide the first conclusive evidence that false alarm calls are deceptive and demonstrate a novel function for vocal mimicry. This work also provides valuable insight into the benefits of deploying variable mimetic signals in deceptive communication.

  2. Fork-tailed drongos use deceptive mimicked alarm calls to steal food

    PubMed Central

    Flower, Tom

    2011-01-01

    Despite the prevalence of vocal mimicry in animals, few functions for this behaviour have been shown. I propose a novel hypothesis that false mimicked alarm calls could be used deceptively to scare other species and steal their food. Studies have previously suggested that animals use their own species-specific alarm calls to steal food. However none have shown conclusively that these false alarms are deceptive, or that mimicked alarm calls are used in this manner. Here, I show that wild fork-tailed drongos (Dicrurus adsimilis) make both drongo-specific and mimicked false alarm calls when watching target species handling food, in response to which targets flee to cover abandoning their food. The drongo-specific and mimicked calls made in false alarms were structurally indistinguishable from calls made during true alarms at predators by drongos and other species. Furthermore, I demonstrate by playback experiments that two of these species, meerkats (Suricata suricatta) and pied babblers (Turdoides bicolor), are deceived by both drongo-specific and mimicked false alarm calls. These results provide the first conclusive evidence that false alarm calls are deceptive and demonstrate a novel function for vocal mimicry. This work also provides valuable insight into the benefits of deploying variable mimetic signals in deceptive communication. PMID:21047861

  3. Development of Stepwise Osteogenesis-mimicking Matrices for the Regulation of Mesenchymal Stem Cell Functions*

    PubMed Central

    Hoshiba, Takashi; Kawazoe, Naoki; Tateishi, Tetsuya; Chen, Guoping

    2009-01-01

    An extracellular microenvironment, including an extracellular matrix (ECM), is an important factor in regulating stem cell differentiation. During tissue development, the ECM is dynamically remodeled to regulate stem cell functions. Here, we developed matrices mimicking ECM remodeling during the osteogenesis of mesenchymal stem cells (MSCs). The matrices were prepared from cultured MSCs controlled at different stages of osteogenesis and referred to as “stepwise osteogenesis-mimicking matrices.” The matrices supported the adhesion and proliferation of MSCs and showed different effects on the osteogenesis of MSCs. On the matrices mimicking the early stage of osteogenesis (early stage matrices), the osteogenesis occurred more rapidly than did that on the matrices mimicking undifferentiated stem cells (stem cell matrices) and the late stage of osteogenesis (late stage matrices). RUNX2 was similarly expressed when MSCs were cultured on both the early stage and late stage matrices but decreased on the stem cell matrices. PPARG expression in the MSCs cultured on the late stage matrices was higher than for those cultured on the stem cell and early stage matrices. This increase of PPARG expression was caused by the suppression of the amount of β-catenin and downstream signal transduction. These results demonstrate that the osteogenesis-mimicking matrices had different effects on the osteogenesis of MSCs, and the early stage matrices provided a favorable microenvironment for the osteogenesis. PMID:19762920

  4. Unilateral lichen planus pigmentosus mimicking acral lentiginous melanoma.

    PubMed

    Bickle, Kelly; Smithberger, Erica; Lien, Mary H; Fenske, Neil Alan

    2010-07-01

    The authors report a case of a Latin American woman who developed progressive pigmentation primarily involving two digits of her right hand. She was scheduled for amputation based on a presumptive histologic diagnosis of melanoma with regression. Dermatology consultation with repeat biopsies disclosed a lichenoid tissue reaction with marked pigment incontinence and no evidence of melanoma. This report should prompt physicians to include lichen planus pigmentosus in the differential diagnosis of acral lentiginous melanoma.

  5. Polymerization of a divalent/tetravalent metal-storing atom-mimicking dendrimer.

    PubMed

    Albrecht, Ken; Hirabayashi, Yuki; Otake, Masaya; Mendori, Shin; Tobari, Yuta; Azuma, Yasuo; Majima, Yutaka; Yamamoto, Kimihisa

    2016-12-01

    The phenylazomethine dendrimer (DPA) has a layer-by-layer electron density gradient that is an analog of the Bohr atom (atom mimicry). In combination with electron pair mimicry, the polymerization of this atom-mimicking dendrimer was achieved. The valency of the mimicked atom was controlled by changing the chemical structure of the dendrimer. By mimicking a divalent atom, a one-dimensional (1D) polymer was obtained, and by using a planar tetravalent atom mimic, a 2D polymer was obtained. These poly(dendrimer) polymers could store Lewis acids (SnCl2) in their unoccupied orbitals, thus indicating that these poly(dendrimer) polymers consist of a series of nanocontainers.

  6. Polymerization of a divalent/tetravalent metal-storing atom-mimicking dendrimer

    PubMed Central

    Albrecht, Ken; Hirabayashi, Yuki; Otake, Masaya; Mendori, Shin; Tobari, Yuta; Azuma, Yasuo; Majima, Yutaka; Yamamoto, Kimihisa

    2016-01-01

    The phenylazomethine dendrimer (DPA) has a layer-by-layer electron density gradient that is an analog of the Bohr atom (atom mimicry). In combination with electron pair mimicry, the polymerization of this atom-mimicking dendrimer was achieved. The valency of the mimicked atom was controlled by changing the chemical structure of the dendrimer. By mimicking a divalent atom, a one-dimensional (1D) polymer was obtained, and by using a planar tetravalent atom mimic, a 2D polymer was obtained. These poly(dendrimer) polymers could store Lewis acids (SnCl2) in their unoccupied orbitals, thus indicating that these poly(dendrimer) polymers consist of a series of nanocontainers. PMID:27957538

  7. Acute tuberculous myopericarditis mimicking acute myocardial infarction: A case report and literature review

    PubMed Central

    REN, MANYI; ZHANG, CHUNSHENG; ZHANG, XIAOJUAN; ZHONG, JINGQUAN

    2016-01-01

    A number of cases of acute myopericarditis mimicking acute myocardial infarction (AMI) have previously been reported in the literature. However, to the best of our knowledge, such a case resulting from Mycobacterium tuberculosis infection has not previously been described. The present study reports the case of a 21-year-old male patient presenting with acute chest pain, in whom focal ST-segment elevation and elevated cardiac enzymes mimicked a diagnosis of AMI. However, acute tuberculous myopericarditis was diagnosed on the basis of a variety of imaging examinations, laboratory tests, as well as the changes observed in electrocardiograms (ECGs) and in the cardiac enzyme levels. The case highlights the importance of a detailed collection of medical history, comprehensive explanations of serial ECGs, thoracic computed tomography, echocardiogram and coronary angiography in the diagnosis and differentiation of acute tuberculous myopericarditis mimicking AMI. PMID:27284323

  8. Benign Schwannoma Mimicking Metastatic Lesion on F-18 FDG PET/CT in Differentiated Thyroid Cancer.

    PubMed

    Kang, Sungmin

    2013-06-01

    We report a case of benign schwannoma mimicking metastatic carcinoma. A 55-year-old female with papillary thyroid carcinoma underwent total thyroidectomy. F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) demonstrated a focal hypermetabolic lesion with maximum standardized uptake value (SUVmax) 5.3 at the right chest wall. Conventional chest CT demonstrated a 5.4 cm ovoid mass lesion between the intercostal muscles and liver. Pathology revealed a schwannoma by tumor excision. This case demonstrates that benign schwannoma may demonstrate FDG uptake mimicking metastatic carcinoma.

  9. Bi-focal atrial tachycardia mimicking atrial fibrillation: fusion and interference between two distinct tachycardias.

    PubMed

    Ejima, Koichiro; Shoda, Morio; Tanizaki, Kohei; Kasanuki, Hiroshi

    2007-11-01

    Irregular tachycardias mimicking atrial fibrillation (AF) have previously been described. We report a case of a 60-year-old man with an antiarrhythmic drug-resistant atrial tachycardia (AT) mimicking AF. The tachycardia consisted of two distinct ATs with interference of one repetitive AT with another sustained AT. Radiofrequency (RF) ablation of two distinct right atrial foci eliminated the irregular tachycardia. Although catheter-based pulmonary vein isolation has become a popular therapeutic approach for patients with symptomatic AF, careful evaluation of the intracardiac recordings in the patients undergoing RF ablation for AF is important.

  10. Cardiac and renal function are progressively impaired with aging in Zucker diabetic fatty type II diabetic rats.

    PubMed

    Baynes, John; Murray, David B

    2009-01-01

    This study investigated the temporal relationship between cardiomyopathy and renal pathology in the type II diabetic Zucker diabetic fatty (ZDF) rat. We hypothesized that changes in renal function will precede the development of cardiac dysfunction in the ZDF rat. Animals (10 weeks old) were divided into four experimental groups: Lean Control (fa/?) LC(n = 7), untreated ZDF rats (n = 7) sacrificed at 16 weeks of age, and LC (n = 7) untreated ZDF rats (n = 9) sacrificed at 36 weeks of age. LV structural/functional parameters were assessed via Millar conductance catheter. Renal function was evaluated via markers of proteinuria and evidence of hydronephrosis. LV mass was significantly less in the ZDF groups at both time points compared to age-matched LC. End diastolic volume was increased by 16% at 16 weeks and by 37% at 36 weeks of age (p < 0.05 vs. LC). End diastolic pressure and end systolic volume were significantly increased (42% and 27%respectively) at 36 weeks of age in the ZDF compared to LC. Kidney weights were significantly increased at both 16 and 36 week in ZDF animals (p < 0.05 vs. LC). Increased urinary albumin and decreased urinary creatinine were paralleled by a marked progression in the severity of hydronephrosis from 16 to 36 weeks of age in the ZDF group. In summary, there is evidence of progressive structural and functional changes in both the heart and kidney, starting as early as 16 weeks,without evidence that one pathology precedes or causes the other in the ZDF model of type II diabetes.

  11. Extraconal cystic schwannoma mimicking an orbital dermoid cyst.

    PubMed

    Feijó, Eduardo Damous; Nery, Ana Carla de Souza; Caiado, Fábio Ramos; Prehis, Aline Maria; Limongi, Roberto Murillo

    2016-01-01

    To our knowledge, we report the first case of an extraconal orbital cystic schwannoma in Brazilian literature. The tumor grew slowly and progressively and was associated with minimal eccentric proptosis and diplopia. The radiologic study (orbital computed tomography) revealed a rounded, encapsulated, and extraconal cystic mass in the superior medial region of the right orbit in the supraorbital and supratrochlear nerve topography. An anterior orbitotomy with full excision of the tumor was performed, and the histopathology examination revealed that the tumor was a schwannoma. After the surgery, the patient experienced total remission of his symptoms.

  12. Sandhoff disease mimicking adult-onset bulbospinal neuronopathy.

    PubMed Central

    Thomas, P K; Young, E; King, R H

    1989-01-01

    A 32 year old male is described with an onset of upper limb postural tremor in adolescence followed by muscle cramps. Progressive proximal amyotrophy and weakness in the limbs developed late in the third decade. Examination disclosed, in addition, bilateral facial weakness and mild dysarthria. Enzyme studies revealed hexosaminidase A and B deficiency, indicating a diagnosis of Sandhoff disease. Intra-axonal membranocytoplasmic bodies were present in a rectal biopsy. The presentation, which resembled that of X-linked bulbospinal neuronopathy, widens the clinical spectrum for disorders related to G(M2) gangliosidosis. Images PMID:2795083

  13. Massive subdural haematomas in Menkes disease mimicking shaken baby syndrome.

    PubMed

    Nassogne, Marie-Cécile; Sharrard, Mark; Hertz-Pannier, Lucie; Armengaud, Didier; Touati, Guy; Delonlay-Debeney, Pascale; Zerah, Michel; Brunelle, Francis; Saudubray, Jean-Marie

    2002-12-01

    Menkes disease is an X-linked inherited disorder of intestinal copper absorption resulting in copper deficiency. Cardinal features include hair abnormalities, facial dysmorphism, severe neurological impairment, hypothermia, arterial anomalies, bone abnormalities and a fatal outcome. We present a case of Menkes disease complicated by progressive macrocephaly following the development of massive subdural haematomas. These lesions associated with femoral metaphyseal spurs could be confused with nonaccidental injury such as that seen in the shaken baby syndrome. This case emphasises that Menkes disease, like glutaric aciduria type 1, should be included in the differential diagnosis of unexplained subdural haematomas and neurological deficits in infants.

  14. Nucleus-staining with biomolecule-mimicking nitrogen-doped carbon dots prepared by a fast neutralization heat strategy.

    PubMed

    Kang, Yan-Fei; Fang, Yang-Wu; Li, Yu-Hao; Li, Wen; Yin, Xue-Bo

    2015-12-11

    Biomolecule-mimicking nitrogen-doped carbon dots (N-Cdots) were synthesized from dopamine by a neutralization heat strategy. Fluorescence imaging of various cells validated their nucleus-staining efficiency. The dopamine-mimicking N-Cdots "trick" nuclear membranes to achieve nuclear localization and imaging.

  15. Postradiation lumbosacral radiculopathy with spinal root cavernomas mimicking carcinomatous meningitis

    PubMed Central

    Ducray, François; Guillevin, Rémy; Psimaras, Dimitri; Sanson, Marc; Mokhtari, Karima; Delanian, Sylvie; Navarro, Soledad; Maisonobe, Thierry; Cornu, Philippe; Hoang-Xuan, Khê; Delattre, Jean-Yves; Pradat, Pierre-François

    2008-01-01

    Lumbosacral radiculopathy is a rare complication of radiotherapy and may be challenging to differentiate from diagnosis of a tumor recurrence. We reviewed the records of three patients with a past history of cancer and radiotherapy who were referred for suspicion of carcinomatous meningitis on lumbar MRI, but whose final diagnosis was radiation-induced lumbosacral radiculopathy. The three patients developed a progressive lumbosacral radiculopathy at 20, 13, and 47 years after lumbar radiotherapy delivered for renal cancer, Hodgkin’s disease, and a seminoma, respectively. MRI showed a diffuse, nodular enhancement of the cauda equina nerve roots on T1 sequences, suggestive of leptomeningeal metastasis. A slowly progressive clinical course over several years and negative cerebrospinal fluid cytologic analysis ruled out the diagnosis of carcinomatous meningitis. Because of the radiologic findings, a biopsy was performed in two patients. In the first, a biopsy limited to the arachnoid excluded a malignant infiltration. In the second, a biopsy of the enhancing lesions demonstrated spinal root cavernomas. These observations, together with three recent case reports in the literature, delineate a syndrome of “radiation-induced lumbosacral radiculopathy with multiple spinal root cavernomas” that mimics carcinomatous meningitis on MRI. Its diagnosis is important in order to avoid inappropriate treatment and useless or dangerous spinal root biopsies. PMID:18755918

  16. Circumferential guided wave measurements of a cylindrical fluid-filled bone-mimicking phantom.

    PubMed

    Nauleau, Pierre; Grimal, Quentin; Minonzio, Jean-Gabriel; Laugier, Pascal; Prada, Claire

    2014-02-01

    In the context of hip fracture risk prediction, measurement of guided waves could improve the assessment of cortical femoral neck properties. The decomposition of the time reversal operator (DORT) method was previously shown to be efficient to measure circumferential guided modes in an empty cortical bone-mimicking tube of circular cross section. In this study, an adaptation of the DORT method is proposed to probe the same bone-mimicking tube but filled with a marrow-mimicking fluid. The contributions to the backscattered field of waves multiply reflected in the cavity of the tube interfere with those of circumferential guided waves. The former contributions are eliminated in the backpropagation image using ad hoc criterion determined with simulation. Eight portions of different guided modes were observed from experimental and simulated data. They were identified by comparison with theoretical predictions. This work confirms the feasibility of measuring guided waves in a fluid-filled tube of bone-mimicking material with the DORT method.

  17. Being Mimicked Increases Prosocial Behavior in 18-Month-Old Infants

    ERIC Educational Resources Information Center

    Carpenter, Malinda; Uebel, Johanna; Tomasello, Michael

    2013-01-01

    Most previous research on imitation in infancy has focused on infants' learning of instrumental actions on objects. This study focused instead on the more social side of imitation, testing whether being mimicked increases prosocial behavior in infants, as it does in adults (van Baaren, Holland, Kawakami, & van Knippenberg, 2004).…

  18. Mimicking time evolution within a quantum ground state: Ground-state quantum computation, cloning, and teleportation

    SciTech Connect

    Mizel, Ari

    2004-07-01

    Ground-state quantum computers mimic quantum-mechanical time evolution within the amplitudes of a time-independent quantum state. We explore the principles that constrain this mimicking. A no-cloning argument is found to impose strong restrictions. It is shown, however, that there is flexibility that can be exploited using quantum teleportation methods to improve ground-state quantum computer design.

  19. Redox enzyme-mimicking activities of CeO2 nanostructures: Intrinsic influence of exposed facets

    NASA Astrophysics Data System (ADS)

    Yang, Yushi; Mao, Zhou; Huang, Wenjie; Liu, Lihua; Li, Junli; Li, Jialiang; Wu, Qingzhi

    2016-10-01

    CeO2 nanoparticles (NPs) have been well demonstrated as an antioxidant in protecting against oxidative stress-induced cellular damages and a potential therapeutic agent for various diseases thanks to their redox enzyme-mimicking activities. The Ce3+/Ce4+ ratio and oxygen vacancies on the surface have been considered as the major originations responsible for the redox enzyme-mimicking activities of CeO2 NPs. Herein, CeO2 nanostructures (nanocubes and nanorods) exposed different facets were synthesized via a facile hydrothermal method. The characterizations by X-ray photoelectron spectroscopy, Raman spectroscopy, and UV-Vis spectroscopy show that the Ce3+/Ce4+ ratio and oxygen vacancy content on the surfaces of as-synthesized CeO2 nanostructures are nearly at the same levels. Meanwhile, the enzymatic activity measurements indicate that the redox enzyme-mimicking activities of as-synthesized CeO2 nanostructures are greatly dependent on their exposed facets. CeO2 nanocubes with exposed {100} facets exhibit a higher peroxidase but lower superoxide dismutase activity than those of the CeO2 nanorods with exposed {110} facets. Our results provide new insights into the redox enzyme-mimicking activities of CeO2 nanostructures, as well as the design and synthesis of inorganic nanomaterials-based artificial enzymes.

  20. Invasive Trichophyton rubrum mimicking blastomycosis in a patient with solid organ transplant.

    PubMed

    Talebi-Liasi, Faezeh; Shinohara, Michi M

    2017-09-01

    We present a case of tissue invasive Trichophyton rubrum (T. rubrum) histologically mimicking blastomycosis in a patient with kidney transplant on chronic immunosuppression. Invasive dermatophyte infections are rare, and present a diagnostic challenge to the dermatopathologist due to atypical clinical and histopathological presentations. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Redox enzyme-mimicking activities of CeO2 nanostructures: Intrinsic influence of exposed facets

    PubMed Central

    Yang, Yushi; Mao, Zhou; Huang, Wenjie; Liu, Lihua; Li, Junli; Li, Jialiang; Wu, Qingzhi

    2016-01-01

    CeO2 nanoparticles (NPs) have been well demonstrated as an antioxidant in protecting against oxidative stress-induced cellular damages and a potential therapeutic agent for various diseases thanks to their redox enzyme-mimicking activities. The Ce3+/Ce4+ ratio and oxygen vacancies on the surface have been considered as the major originations responsible for the redox enzyme-mimicking activities of CeO2 NPs. Herein, CeO2 nanostructures (nanocubes and nanorods) exposed different facets were synthesized via a facile hydrothermal method. The characterizations by X-ray photoelectron spectroscopy, Raman spectroscopy, and UV-Vis spectroscopy show that the Ce3+/Ce4+ ratio and oxygen vacancy content on the surfaces of as-synthesized CeO2 nanostructures are nearly at the same levels. Meanwhile, the enzymatic activity measurements indicate that the redox enzyme-mimicking activities of as-synthesized CeO2 nanostructures are greatly dependent on their exposed facets. CeO2 nanocubes with exposed {100} facets exhibit a higher peroxidase but lower superoxide dismutase activity than those of the CeO2 nanorods with exposed {110} facets. Our results provide new insights into the redox enzyme-mimicking activities of CeO2 nanostructures, as well as the design and synthesis of inorganic nanomaterials-based artificial enzymes. PMID:27748403

  2. Being Mimicked Increases Prosocial Behavior in 18-Month-Old Infants

    ERIC Educational Resources Information Center

    Carpenter, Malinda; Uebel, Johanna; Tomasello, Michael

    2013-01-01

    Most previous research on imitation in infancy has focused on infants' learning of instrumental actions on objects. This study focused instead on the more social side of imitation, testing whether being mimicked increases prosocial behavior in infants, as it does in adults (van Baaren, Holland, Kawakami, & van Knippenberg, 2004).…

  3. Achromobacter xylosoxidans Infection Presenting as a Pulmonary Nodule Mimicking Cancer ▿

    PubMed Central

    Claassen, Stephanie L.; Reese, Jason M.; Mysliwiec, Vincent; Mahlen, Steven D.

    2011-01-01

    Achromobacter xylosoxidans is typically isolated from pulmonary sources, presenting as pneumonia in immunosuppressed individuals. We describe a novel clinical presentation of A. xylosoxidans infection presenting as multiple spiculated, pulmonary nodules mimicking cancer for which the patient underwent a wedge resection of the lung for diagnosis and staging of presumptive cancer. PMID:21593259

  4. Peroxidase-Mimicking Nanozyme with Enhanced Activity and High Stability based on Metal-Support Interaction.

    PubMed

    Li, Zhihao; Yang, Xiangdong; Yang, Yanbing; Tan, Yaning; He, Yue; Liu, Meng; Liu, Xinwen; Yuan, Quan

    2017-10-09

    Peroxidase-mimicking nanozyme offers unique advantages of high stability and low cost over natural peroxidase for applications in bioanalysis, biomedicine and pollution treatment. However, the design of high-efficiency peroxidase-mimicking nanozymes remains a grand challenge. In this work, we adopted a structural design approach through hybridization of cube-CeO2 and Pt nanoparticles to create a novel peroxidase-mimicking nanozyme with high efficiency and excellent stability. Compared to pure cube-CeO2 and Pt nanoparticles, the as-hybridized Pt/cube-CeO2 nanocomposites display much improved activity because of the strong metal-support interaction. Meanwhile, the nanocomposites also maintain high catalytic activity after long-term storage and several-time recycle. Based on their excellent properties, Pt/cube-CeO2 nanocomposites were used to construct high-performance colorimetric biosensors for the sensitive detection of metabolites including H2O2 and glucose. Our findings highlight opportunities for the development of high-efficiency peroxidase-mimicking nanozyme with potentially various applications in diagnostic, biomedicine and pollution treatment. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Marked left ventricular hypertrophy mimicking hypertrophic cardiomyopathy associated with steroid therapy for congenital adrenal hyperplasia.

    PubMed

    Scirè, Giuseppe; D'Anella, Giorgio; Cristofori, Laura; Mazzuca, Valentina; Cianfarani, Stefano

    2007-06-01

    We describe a child treated with high-dose steroid therapy for congenital adrenal hyperplasia who showed marked left ventricular hypertrophy mimicking hypertrophic cardiomyopathy associated with steroid therapy for congenital adrenal hyperplasia. Cardiomyopathy reversed completely when an appropriate steroid therapeutic regimen was established.

  6. Redox enzyme-mimicking activities of CeO2 nanostructures: Intrinsic influence of exposed facets.

    PubMed

    Yang, Yushi; Mao, Zhou; Huang, Wenjie; Liu, Lihua; Li, Junli; Li, Jialiang; Wu, Qingzhi

    2016-10-17

    CeO2 nanoparticles (NPs) have been well demonstrated as an antioxidant in protecting against oxidative stress-induced cellular damages and a potential therapeutic agent for various diseases thanks to their redox enzyme-mimicking activities. The Ce(3+)/Ce(4+) ratio and oxygen vacancies on the surface have been considered as the major originations responsible for the redox enzyme-mimicking activities of CeO2 NPs. Herein, CeO2 nanostructures (nanocubes and nanorods) exposed different facets were synthesized via a facile hydrothermal method. The characterizations by X-ray photoelectron spectroscopy, Raman spectroscopy, and UV-Vis spectroscopy show that the Ce(3+)/Ce(4+) ratio and oxygen vacancy content on the surfaces of as-synthesized CeO2 nanostructures are nearly at the same levels. Meanwhile, the enzymatic activity measurements indicate that the redox enzyme-mimicking activities of as-synthesized CeO2 nanostructures are greatly dependent on their exposed facets. CeO2 nanocubes with exposed {100} facets exhibit a higher peroxidase but lower superoxide dismutase activity than those of the CeO2 nanorods with exposed {110} facets. Our results provide new insights into the redox enzyme-mimicking activities of CeO2 nanostructures, as well as the design and synthesis of inorganic nanomaterials-based artificial enzymes.

  7. Pulmonary cavitation and skin lesions mimicking tuberculosis in a HIV negative patient caused by Sporothrix brasiliensis

    PubMed Central

    Orofino-Costa, Rosane; Unterstell, Natasha; Carlos Gripp, Alexandre; de Macedo, Priscila Marques; Brota, Arles; Dias, Emylli; de Melo Teixeira, Marcus; Felipe, Maria Sueli; Bernardes-Engemann, Andréa R; Lopes-Bezerra, Leila Maria

    2013-01-01

    A 32-year-old HIV negative male presented with multiple pulmonary cavitation and skin abscesses up to 15 cm in diameter mimicking tuberculosis. Sporothrix brasiliensis was isolated and patient responded well to amphotericin B followed by itraconazole, except the skin lesions that had to be surgical drained to obtain cure. PMID:24432220

  8. Synonymies of wasp-mimicking species within the katydid genus Aganacris (Orthoptera: Tettigoniidae: Phaneropterinae)

    USDA-ARS?s Scientific Manuscript database

    Five neotropical wasp-mimicking species of the genus Aganacris—two known from females only and three from males only—are reviewed. Based on observations of interspecific interactions and morphological comparisons, sexual dimorphism is shown to occur within species, and that female species are consp...

  9. Alleviation of capsular formations on silicone implants in rats using biomembrane-mimicking coatings.

    PubMed

    Park, Ji Ung; Ham, Jiyeon; Kim, Sukwha; Seo, Ji-Hun; Kim, Sang-Hyon; Lee, Seonju; Min, Hye Jeong; Choi, Sunghyun; Choi, Ra Mi; Kim, Heejin; Oh, Sohee; Hur, Ji An; Choi, Tae Hyun; Lee, Yan

    2014-10-01

    Despite their popular use in breast augmentation and reconstruction surgeries, the limited biocompatibility of silicone implants can induce severe side effects, including capsular contracture - an excessive foreign body reaction that forms a tight and hard fibrous capsule around the implant. This study examines the effects of using biomembrane-mimicking surface coatings to prevent capsular formations on silicone implants. The covalently attached biomembrane-mimicking polymer, poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC), prevented nonspecific protein adsorption and fibroblast adhesion on the silicone surface. More importantly, in vivo capsule formations around PMPC-grafted silicone implants in rats were significantly thinner and exhibited lower collagen densities and more regular collagen alignments than bare silicone implants. The observed decrease in α-smooth muscle actin also supported the alleviation of capsular formations by the biomembrane-mimicking coating. Decreases in inflammation-related cells, myeloperoxidase and transforming growth factor-β resulted in reduced inflammation in the capsular tissue. The biomembrane-mimicking coatings used on these silicone implants demonstrate great potential for preventing capsular contracture and developing biocompatible materials for various biomedical applications.

  10. Collar Osteophytes Mimicking Osteonecrosis in Planar Bone Scintigraphy and Usefulness of SPECT/CT Images.

    PubMed

    Juang, Jr-Jian; Chen, Yi-Hsing; Tsai, Shih-Chuan; Lin, Wan-Yu

    2017-03-01

    The use of prednisolone is one major risk factor for osteonecrosis in patients with systemic lupus erythematosus. Bone scintigraphy can be a diagnostic tool for early diagnosis. We present a case who had collar osteophytes at the bilateral femoral heads, which mimicked osteonecrosis in the planar bone scintigram. An SPECT/CT scan avoided this pitfall and increased the diagnostic accuracy for osteonecrosis.

  11. Pseudocarcinomatous hyperplasia mimicking squamous cell carcinoma in a case of CD56-positive cytotoxic T-cell lymphoma.

    PubMed

    Ginsberg, David; Hill, Hilary; Wilson, Barbara; Plaza, Jose A; Schieke, Stefan M

    2015-03-01

    We present the case of an 84-year-old patient with a cutaneous CD56 positive cytotoxic T-cell lymphoma associated with substantial pseudocarcinomatous hyperplasia mimicking squamous cell carcinoma (SCC). The patient presented with a 7-month history of several progressive, ulcerated plaques on his right forearm. An initial biopsy showed changes consistent with a diagnosis of SCC for which the patient underwent surgical treatment. Several months later, the patient developed recurrent ulcerated plaques on the right forearm of which several biopsies were performed. The biopsies repeatedly showed marked pseudocarcinomatous hyperplasia resembling SCC. Deeper punch biopsies, however, showed a dense superficial and deep infiltrate of markedly atypical lymphocytes. Immunohistochemical analysis revealed strong positive staining for CD3, CD8, CD56 with negative stains for CD30 and Epstein-Barr virus-encoded small non-polyadenylated RNAs (EBER). Staining for beta F1 and gamma-delta T-cell receptor (γδ TCR) were both negative. This constellation was most consistent with a diagnosis of cutaneous peripheral T-cell lymphoma, unspecified in association with marked pseudocarcinomatous hyperplasia. Our case adds cutaneous peripheral T-cell lymphoma, unspecified to the list of conditions associated with pseudocarcinomatous hyperplasia (PCH) and illustrates once again the potential pitfalls of distinguishing marked pseudocarcinomatous hyperplasia from SCC. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Pathogen-mimicking vaccine delivery system designed with a bioactive polymer (inulin acetate) for robust humoral and cellular immune responses.

    PubMed

    Kumar, Sunny; Kesharwani, Siddharth S; Kuppast, Bhimanna; Bakkari, Mohammed Ali; Tummala, Hemachand

    2017-09-10

    New and improved vaccines are needed against challenging diseases such as malaria, tuberculosis, Ebola, influenza, AIDS, and cancer. The majority of existing vaccine adjuvants lack the ability to significantly stimulate the cellular immune response, which is required to prevent the aforementioned diseases. This study designed a novel particulate based pathogen-mimicking vaccine delivery system (PMVDS) to target antigen-presenting-cells (APCs) such as dendritic cells. The uniqueness of PMVDS is that the polymer used to prepare the delivery system, Inulin Acetate (InAc), activates the innate immune system. InAc was synthesized from the plant polysaccharide, inulin. PMVDS provided improved and persistent antigen delivery to APCs as an efficient vaccine delivery system, and simultaneously, activated Toll-Like Receptor-4 (TLR-4) on APCs to release chemokine's/cytokines as an immune-adjuvant. Through this dual mechanism, PMVDS robustly stimulated both the humoral (>32 times of IgG1 levels vs alum) and the cell-mediated immune responses against the encapsulated antigen (ovalbumin) in mice. More importantly, PMVDS stimulated both cytotoxic T cells and natural killer cells of cell-mediated immunity to provide tumor (B16-ova-Melanoma) protection in around 40% of vaccinated mice and significantly delayed tumor progression in rest of the mice. PMVDS is a unique bio-active vaccine delivery technology with broader applications for vaccines against cancer and several intracellular pathogens, where both humoral and cellular immune responses are desired. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Lymphomatous variant of hairy cell leukaemia: a distinctive presentation mimicking low-grade B-cell lymphoma.

    PubMed

    Liu, Hui; Wang, Wei; Tang, Guilin; Yin, Cheng Cameron; Muzzafar, Tariq; Medeiros, Leonard Jeffrey; Hu, Shimin

    2015-11-01

    Hairy cell leukaemia (HCL) is an indolent B-cell neoplasm that primarily involves the peripheral blood, bone marrow, and spleen. Rarely, patients with HCL present with a lymphoma-like clinicopathological picture mimicking other types of low-grade B-cell lymphoma. Distinguishing HCL from other types of lymphoma is essential, given the different treatments and prognoses. We report two cases of the lymphomatous variant of HCL to draw attention to this unusual presentation. Two cases of HCL presented initially as salivary gland and soft tissue masses. Morphologically, the neoplastic cells showed a typical fried-egg or monocytoid appearance with reniform nuclei, and were positive for CD11c, CD20, CD25, CD103, annexin A1, and cyclin D1. Both cases were positive for the BRAF V600E mutation, as shown by pyrosequencing and mutation-specific immunohistochemistry. The diagnosis was challenging in both patients, and one patient experienced 5 years of disease relapse and progression after treatment with multiple lymphoma-type regimens before the final diagnosis of HCL was established and complete remission was achieved following cladribine therapy. HCL can very rarely present as an extranodal mass. Being aware of this unusual presentation of HCL is essential to avoid diagnostic confusion with other types of low-grade B-cell lymphoma and to facilitate appropriate therapy. © 2015 John Wiley & Sons Ltd.

  14. Tissue mimicking materials for a multi-imaging modality prostate phantom.

    PubMed

    D'Souza, W D; Madsen, E L; Unal, O; Vigen, K K; Frank, G R; Thomadsen, B R

    2001-04-01

    Materials that simultaneously mimic soft tissue in vivo for magnetic resonance imaging (MRI), ultrasound (US), and computed tomography (CT) for use in a prostate phantom have been developed. Prostate and muscle mimicking materials contain water, agarose, lipid particles, protein, Cu++, EDTA, glass beads, and thimerosal (preservative). Fat was mimicked with safflower oil suffusing a random mesh (network) of polyurethane. Phantom material properties were measured at 22 degrees C. (22 degrees C is a typical room temperature at which phantoms are used.) The values of material properties should match, as well as possible, the values for tissues at body temperature, 37 degrees C. For MRI, the primary properties of interest are T1 and T2 relaxations times, for US they are the attenuation coefficient, propagation speed, and backscatter, and for CT, the x-ray attenuation. Considering the large number of parameters to be mimicked, rather good agreement was found with actual tissue values obtained from the literature. Using published values for prostate parenchyma, T1 and T2 at 37 degrees C and 40 MHz are estimated to be about 1,100 and 98 ms, respectively. The CT number for in vivo prostate is estimated to be 45 HU (Hounsfield units). The prostate mimicking material has a T1 of 937 ms and a T2 of 88 ms at 22 degrees C and 40 MHz; the propagation speed and attenuation coefficient slope are 1,540 m/s and 0.36 dB/cm/MHz, respectively, and the CT number of tissue mimicking prostate is 43 HU. Tissue mimicking (TM) muscle differs from TM prostate in the amount of dry weight agarose, Cu++, EDTA, and the quality and quantity of glass beads. The 18 microm glass beads used in TM muscle increase US backscatter and US attenuation; the presence of the beads also has some effect on T1 but no effect on T2. The composition of tissue-mimicking materials developed is such that different versions can be placed in direct contact with one another in a phantom with no long term change in US, MRI

  15. Granulomatous mycosis fungoides with hypohidrosis mimicking lepromatous leprosy.

    PubMed

    Gutte, Rameshwar; Kharkar, Vidya; Mahajan, Sunanda; Chikhalkar, Siddhi; Khopkar, Uday

    2010-01-01

    Granulomatous mycosis fungoides (GMF) is a rare type of cutaneous T cell lymphoma. A 38-year-old married male presented with decreased sweating all over the body for last 8 years, progressive redness and scaling over body for 2 years and multiple noduloulcerative lesions over the body for 1 year. Cutaneous examination revealed generalized erythema and scaling with poikilodermatous changes over chest and upper back along with multiple noduloulcerative lesions. Skin biopsy from a nodular lesion revealed dense granulomatous infiltrate of atypical lymphocytes with epidermotropism and sparing of appendages. Diagnosis of GMF was made. Computed tomographic scan of thorax, abdomen and pelvis revealed axillary and inguinal lymphadenopathy. Immunohistochemistry revealed leukocyte common antigen and CD3 positivity suggestive of T cell origin. Patient was started on CHOP (Cyclophosphamide, Hydroxydaunorubicin, Oncovin and Prednisolone) regimen of chemotherapy with marked improvement after three cycles of chemotherapy. This case had some clinical resemblance to lepromatous leprosy.

  16. Vulvovaginal Infralevator Haematoma Mimicking the Second Stage of Labour

    PubMed Central

    Ipinnimo, O. M.

    2017-01-01

    Even though they are quite uncommon, puerperal genital haematomas can be associated with serious maternal morbidity. Key findings are significant perineal pain and, depending on the location, visible swelling. However, attention can be drawn to its progression by the rare occurrence of persistent painful “bearing down” efforts, even after the successful delivery of the baby. The final size of this haematoma and the rare presentation make it truly uncommon. The primary goals of treatment include the prevention of further blood loss, minimizing tissue damage, relieving pain, and reducing the risk of infection. Management is generally conservative for small collections, but surgery is indispensable when they acutely expand in size or are large with worsening symptoms. PMID:28197352

  17. An electronic prosthesis mimicking the dynamic vestibular function

    NASA Astrophysics Data System (ADS)

    Shkel, Andrei M.

    2006-03-01

    This paper reports our progress toward development of a unilateral vestibular prosthesis. The sensing element of the prosthesis is a custom designed one-axis MEMS gyroscope. Similarly to the natural semicircular canal, the microscopic gyroscope senses angular motion of the head and generates voltages proportional to the corresponding angular accelerations. Then, voltages are sent to the pulse generating unit where angular motion is translated into voltage pulses. The voltage pulses are converted into current pulses and are delivered through specially designed electrodes, conditioned to stimulate the corresponding vestibular nerve branch. Our preliminary experimental evaluations of the prosthesis on a rate table indicate that the device's output matches the average firing rate of vestibular neurons to those in animal models reported in the literature. The proposed design is scalable; the sensing unit, pulse generator, and the current source can be potentially implemented on a single chip using integrated MEMS technology.

  18. Granulomatosis with polyangiitis mimicking infective endocarditis in an adolescent male.

    PubMed

    Varnier, Giulia Camilla; Sebire, Neil; Christov, Georgi; Eleftheriou, Despina; Brogan, Paul A

    2016-09-01

    Granulomatosis with polyangiitis (GPA) is a rare but serious small vessel vasculitis with heterogeneous clinical presentation ranging from mainly localised disease with a chronic course, to a florid, acute small vessel vasculitic form characterised by severe pulmonary haemorrhage and/or rapidly progressive vasculitis or other severe systemic vasculitic manifestations. Cardiac involvement is, however, uncommon in the paediatric population. We report a case of a 16-year-old male who presented with peripheral gangrene and vegetation with unusual location on the supporting apparatus of the tricuspid valve, initially considered to have infective endocarditis but ultimately diagnosed with GPA. We provide an overview of the limited literature relating to cardiac involvement in GPA, and the diagnostic challenge relating to infective endocarditis in this context, especially focusing on the interpretation of the antineutrophil cytoplasmic antibody (ANCA) and the characteristic clinical features to identify in order to promptly recognise GPA, since timely diagnosis and treatment are essential for this potentially life-threatening condition.

  19. Melanoma Stem Cells and Metastasis: Mimicking Hematopoietic Cell Trafficking?

    PubMed Central

    Lee, Nayoung; Barthel, Steven R.; Schatton, Tobias

    2014-01-01

    Malignant melanoma is a highly metastatic cancer that bears responsibility for the majority of skin cancer-related deaths. Amidst the research efforts to better understand melanoma progression, there has been increasing evidence that hints at a role for a subpopulation of virulent cancer cells, termed malignant melanoma stem or initiating cells (MMICs), in metastasis formation. MMICs are characterized by their preferential ability to initiate and propagate tumor growth and their selective capacity for self-renewal and differentiation into less tumorigenic melanoma cells. The frequency of MMICs has been shown to correlate with poor clinical prognosis in melanoma. Additionally, MMICs are enriched among circulating tumor cells (CTCs) in the peripheral blood of cancer patients, suggesting that MMICs may be a critical player in the metastatic cascade. Although these links exist between MMICs and metastatic disease, the mechanisms by which MMICs may advance metastatic progression are only beginning to be elucidated. Recent studies have shown that MMICs express molecules critical for hematopoietic cell maintenance and trafficking, providing a possible explanation for how circulating MMICs could drive melanoma dissemination. We therefore propose that MMICs might fuel melanoma metastasis by exploiting homing mechanisms commonly utilized by hematopoietic cells. Here we review the biological properties of MMICs and the existing literature on their metastatic potential. We will discuss possible mechanisms by which MMICs might initiate metastases in the context of established knowledge of cancer stem cells (CSCs) in other cancers and of hematopoietic homing molecules, with a particular focus on selectins, integrins, chemokines, and chemokine receptors known to be expressed by melanoma cells. Biological understanding of how these molecules might be utilized by MMICs to propel the metastatic cascade could critically impact the development of more effective therapies for advanced

  20. Myc Depletion Induces a Pluripotent Dormant State Mimicking Diapause

    PubMed Central

    Scognamiglio, Roberta; Cabezas-Wallscheid, Nina; Thier, Marc Christian; Altamura, Sandro; Reyes, Alejandro; Prendergast, Áine M.; Baumgärtner, Daniel; Carnevalli, Larissa S.; Atzberger, Ann; Haas, Simon; von Paleske, Lisa; Boroviak, Thorsten; Wörsdörfer, Philipp; Essers, Marieke A.G.; Kloz, Ulrich; Eisenman, Robert N.; Edenhofer, Frank; Bertone, Paul; Huber, Wolfgang; van der Hoeven, Franciscus; Smith, Austin; Trumpp, Andreas

    2016-01-01

    Summary Mouse embryonic stem cells (ESCs) are maintained in a naive ground state of pluripotency in the presence of MEK and GSK3 inhibitors. Here, we show that ground-state ESCs express low Myc levels. Deletion of both c-myc and N-myc (dKO) or pharmacological inhibition of Myc activity strongly decreases transcription, splicing, and protein synthesis, leading to proliferation arrest. This process is reversible and occurs without affecting pluripotency, suggesting that Myc-depleted stem cells enter a state of dormancy similar to embryonic diapause. Indeed, c-Myc is depleted in diapaused blastocysts, and the differential expression signatures of dKO ESCs and diapaused epiblasts are remarkably similar. Following Myc inhibition, pre-implantation blastocysts enter biosynthetic dormancy but can progress through their normal developmental program after transfer into pseudo-pregnant recipients. Our study shows that Myc controls the biosynthetic machinery of stem cells without affecting their potency, thus regulating their entry and exit from the dormant state. PMID:26871632

  1. Lumbar Aspergillus osteomyelitis mimicking pyogenic osteomyelitis in an immunocompetent adult.

    PubMed

    Yoon, Kyeong-Wook; Kim, Young-Jin

    2015-04-01

    Spinal Aspergillus osteomyelitis is rare and occurs mostly in immunocompromised patients, but especially very rare in immunocompetent adult. This report presents a case of lumbar vertebral osteomyelitis in immunocompetent adult. A 53-year-old male who had no significant medical history was admitted due to complaints of back pain radiating to the flank for the last 3 months, followed by a progressive motor weakness of both lower limbs. Lumbar magnetic resonance imaging (MRI) demonstrated osteomyelitis and diskitis, suspected to be a pyogenic condition rather than a tuberculosis infection. Despite antibiotic treatment for several weeks, the symptoms worsened, and finally, open surgery was performed. Surgical biopsy revealed an Aspergillus infection and medical treatment with amphotericin B was started. It can be diagnosed early through an MRI; biopsy is very important but difficult, and making the correct differential diagnosis is essential for avoiding unexpected complications. The authors report a case of lumbar Aspergillus osteomyelitis in an immunocompetent adult and reviewed previously described cases of spinal aspergillosis.

  2. Localized amyloidosis of the stomach mimicking a superficial gastric cancer.

    PubMed

    Kagawa, Miwako; Fujino, Yasuteru; Muguruma, Naoki; Murayama, Noriaki; Okamoto, Koichi; Kitamura, Shinji; Kimura, Tetsuo; Kishi, Kazuhiro; Miyamoto, Hiroshi; Uehara, Hisanori; Takayama, Tetsuji

    2016-06-01

    A 73-year-old man was referred to our hospital for further examination of a depressed lesion in the stomach found by cancer screening gastroscopy. A barium upper gastrointestinal series showed an area of irregular mucosa measuring 15 mm on the anterior wall of the gastric body. Esophagogastroduodenoscopy revealed a 15 mm depressed lesion on the anterior wall of the lower gastric body. We suspected an undifferentiated adenocarcinoma from the appearance and took some biopsies. However, histology of the specimens revealed amyloidal deposits in the submucosal layer without malignant findings. Congo red staining was positive for amyloidal protein and green birefringence was observed under polarized light microscopy. Congo red staining with prior potassium permanganate incubation confirmed the light chain (AL) amyloid type. There were no amyloid deposits in the colon or duodenum. Computed tomography of the chest, abdomen, and pelvis showed no remarkable findings. Thus, this case was diagnosed as a localized gastric amyloidosis characterized by AL type amyloid deposition in the mucosal or submucosal layer. As the clinical outcome of gastric AL amyloidosis seems favorable, this case is scheduled for periodic examination to recognize potential disease progression and has been stable for 2 years.

  3. Lung adenocarcinoma mimicking pulmonary fibrosis-a case report.

    PubMed

    Mehić, Bakir; Duranović Rayan, Lina; Bilalović, Nurija; Dohranović Tafro, Danina; Pilav, Ilijaz

    2016-09-13

    Lung cancer is usually presented with cough, dyspnea, pain and weight loss, which is overlapping with symptoms of other lung diseases such as pulmonary fibrosis. Pulmonary fibrosis shows characteristic reticular and nodular pattern, while lung cancers are mostly presented with infiltrative mass, thick-walled cavitations or a solitary nodule with spiculated borders. If the diagnosis is established based on clinical symptoms and CT findings, it would be a misapprehension. We report a case of lung adenocarcinoma whose symptoms as well as clinical images overlapped strongly with pulmonary fibrosis. The patient's non-productive cough, progressive dyspnea, restrictive pattern of pulmonary function test and CT scans (showing reticular interstitial opacities) were all indicative of pulmonary fibrosis. The patient underwent a treatment consisting of corticosteroids and antibiotics, to no avail. Histopathology of the lung showed that the patient suffered from mucinous adenocarcinoma. Albeit the immunohistochemical staining was not consistent with lung adenocarcinoma, tumor's morphological characteristics were consistent, and were used to make the definitive diagnosis. Given the fact that radiography cannot always make a clear-cut difference between pulmonary fibrosis and lung adenocarcinomas, and that clinical symptoms often overlap, histological examination should be considered as gold standard for diagnosis of lung adenocarcinoma.

  4. Calorie restriction mimicking effects of roflumilast prevents diabetic nephropathy.

    PubMed

    Tikoo, Kulbhushan; Lodea, Saritha; Karpe, Pinakin Arun; Kumar, Sandeep

    2014-08-08

    Little is known about role of PDE4 in the development and progression of diabetic nephropathy. Here, we investigated the effect of roflumilast, a selective PDE 4 inhibitor in type 1 diabetic nephropathy. Diabetes was induced in male Sprague-Dawley rats using streptozotocin (55 mg/kg). Diabetic rats showed elevated plasma glucose, blood urea nitrogen, creatinine and decrease in plasma albumin confirming signs of nephropathy. Roflumilast at 2 and 3mg/kg normalized these alterations. Roflumilast also suppressed oxidative stress and deposition of an extracellular matrix protein such as fibronectin and collagen in kidney of diabetic rats. TUNEL assay revealed apoptosis in diabetic kidney than control and that roflumilast prevents this effect. We show that kidney of diabetic rats displayed a state of p-AMPK and SIRT1 deficiency and that roflumilast, interestingly, was able to restore their levels. Further, roflumilast prevented an increase in HO-1 and loss in the FoxO1 expression in diabetes. However, it did not improve the reduced NRF2 levels in diabetes. This is the first report to show that, like resveratrol and other SIRT1 activators, roflumilast also mimics calorie restriction effects through activation of AMPK/SIRT1 and protects against diabetic nephropathy. This study unveils the unexplored potential of roflumilast which can be used in treatment of metabolic disorders.

  5. Teaching of the Society for Fetal Urology grading system for pediatric hydronephrosis is improved by e-Learning using Computer Enhanced Visual Learning (CEVL): A multi-institutional trial.

    PubMed

    Liu, Dennis B; Palmer, Blake; Herndon, C D Anthony; Maizels, Max

    2015-08-01

    It is unclear how clinicians learn to grade pediatric hydronephrosis (HN) and how effective their training has been. We sought to: 1. Assess how clinicians learn to grade HN and their confidence in their training and abilities and 2. To assess Computer Enhanced Visual Learning (CEVL) e-Learning to learn the Society for Fetal Urology (SFU) grading system for pediatric HN. A multi-institutional online survey was distributed to pediatric urologists, nephrologists, and radiologists. Respondents used a 6-point Likert scale (0 = not confident to 5 = very confident) to assess their confidence in knowledge of the criteria, indications, and ability to grade HN, and how they learned to grade. Participants assigned SFU grades to 15 neonatal ultrasounds (US). A CEVL module on the SFU grading system was accessed and a post-CEVL survey completed. Changes in confidence and accuracy of grading were compared before and after CEVL e-Learning. The most common method of learning was "casually during training" (44.5%). Significant increases in confidence in knowledge of criteria, indications, and ability to grade, as well as the accuracy of grading were seen following CEVL e-Learning (Figure A and B). Although the SFU grading system is considered the predominant grading system for HN, its application in clinical practice has been inconsistent. While this may be due to the grading system itself, it is possible that deficient training and confidence are the root causes. Our data supports this by demonstrating that most clinicians receive only casual training and accordingly, report low confidence in their knowledge and ability to grade HN. Therefore, we conclude that there exists a strong need to improve the teaching of the SFU grading system. e-Learning has been shown to be effective in teaching difficult topics and skills. We demonstrate that e-Learning with CEVL is effective in increasing both the confidence and accuracy of SFU grading of pediatric HN. Limitations of our study include

  6. Biomimetic photo-actuation: progress and challenges

    NASA Astrophysics Data System (ADS)

    Dicker, Michael P. M.; Weaver, Paul M.; Rossiter, Jonathan M.; Bond, Ian P.; Faul, Charl F. J.

    2016-04-01

    Photo-actuation, such as that observed in the reversible sun-tracking movements of heliotropic plants, is produced by a complex, yet elegant series of processes. In the heliotropic leaf movements of the Cornish Mallow, photo-actuation involves the generation, transport and manipulation of chemical signals from a distributed network of sensors in the leaf veins to a specialized osmosis driven actuation region in the leaf stem. It is theorized that such an arrangement is both efficient in terms of materials use and operational energy conversion, as well as being highly robust. We concern ourselves with understanding and mimicking these light driven, chemically controlled actuating systems with the aim of generating intelligent structures which share the properties of efficiency and robustness that are so important to survival in Nature. In this work we present recent progress in mimicking these photo-actuating systems through remote light exposure of a metastable state photoacid and the resulting signal and energy transfer through solution to a pH-responsive hydrogel actuator. Reversible actuation strains of 20% were achieved from this arrangement, with modelling then employed to reveal the critical influence hydrogel pKa has on this result. Although the strong actuation achieved highlights the progress that has been made in replicating the principles of biomimetic photo-actuation, challenges such as photoacid degradation were also revealed. It is anticipated that current work can directly lead to the development of high-performance and low-cost solartrackers for increased photovoltaic energy capture and to the creation of new types of intelligent structures employing chemical control systems.

  7. Study of single-electron information-processing circuit mimicking foraging behavior of honeybee swarm

    NASA Astrophysics Data System (ADS)

    Tanabe, Toshihiko; Oya, Takahide

    2017-06-01

    A new single-electron (SE) circuit mimicking the foraging behavior of a honeybee swarm is proposed. Recently, a “nature-inspired” or “biomimetic” technology has been attracting attention for developing innovative functional systems applying emerging nanoscale devices. In particular, the foraging behavior of honeybees is focused on as an architecture for a SE circuit. Honeybees show two foraging behaviors, namely, a probability search and a “waggle dance” (sharing information). By combining these behaviors, it can be considered that the foraging behavior is a unique information-processing act. For constructing a new system, a SE circuit mimicking the behavior was designed, constructed, and simulated. The SE circuit was constructed by assuming that the information that honeybees share corresponds to the operation of the circuit. The results of the simulation confirmed that the SE circuit mimics the information-sharing behavior of honeybees. Namely, the proposed honeybee-inspired SE circuit can perform functional information processing.

  8. Occupational Neurobrucellosis Mimicking a Brain Tumor: A Case Report and Review of the Literature

    PubMed Central

    Abdulghani, Dina; Farhan, Roiya; Algahtani, Raghad

    2017-01-01

    Brucellosis is a zoonotic bacterial infection which is transmitted to humans from infected animals and is endemic in many parts of the world including Saudi Arabia. In this article, we report a case of occupational neurobrucellosis that presented with a space-occupying lesion mimicking a brain tumor. We stress on the importance of obtaining detailed social history including occupation to reach the diagnosis in several conditions including brucellosis. We also stress on taking universal precautions when handling any specimens. It may be advisable that manipulation of all unknown specimens arriving at the laboratory should occur in biological safety cabinet until a highly infectious organism is ruled out. Neurobrucellosis should be included in the differential diagnosis in patients presenting with solitary mass lesion mimicking brain tumor especially in endemic areas or high occupational risk group. PMID:28299214

  9. The Face of the Chameleon: The Experience of Facial Mimicry for the Mimicker and the Mimickee

    PubMed Central

    Kulesza, Wojciech Marek; Cisłak, Aleksandra; Vallacher, Robin R.; Nowak, Andrzej; Czekiel, Martyna; Bedynska, Sylwia

    2015-01-01

    ABSTRACT This research addressed three questions concerning facial mimicry: (a) Does the relationship between mimicry and liking characterize all facial expressions, or is it limited to specific expressions? (b) Is the relationship between facial mimicry and liking symmetrical for the mimicker and the mimickee? (c) Does conscious mimicry have consequences for emotion recognition? A paradigm is introduced in which participants interact over a computer setup with a confederate whose prerecorded facial displays of emotion are synchronized with participants’ behavior to create the illusion of social interaction. In Experiment 1, the confederate did or did not mimic participants’ facial displays of various subsets of basic emotions. Mimicry promoted greater liking for the confederate regardless of which emotions were mimicked. Experiment 2 reversed these roles: participants were instructed to mimic or not to mimic the confederate’s facial displays. Mimicry did not affect liking for the confederate but it did impair emotion recognition. PMID:25811746

  10. Peripheral Odontogenic Fibroma: A Rare Tumor mimicking a Gingival Reactive Lesion

    PubMed Central

    Khot, Komal; Bagri-Manjrekar, Kriti; Khot, Paresh

    2017-01-01

    Gingival growths are one of the most frequently encountered lesions in the oral cavity. A plethora of lesions can be seen having similar clinical presentation, making diagnosis a dilemma. Peripheral odontogenic tumors are rare neoplasms to occur on gingiva, the most common among them being the peripheral odontogenic fibroma (POdF). The POdF is a benign, slow-growing, exophytic lesion. Although considered to have a recurrence potential after excision, the actual recurrence rate is not known due to paucity of reported cases. Presented here is a case of a rare neoplasm mimicking an inflammatory gingival lesion with review of the available literature. How to cite this article Khot K, Deshmane S, Bagri-Manjrekar K, Khot P. Peripheral Odontogenic Fibroma: A Rare Tumor mimicking a Gingival Reactive Lesion. Int J Clin Pediatr Dent 2017;10(1):103-106. PMID:28377665

  11. Super-Anticoagulant Heparin-Mimicking Hydrogel Thin Film Attached Substrate Surfaces to Improve Hemocompatibility.

    PubMed

    He, Min; Cui, Xiaofei; Jiang, Huiyi; Huang, Xuelian; Zhao, Weifeng; Zhao, Changsheng

    2017-02-01

    In this study, heparin-mimicking hydrogel thin films are covalently attached onto poly(ether sulfone) membrane surfaces to improve anticoagulant property. The hydrogel films display honeycomb-like porous structure with well controlled thickness and show long-term stability. After immobilizing the hydrogel films, the membranes show excellent anticoagulant property confirmed by the activated partial thromboplastin time values exceeding 600 s. Meanwhile, the thrombin time values increase from 20 to 61 s as the sodium allysulfonate proportions increase from 0 to 80 mol%. In vitro investigations of protein adsorption and blood-related complement activation also confirm that the membranes exhibit super-anticoagulant property. Furthermore, gentamycin sulfate is loaded into the hydrogel films, and the released drug shows significant inhibition toward E. coli bacteria. It is believed that the surface attached heparin-mimicking hydrogel thin films may show high potential for the applications in various biological fields, such as blood contacting materials and drug loading materials.

  12. Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh.

    PubMed

    Guzman, Grace; Kallwitz, Eric R; Wojewoda, Christina; Chennuri, Rohini; Berkes, Jamie; Layden, Thomas J; Cotler, Scott J

    2009-01-01

    There are a growing number of cases detailing acute hepatic necrosis in patients taking black cohosh (Cimicifuga racemosa), an over-the-counter herbal supplement for management of menopausal symptoms. Our aim is to illustrate two cases of liver injury following the use of black cohosh characterized by histopathological features mimicking autoimmune hepatitis. Both patients reported black cohosh use for at least six months and had no evidence of another cause of liver disease. Their liver biopsies showed a component of centrilobular necrosis consistent with severe drug-induced liver injury. In addition, the biopsies showed characteristics of autoimmune-like liver injury with an interface hepatitis dominated by plasma cells. Although serum markers for autoimmune hepatitis were not particularly elevated, both patients responded to corticosteroids, supporting an immune-mediated component to the liver injury. Liver injury following the use of black cohosh should be included in the list of differential diagnoses for chronic hepatitis with features mimicking autoimmune hepatitis.

  13. Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh

    PubMed Central

    Guzman, Grace; Kallwitz, Eric R.; Wojewoda, Christina; Chennuri, Rohini; Berkes, Jamie; Layden, Thomas J.; Cotler, Scott J.

    2009-01-01

    There are a growing number of cases detailing acute hepatic necrosis in patients taking black cohosh (Cimicifuga racemosa), an over-the-counter herbal supplement for management of menopausal symptoms. Our aim is to illustrate two cases of liver injury following the use of black cohosh characterized by histopathological features mimicking autoimmune hepatitis. Both patients reported black cohosh use for at least six months and had no evidence of another cause of liver disease. Their liver biopsies showed a component of centrilobular necrosis consistent with severe drug-induced liver injury. In addition, the biopsies showed characteristics of autoimmune-like liver injury with an interface hepatitis dominated by plasma cells. Although serum markers for autoimmune hepatitis were not particularly elevated, both patients responded to corticosteroids, supporting an immune-mediated component to the liver injury. Liver injury following the use of black cohosh should be included in the list of differential diagnoses for chronic hepatitis with features mimicking autoimmune hepatitis. PMID:20130783

  14. Discrimination of Umami Tastants Using Floating Electrode-Based Bioelectronic Tongue Mimicking Insect Taste Systems.

    PubMed

    Lee, Minju; Jung, Je Won; Kim, Daesan; Ahn, Young-Joon; Hong, Seunghun; Kwon, Hyung Wook

    2015-12-22

    We report a floating electrode-based bioelectronic tongue mimicking insect taste systems for the detection and discrimination of umami substances. Here, carbon nanotube field-effect transistors with floating electrodes were hybridized with nanovesicles containing honeybee umami taste receptor, gustatory receptor 10 of Apis mellifera (AmGr10). This strategy enables us to discriminate between l-monosodium glutamate (MSG), best-known umami tastant, and non-umami substances with a high sensitivity and selectivity. It could also be utilized for the detection of MSG in liquid food such as chicken stock. Moreover, we demonstrated the synergism between MSG and disodium 5'-inosinate (IMP) for the umami taste using this platform. This floating electrode-based bioelectronic tongue mimicking insect taste systems can be a powerful platform for various applications such as food screening, and it also can provide valuable insights on insect taste systems.

  15. An extremely unusual presentation of varicella zoster viral infection of cranial nerves mimicking Garcin syndrome.

    PubMed

    Nishioka, Kenya; Fujishima, Kenji; Kobayashi, Hirokazu; Mizuno, Yoshikuni; Okuma, Yasuyuki

    2006-12-01

    We report a patient with the varicella zoster viral (VZV) infection of multiple cranial nerves mimicking Garcin syndrome, who initially presented with Ramsay Hunt syndrome (herpes zoster oticus). A 78-year-old man showed left facial palsy with zosteric eruptions in his left auricle and dysphagia, followed by left total ophthalmoplegia. His serum anti-VZV antibody titer was elevated. Cerebrospinal fluid examination revealed pleocytosis with a slightly elevated protein level. He was treated with intravenous acyclovir and corticosteroids. His tongue weakness resolved, and then ocular movement improved. The improvement of facial palsy and swallowing difficulty was delayed. VZV infection should be considered even in patients who show unilateral multiple cranial neuropathy mimicking Garcin syndrome because it is treatable.

  16. Synthetic mimicking of plant oils and comparison with naturally grown products in polyurethane synthesis.

    PubMed

    Coles, Stuart R; Barker, Guy; Clark, Andrew J; Kirwan, Kerry; Jacobs, Daniel; Makenji, Kylash; Pink, David

    2008-06-11

    The use of plant oils as industrial feedstocks can often be hampered by their lack of optimization towards a particular process, as well as their development being risky; growing suitable volumes of crops to test can take up to five years. To circumvent this, we aimed to discover a method that would mimic plant oil profiles in the laboratory, and show that they exhibited similar properties to the naturally grown plant oils in a given process. Using the synthesis of polyurethanes as an example, we have synthesized six different polymers and demonstrated that plant oils will produce polymers with similar physical properties to those oils mimicked in the laboratory. The use of this mimicking process can be extended to other types of polymers to obtain a method for predicting the properties of a given material based on the plant oil composition of a crop before it is grown in bulk.

  17. Structure-Based Design of Inhibitors of Protein–Protein Interactions: Mimicking Peptide Binding Epitopes

    PubMed Central

    Pelay-Gimeno, Marta; Glas, Adrian; Koch, Oliver; Grossmann, Tom N

    2015-01-01

    Protein–protein interactions (PPIs) are involved at all levels of cellular organization, thus making the development of PPI inhibitors extremely valuable. The identification of selective inhibitors is challenging because of the shallow and extended nature of PPI interfaces. Inhibitors can be obtained by mimicking peptide binding epitopes in their bioactive conformation. For this purpose, several strategies have been evolved to enable a projection of side chain functionalities in analogy to peptide secondary structures, thereby yielding molecules that are generally referred to as peptidomimetics. Herein, we introduce a new classification of peptidomimetics (classes A–D) that enables a clear assignment of available approaches. Based on this classification, the Review summarizes strategies that have been applied for the structure-based design of PPI inhibitors through stabilizing or mimicking turns, β-sheets, and helices. PMID:26119925

  18. The Face of the Chameleon: The Experience of Facial Mimicry for the Mimicker and the Mimickee.

    PubMed

    Kulesza, Wojciech Marek; Cisłak, Aleksandra; Vallacher, Robin R; Nowak, Andrzej; Czekiel, Martyna; Bedynska, Sylwia

    2015-01-01

    This research addressed three questions concerning facial mimicry: (a) Does the relationship between mimicry and liking characterize all facial expressions, or is it limited to specific expressions? (b) Is the relationship between facial mimicry and liking symmetrical for the mimicker and the mimickee? (c) Does conscious mimicry have consequences for emotion recognition? A paradigm is introduced in which participants interact over a computer setup with a confederate whose prerecorded facial displays of emotion are synchronized with participants' behavior to create the illusion of social interaction. In Experiment 1, the confederate did or did not mimic participants' facial displays of various subsets of basic emotions. Mimicry promoted greater liking for the confederate regardless of which emotions were mimicked. Experiment 2 reversed these roles: participants were instructed to mimic or not to mimic the confederate's facial displays. Mimicry did not affect liking for the confederate but it did impair emotion recognition.

  19. Possible neuro-Sweet disease mimicking brain tumor in the medulla oblongata--case report.

    PubMed

    Akiba, Chihiro; Esaki, Takanori; Ando, Maya; Furuya, Tsuyoshi; Noda, Kazuyuki; Nakao, Yasuaki; Yamamoto, Takuji; Okuma, Yasuyuki; Mori, Kentaro

    2011-01-01

    A 62-year-old male presented with a rare case of possible neuro-Sweet Disease (NSD) mimicking brain tumor in the medulla oblongata, manifesting as numbness in the bilateral upper and lower extremities, gait disturbance, dysarthria, and swallowing disturbance which gradually deteriorated over 3 months. Magnetic resonance imaging showed a mass lesion in the medulla oblongata, extending to the upper cervical cord with rim enhancement by gadolinium. The preoperative diagnosis was brain tumor, such as glioma, or inflammatory disease. His neurological symptoms gradually deteriorated, so biopsy was performed through the midline suboccipital approach. Histological examination showed infiltration of inflammatory cells, mainly lymphocytes and macrophages. Human leukocyte antigen typing showed Cw1 and B54 which strongly suggested possible NSD. Steroid pulse therapy was started after surgery and the clinical symptoms improved. Neurosurgeons should be aware of inflammatory disorders such as NSD mimicking brain tumor.

  20. Self-assembled monolayer facilitates epithelial-mesenchymal interactions mimicking odontogenesis.

    PubMed

    Muni, Tanvi; Mrksich, Milan; George, Anne

    2014-01-01

    Cell-cell interactions are vital for embryonic organ development and normal function of differentiated cells and tissues. In this study we have developed a self-assembled monolayer-based co-culture system to study tooth morphogenesis. Specifically, we designed a 2-D microenvironment present in the dental tissue by creating a well-structured, laterally organized epithelial and mesenchymal cell co-culture system by patterning the cell-attachment substrate. Chemical modifications were used to develop tunable surface patterns to facilitate epithelial-mesenchymal interactions mimicking the developing tooth. Such a design promoted interactions between monolayer's of the 2 cell types and provided signaling cues that resulted in cellular differentiation and mineralized matrix formation. Gene expression analysis showed that these co-cultures mimicked in-vivo conditions than monolayer cultures of a single cell type.

  1. The dependencies of phase velocity and dispersion on volume fraction in cancellous-bone-mimicking phantoms.

    PubMed

    Wear, Keith A

    2009-02-01

    Frequency-dependent phase velocity was measured in eight cancellous-bone-mimicking phantoms consisting of suspensions of randomly oriented nylon filaments (simulating trabeculae) in a soft-tissue-mimicking medium (simulating marrow). Trabecular thicknesses ranged from 152 to 356 mum. Volume fractions of nylon filament material ranged from 0% to 10%. Phase velocity varied approximately linearly with frequency over the range from 300 to 700 kHz. The increase in phase velocity (compared with phase velocity in a phantom containing no filaments) at 500 kHz was approximately proportional to volume fraction occupied by nylon filaments. The derivative of phase velocity with respect to frequency was negative and exhibited nonlinear, monotonically decreasing dependence on volume fraction. The dependencies of phase velocity and its derivative on volume fraction in these phantoms were similar to those reported in previous studies on (1) human cancellous bone and (2) phantoms consisting of parallel nylon wires immersed in water.

  2. Abdominal varices mimicking an acute gastrointestinal hemorrhage during technetium-99m red blood cell scintigraphy

    SciTech Connect

    Moreno, A.J.; Byrd, B.F.; Berger, D.E.; Turnbull, G.L.

    1985-04-01

    Abdominal varices consisting of a caput medusae and dilated mesenteric veins resulted in pooling of Tc-99m tagged red blood cells (RBC) within these dilated vessels in a 57-year-old man with severe Laennec's cirrhosis. The atypical radiotracer localization within the abdomen mimicked an acute gastrointestinal hemorrhage. Clinical suspicion and careful evaluation of scintigraphic gastrointestinal bleeding studies will avoid false-positive interpretations.

  3. Looks can be deceiving: three cases of neurological diseases mimicking Guillain-Barrè syndrome.

    PubMed

    Sciacca, G; Nicoletti, A; Fermo, S Lo; Mostile, G; Giliberto, C; Zappia, Mario

    2016-04-01

    Guillain-Barrè syndrome (GBS) is an acute, paralyzing, inflammatory peripheral nerve disease, featured by monophasic disease course, symmetrical limb weakness and areflexia. Several pathologies can mimic the clinical presentation of GBS, making hard the differential diagnosis for patients complaining of acute flaccid paralysis. In this paper we describe three cases of different neurological diseases presenting with acute motor symptoms mimicking GBS, reviewing the relevant literature on misdiagnosis of GBS.

  4. Mixed capillary-cavernous extramedullary intradural hemangioma of the spinal cord mimicking meningioma: Case report.

    PubMed

    Alobaid, Abdullah; Bennardo, Michael Ross; Cenic, Aleksa; Lach, Boleslaw

    2015-06-01

    Hemangiomas are customarily described as low-grade vascular tumors most often located in the head and neck, but on rare occasions occurring in the intradural space of the spine. The different subtypes of hemangiomas can be distinguished histologically as capillary, cavernous, or mixed types. We describe a rare case of a mixed capillary-cavernous extramedullary intradural hemangioma of the thoracic spinal cord, mimicking meningioma radiologically.

  5. MRI of the small-bowel: how to differentiate primary neoplasms and mimickers

    PubMed Central

    Masselli, G; Colaiacomo, M C; Marcelli, G; Bertini, L; Casciani, E; Laghi, F; D'Amico, P; Caprasecca, S; Polettini, E; Gualdi, G

    2012-01-01

    MRI of the gastrointestinal tract is gaining clinical acceptance and is increasingly used to evaluate patients with suspected small-bowel diseases. MRI may be performed with enterography or enteroclysis, both of which combine the advantages of cross-sectional imaging with those of conventional enteroclysis. In this paper, MRI features of primary small-bowel neoplasms, the most important signs for differential diagnosis and the diseases that can be considered as mimickers of small-bowel neoplasms, are discussed. PMID:22422388

  6. Tissue Boundaries: Mimicking Tissue Boundaries by Sharp Multiparameter Matrix Interfaces (Adv. Healthcare Mater. 15/2016).

    PubMed

    Sapudom, Jiranuwat; Rubner, Stefan; Martin, Steve; Pompe, Tilo

    2016-08-01

    Engineering interfaces of extracellular compartments mimicking native tissues is key to study cell behavior in a physiologically relevant context and for a successful translation of these new biomaterials engineering principles in regenerative and therapeutic applications. Tilo Pompe and co-workers demonstrate a strategy to engineer multiparameter matrix interfaces using a sequential reconstitution of two well-defined Collagen I based matrices on page 1861. Such matrix interfaces trigger cell migration directionality normal to the interface plane in dependence on matrix pore size.

  7. Neglected Thorn Injury Mimicking Soft Tissue Mass in a Child: A Case Report

    PubMed Central

    Gupta, Mayank; Kumar, Dharmendra; Naik, Ananta Kumar; Arya, Rajendera Kumar

    2015-01-01

    Thorn injuries are common especially in rural areas. The diagnosis of such in children is always missed. An untreated retained thorn may cause late soft tissue and osseous complications. Herein, we report a case of neglected thorn injury mimicking soft tissue mass in an 11-year-old male child. The presence of the thorn was confirmed with ultrasound scan and computerized tomography. The child was successfully managed with removal of thorn with excision of foreign body granuloma. PMID:26155524

  8. Cutaneous metastasis of ovarian carcinoma with shadow cells mimicking a primary pilomatrical neoplasm.

    PubMed

    Lalich, Daniel; Tawfik, Ossama; Chapman, Julia; Fraga, Garth

    2010-07-01

    Shadow cells are characteristic of pilomatricoma, although they have been described in other cutaneous and visceral neoplasms, particularly endometrioid adenocarcinomas of the female genital tract. We describe a metastasis of an ovarian endometrioid adenocarcinoma with shadow cells to the skin that was initially misinterpreted as a pilomatricoma. We compare the histology of the ovarian neoplasm to 21 pilomatricomas. This is the first reported case of a cutaneous metastasis of a visceral neoplasm mimicking a primary pilomatrical neoplasm.

  9. Perforated appendix in hernial sac mimicking torsion of undescended testis in a neonate.

    PubMed

    Kumar, Renu; Mahajan, J K; Rao, K L N

    2008-04-01

    In pediatric surgical practice, finding of the vermiform appendix in an inguinal hernia sac is not that uncommon; however, a perforation is rare. There are only a few case reports of a perforated appendix with periappendicular abscess in the inguinal hernial sac in a neonate. We report an unusual case of inguinal hernia containing a perforated appendix that was clinically mimicking testicular torsion of the undescended testis.

  10. Tissue mimicking materials for the detection of prostate cancer using shear wave elastography: a validation study.

    PubMed

    Cao, Rui; Huang, Zhihong; Varghese, Tomy; Nabi, Ghulam

    2013-02-01

    Quantification of stiffness changes may provide important diagnostic information and aid in the early detection of cancers. Shear wave elastography is an imaging technique that assesses tissue stiffness using acoustic radiation force as an alternate to manual palpation reported previously with quasistatic elastography. In this study, the elastic properties of tissue mimicking materials, including agar, polyacrylamide (PAA), and silicone, are evaluated with an objective to determine material characteristics which resemble normal and cancerous prostate tissue. Acoustic properties and stiffness of tissue mimicking phantoms were measured using compressional mechanical testing and shear wave elastography using supersonic shear imaging. The latter is based on the principles of shear waves generated using acoustic radiation force. The evaluation included tissue mimicking materials (TMMs) within the prostate at different positions and sizes that could mimic cancerous and normal prostate tissue. Patient data on normal and prostate cancer tissues quantified using biopsy histopathology were used to validate the findings. Pathologist reports on histopathology were blinded to mechanical testing and elastographic findings. Young's modulus values of 86.2 ± 4.5 and 271.5 ± 25.7 kPa were obtained for PAA mixed with 2% Al(2)O(3) particles and silicone, respectively. Young's modulus of TMMs from mechanical compression testing showed a clear trend of increasing stiffness with an increasing percentage of agar. The silicone material had higher stiffness values when compared with PAA with Al(2)O(3). The mean Young's modulus value in cancerous tissue was 90.5 ± 4.5 kPa as compared to 93.8 ± 4.4 and 86.2 ± 4.5 kPa obtained with PAA with 2% Al(2)O(3) phantom at a depth of 52.4 and 36.6 mm, respectively. PAA mixed with Al(2)O(3) provides the most suitable tissue mimicking material for prostate cancer tumor material, while agar could form the surrounding background to simulate normal

  11. Large retroperitoneal schwannoma mimicking a cystic ovarian mass in a patient with Hansen's disease.

    PubMed

    Surendrababu, Narayanam R S; Cherian, Sucy Rekha; Janakiraman, Rajinikanth; Walter, Noel

    2008-06-01

    We present a rare case of retroperitoneal cystic schwannoma of the pelvis in a patient with Hansen's disease that mimicked an ovarian cyst. Due to economic constraints and because the lesion was assumed to be of ovarian origin, the patient did not undergo any cross-sectional imaging other than sonography. Sonographically guided fine needle aspiration of the cystic lesion was inconclusive. A cystic schwannoma was diagnosed at laparotomy.

  12. Medulla oblongata tuberculoma mimicking metastasis presenting with stroke-like symptoms.

    PubMed

    Donmez, Fuldem Yildirim; Coskun, Mehmet; Guven, Gulnur

    2009-08-01

    Tuberculomas are common forms of central nervous system tuberculosis, presenting as space-occupying-lesions. Brainstem tuberculomas are rare among all intracranial tuberculomas. In old patients, in the absence of tuberculosis history, diagnosis may be challenging. In this case, we present a 70-year-old patient, with bladder cancer, without known tuberculosis who presented with stroke-like symptoms, clinically. Diffusion-weighted imaging revealed no finding of stroke, however, a medulla oblongata tuberculoma, mimicking metastasis was evident on MRI.

  13. Massive retroperitoneal tubercular abscess mimicking a leaking abdominal aortic aneurysm: a case report

    PubMed Central

    Singh, Pankaj K; Azam, Amir; Singh, Vinay K; Tomar, Juhi; Mishra, Alka; Singh, Kuldeep K; Gupta, Sanjeev

    2008-01-01

    In spite of being a common diagnosis in the patients of Asian origin, atypical presentations of tuberculosis may pose diagnostic challenges. We report a huge prevertebral abscess in a 30-year-old female, mimicking a leaking aortic aneurysm. The patient was managed successfully by emergency decompression and stabilization. The issues related to poor patient compliance to chemotherapy and management of atypical presentations of spinal tuberculosis are discussed here. PMID:18854051

  14. A Retroperitoneal Isolated Enteric Duplication Cyst Mimicking a Teratoma: A Case Report and Literature Review

    PubMed Central

    Momosaka, Daichi; Ushijima, Yasuhiro; Asayama, Yoshiki; Ishigami, Kousei; Takayama, Yukihisa; Okamoto, Daisuke; Fujita, Nobuhiro; Ikeda, Tetsuo; Uchida, Keiichiro; Sugimoto, Masaaki; Kohashi, Kenichi; Honda, Hiroshi

    2016-01-01

    Enteric duplication cysts lacking anatomic association with the gastrointestinal tract are called isolated enteric duplication cysts (IEDCs). We present an atypical case of a retroperitoneal IEDC with a tortuous tubular complex shape that enfolded the surrounding retroperitoneal fat and mimicked a retroperitoneal teratoma. Multiplanar reconstruction images should be used to evaluate such a lesion correctly. A tortuous tubular complex shape could be a key finding to differentiate from other retroperitoneal cysts. PMID:28083153

  15. Syphilis Mimicking Other Dermatological Diseases: Reactive Arthritis and Mucha-Habermann Disease

    PubMed Central

    da Silva Carneiro, Sueli Coelho; Pirmez, Rodrigo; de Hollanda, Taciana Rocha; Cuzzi, Tullia; Ramos-e-Silva, Marcia

    2013-01-01

    The authors present two cases of syphilis: one mimicking reactive arthritis and the other Mucha-Habermann disease. Both reports illustrate syphilis as ‘the great imitator’, a description given by Sir William Osler, and call attention to the strong need for awareness among physicians of all specialties, especially the younger ones, who are not used to seeing this increasingly prevalent disease, as it once was in the past. PMID:23467097

  16. Multi-modality gellan gum-based tissue-mimicking phantom with targeted mechanical, electrical, and thermal properties

    NASA Astrophysics Data System (ADS)

    Chen, Roland K.; Shih, A. J.

    2013-08-01

    This study develops a new class of gellan gum-based tissue-mimicking phantom material and a model to predict and control the elastic modulus, thermal conductivity, and electrical conductivity by adjusting the mass fractions of gellan gum, propylene glycol, and sodium chloride, respectively. One of the advantages of gellan gum is its gelling efficiency allowing highly regulable mechanical properties (elastic modulus, toughness, etc). An experiment was performed on 16 gellan gum-based tissue-mimicking phantoms and a regression model was fit to quantitatively predict three material properties (elastic modulus, thermal conductivity, and electrical conductivity) based on the phantom material's composition. Based on these material properties and the regression model developed, tissue-mimicking phantoms of porcine spinal cord and liver were formulated. These gellan gum tissue-mimicking phantoms have the mechanical, thermal, and electrical properties approximately equivalent to those of the spinal cord and the liver.

  17. Antimicrobial Peptide Mimicking Primary Amine and Guanidine Containing Methacrylamide Copolymers Prepared by Raft Polymerization.

    PubMed

    Exley, Sarah E; Paslay, Lea C; Sahukhal, Gyan S; Abel, Brooks A; Brown, Tyler D; McCormick, Charles L; Heinhorst, Sabine; Koul, Veena; Choudhary, Veena; Elasri, Mohamed O; Morgan, Sarah E

    2015-12-14

    Naturally occurring antimicrobial peptides (AMPs) display the ability to eliminate a wide variety of bacteria, without toxicity to the host eukaryotic cells. Synthetic polymers containing moieties mimicking lysine and arginine components found in AMPs have been reported to show effectiveness against specific bacteria, with the mechanism of activity purported to depend on the nature of the amino acid mimic. In an attempt to incorporate the antimicrobial activity of both amino acids into a single water-soluble copolymer, a series of copolymers containing lysine mimicking aminopropyl methacrylamide (APMA) and arginine mimicking guanadinopropyl methacrylamide (GPMA) were prepared via aqueous RAFT polymerization. Copolymers were prepared with varying ratios of the comonomers, with degree of polymerization of 35-40 and narrow molecular weight distribution to simulate naturally occurring AMPs. Antimicrobial activity was determined against Gram-negative and Gram-positive bacteria under conditions with varying salt concentration. Toxicity to mammalian cells was assessed by hemolysis of red blood cells and MTT assays of MCF-7 cells. Antimicrobial activity was observed for APMA homopolymer and copolymers with low concentrations of GPMA against all bacteria tested, with low toxicity toward mammalian cells.

  18. Integrated photocatalytic micropillar nanoreactor electrospray ionization chip for mimicking phase I metabolic reactions.

    PubMed

    Nissilä, Teemu; Sainiemi, Lauri; Karikko, Mika-Matti; Kemell, Marianna; Ritala, Mikko; Franssila, Sami; Kostiainen, Risto; Ketola, Raimo A

    2011-04-21

    We developed a nanoreactor chip based system to mimic phase I metabolic reactions of small organic compounds. The microchip, made of silicon, has an anatase-phase titanium dioxide (TiO(2)) nanolayer coating for photocatalysis and an integrated electrospray ionization (ESI) tip for direct mass spectrometric (MS) analysis. This novel method for mimicking phase I metabolic reactions uses an on-chip TiO(2)-nanolayer and an external UV-lamp to induce photocatalyzed chemical reactions of drug compounds in aqueous solutions. The reactions of selected test compounds (verapamil, metoprolol, propranolol, lidocaine, 2-acetamidofluorene, and S-methylthiopurine) produced mostly the same main products as phase I metabolic reactions induced by human liver microsomes, rat hepatocytes, or cytochrome P enzymes, showing hydroxylation, dehydrogenation, and dealkylations as the main photocatalytic reactions. With this method it is possible to detect reactive and toxic products (mimicking reactive metabolites) due to the absence of biological matrices and an immediate analysis. The method used is sensitive: only 20-40 pmol (1-10 ng) of a substrate was needed for the experiment, thus it provides an inexpensive method for screening possible metabolites of new drug candidates. Due to small dimensions of the microchip, diffusion lengths are suitable for the high reaction rates, thus providing a rapid analysis as the reaction products can be detected and identified directly after the photoinduced reactions have occurred. The method shows a similar performance to that of electrochemistry, a commonly used technique for mimicking phase I metabolism.

  19. A reusable perfusion supporting tissue-mimicking material for ultrasound hyperthermia phantoms.

    PubMed

    Chin, R B; Madsen, E L; Zagzebski, J A; Jadvar, H; Wu, X K; Frank, G R

    1990-01-01

    A new ultrasonically and thermodynamically tissue-mimicking material is reported. The material is well suited for use in phantoms for testing ultrasound hyperthermia systems or related predictive models. Controlled convective heat transfer effects, mimicking to some extent perfusive heat transfer in tissues, can be instituted in the material with appropriate fluid sources and sinks. The material consists of closely packed agar spheres varying in diameters from 0.3-3.6 mm. The interstitial space between spheres is filled with 10% n-propanol solution. The material has two practical advantages over the solid-gel-type tissue-mimicking materials. The first advantage is that it allows rapid return of a hyperthermia phantom to thermal equilibrium following a heating test by rapid circulation of the perfusion fluid. The second advantage is that the material is in a "liquid" form. It can be easily siphoned in and out of phantom containers of any geometric shape for different purposes without change in its physical properties. Methods for measuring ultrasonic and thermodynamic properties of the material and the results of the measurements are reported. The physical parameters measured are the intensity attenuation and absorption coefficients, the ultrasonic speed, the thermal conductivity, specific-heat capacity and the mass density. Temperature measurements in a hyperthermia phantom made of the material are also reported.

  20. Antimicrobial Peptide Mimicking Primary Amine and Guanidine Containing Methacrylamide Copolymers Prepared by Raft Polymerization

    PubMed Central

    Exley, Sarah E.; Paslay, Lea C.; Sahukhal, Gyan S.; Abel, Brooks A.; Brown, Tyler D.; McCormick, Charles L.; Heinhorst, Sabine; Koul, Veena; Choudhary, Veena; Elasri, Mohamed O.; Morgan, Sarah E.

    2016-01-01

    Naturally occurring antimicrobial peptides (AMPs) display the ability to eliminate a wide variety of bacteria, without toxicity to the host eukaryotic cells. Synthetic polymers containing moieties mimicking lysine and arginine components found in AMPs have been reported to show effectiveness against specific bacteria, with the mechanism of activity purported to depend on the nature of the amino acid mimic. In an attempt to incorporate the antimicrobial activity of both amino acids into a single water-soluble copolymer, a series of copolymers containing lysine mimicking aminopropyl methacrylamide (APMA) and arginine mimicking guanadinopropyl methacrylamide (GPMA) were prepared via aqueous RAFT polymerization. Copolymers were prepared with varying ratios of the comonomers, with degree of polymerization of 35–40 and narrow molecular weight distribution to simulate naturally occurring AMPs. Antimicrobial activity was determined against Gram-negative and Gram-positive bacteria under conditions with varying salt concentration. Toxicity to mammalian cells was assessed by hemolysis of red blood cells and MTT assays of MCF-7 cells. Antimicrobial activity was observed for APMA homopolymer and copolymers with low concentrations of GPMA against all bacteria tested, with low toxicity toward mammalian cells. PMID:26558609

  1. Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves' orbitopathy.

    PubMed

    Monteiro, Mário Luiz Ribeiro; Gonçalves, Allan Christian Pieroni; Bezerra, Alanna Mara Pinheiro Sobreira

    2016-01-01

    The diagnosis of Graves' orbitopathy is usually straightforward. However, orbital diseases that mimick some clinical signs of Graves' orbitopathy may cause diagnostic confusion, particularly when associated to some form of thyroid dysfunction. This report describes the rare occurrence of localized inferior rectus muscle amyloidosis in a patient with autoimmune hypothyroidism, who was misdiagnosed as Graves' orbitopathy. A 48-year-old man complained of painless progressive proptosis on the left side and intermittent vertical diplopia for 6 months. The diagnosis of Graves' orbitopathy was entertained after magnetic resonance imaging revealing a markedly enlarged, tendon-sparing inferior rectus enlargement on the left side, and an autoimmune hypothyroidism was disclosed on systemic medical workup. After no clinical improvement with treatment, the patient was referred to an ophthalmologist and further investigation was performed. The presence of calcification in the inferior rectus muscle on computed tomography, associated with the clinical findings led to a diagnostic biopsy, which revealed amyloid deposition. This report emphasizes that a careful evaluation of atypical forms of Graves' orbitopathy may be crucial and should include, yet with rare occurrence, amyloidosis in its differential diagnosis. RESUMO O diagnóstico de orbitopatia de Graves usualmente é fácil de ser estabelecido. No entanto, doenças da órbita que simulam alguns sinais clínicos da orbitopatia de Graves podem levar à confusão diagnóstica, particularmente quando associada à alguma forma de disfunção tireoidiana. Relatamos a ocorrência rara de amiloidose localizada no músculo reto inferior em paciente com hipotireoidismo autoimune, que recebeu inicialmente o diagnóstico errôneo de orbitopatia de Graves. Paciente masculino, 48 anos, com queixa de proptose progressiva e indolor do lado esquerdo e diplopia vertical intermitente há 6 meses. O diagnóstico de orbitopatia de Graves foi

  2. High-Affinity Binding of Remyelinating Natural Autoantibodies to Myelin-Mimicking Lipid Bilayers Revealed by Nanohole Surface Plasmon Resonance

    PubMed Central

    Wittenberg, Nathan J.; Im, Hyungsoon; Xu, Xiaohua; Wootla, Bharath; Watzlawik, Jens; Warrington, Arthur E.; Rodriguez, Moses; Oh, Sang-Hyun

    2012-01-01

    Multiple sclerosis is a progressive neurological disorder that results in the degradation of myelin sheaths that insulate axons in the central nervous system. Therefore promotion of myelin repair is a major thrust of multiple sclerosis treatment research. Two mouse monoclonal natural autoantibodies, O1 and O4, promote myelin repair in several mouse models of multiple sclerosis. Natural autoantibodies are generally polyreactive and predominantly of the IgM isotype. The prevailing paradigm is that because they are polyreactive, these antibodies bind antigens with low affinities. Despite their wide use in neuroscience and glial cell research, however, the affinities and kinetic constants of O1 and O4 antibodies have not been measured to date. In this work, we developed a membrane biosensing platform based on surface plasmon resonance in gold nanohole arrays with a series of surface modification techniques to form myelin-mimicking lipid bilayer membranes to measure both the association and dissociation rate constants for O1 and O4 antibodies binding to their myelin lipid antigens. The ratio of rate constants shows that O1 and O4 bind to galactocerebroside and sulfated galactocerebroside, respectively, with unusually small apparent dissociation constants (KD ~0.9 nM) for natural autoantibodies. This is approximately one to two orders of magnitude lower than typically observed for the highest affinity natural autoantibodies. We propose that the unusually high affinity of O1 and O4 to their targets in myelin contributes to the mechanism by which they signal oligodendrocytes and induce central nervous system repair. PMID:22762372

  3. Distinct effects of Abelson kinase mutations on myocytes and neurons in dissociated Drosophila embryonic cultures: mimicking of high temperature.

    PubMed

    Liu, Lijuan; Wu, Chun-Fang

    2014-01-01

    Abelson tyrosine kinase (Abl) is known to regulate axon guidance, muscle development, and cell-cell interaction in vivo. The Drosophila primary culture system offers advantages in exploring the cellular mechanisms mediated by Abl with utilizing various experimental manipulations. Here we demonstrate that single-embryo cultures exhibit stage-dependent characteristics of cellular differentiation and developmental progression in neurons and myocytes, as well as nerve-muscle contacts. In particular, muscle development critically depends on the stage of dissociated embryos. In wild-type (WT) cultures derived from embryos before stage 12, muscle cells remained within cell clusters and were rarely detected. Interestingly, abundant myocytes were spotted in Abl mutant cultures, exhibiting enhanced myocyte movement and fusion, as well as neuron-muscle contacts even in cultures dissociated from younger, stage 10 embryos. Notably, Abl myocytes frequently displayed well-expanded lamellipodia. Conversely, Abl neurons were characterized with fewer large veil-like lamellipodia, but instead had increased numbers of filopodia and darker nodes along neurites. These distinct phenotypes were equally evident in both homo- and hetero-zygous cultures (Abl/Abl vs. Abl/+) of different alleles (Abl(1) and Abl(4) ) indicating dominant mutational effects. Strikingly, in WT cultures derived from stage 10 embryos, high temperature (HT) incubation promoted muscle migration and fusion, partially mimicking the advanced muscle development typical of Abl cultures. However, HT enhanced neuronal growth with increased numbers of enlarged lamellipodia, distinct from the characteristic Abl neuronal morphology. Intriguingly, HT incubation also promoted Abl lamellipodia expansion, with a much greater effect on nerve cells than muscle. Our results suggest that Abl is an essential regulator for myocyte and neuron development and that high-temperature incubation partially mimics the faster muscle development

  4. Insulin-like growth factor 1 deficiency exacerbates hypertension-induced cerebral microhemorrhages in mice, mimicking the aging phenotype.

    PubMed

    Tarantini, Stefano; Valcarcel-Ares, Noa M; Yabluchanskiy, Andriy; Springo, Zsolt; Fulop, Gabor A; Ashpole, Nicole; Gautam, Tripti; Giles, Cory B; Wren, Jonathan D; Sonntag, William E; Csiszar, Anna; Ungvari, Zoltan

    2017-03-14

    Clinical and experimental studies show that aging exacerbates hypertension-induced cerebral microhemorrhages (CMHs), which progressively impair neuronal function. There is growing evidence that aging promotes insulin-like growth factor 1 (IGF-1) deficiency, which compromises multiple aspects of cerebromicrovascular and brain health. To determine the role of IGF-1 deficiency in the pathogenesis of CMHs, we induced hypertension in mice with liver-specific knockdown of IGF-1 (Igf1(f/f)  + TBG-Cre-AAV8) and control mice by angiotensin II plus l-NAME treatment. In IGF-1-deficient mice, the same level of hypertension led to significantly earlier onset and increased incidence and neurological consequences of CMHs, as compared to control mice, as shown by neurological examination, gait analysis, and histological assessment of CMHs in serial brain sections. Previous studies showed that in aging, increased oxidative stress-mediated matrix metalloprotease (MMP) activation importantly contributes to the pathogenesis of CMHs. Thus, it is significant that hypertension-induced cerebrovascular oxidative stress and MMP activation were increased in IGF-1-deficient mice. We found that IGF-1 deficiency impaired hypertension-induced adaptive media hypertrophy and extracellular matrix remodeling, which together with the increased MMP activation likely also contributes to increased fragility of intracerebral arterioles. Collectively, IGF-1 deficiency promotes the pathogenesis of CMHs, mimicking the aging phenotype, which likely contribute to its deleterious effect on cognitive function. Therapeutic strategies that upregulate IGF-1 signaling in the cerebral vessels and/or reduce microvascular oxidative stress, and MMP activation may be useful for the prevention of CMHs, protecting cognitive function in high-risk elderly patients.

  5. High-affinity binding of remyelinating natural autoantibodies to myelin-mimicking lipid bilayers revealed by nanohole surface plasmon resonance.

    PubMed

    Wittenberg, Nathan J; Im, Hyungsoon; Xu, Xiaohua; Wootla, Bharath; Watzlawik, Jens; Warrington, Arthur E; Rodriguez, Moses; Oh, Sang-Hyun

    2012-07-17

    Multiple sclerosis is a progressive neurological disorder that results in the degradation of myelin sheaths that insulate axons in the central nervous system. Therefore promotion of myelin repair is a major thrust of multiple sclerosis treatment research. Two mouse monoclonal natural autoantibodies, O1 and O4, promote myelin repair in several mouse models of multiple sclerosis. Natural autoantibodies are generally polyreactive and predominantly of the IgM isotype. The prevailing paradigm is that because they are polyreactive, these antibodies bind antigens with low affinities. Despite their wide use in neuroscience and glial cell research, however, the affinities and kinetic constants of O1 and O4 antibodies have not been measured to date. In this work, we developed a membrane biosensing platform based on surface plasmon resonance in gold nanohole arrays with a series of surface modification techniques to form myelin-mimicking lipid bilayer membranes to measure both the association and dissociation rate constants for O1 and O4 antibodies binding to their myelin lipid antigens. The ratio of rate constants shows that O1 and O4 bind to galactocerebroside and sulfated galactocerebroside, respectively, with unusually small apparent dissociation constants (K(D) ≈ 0.9 nM) for natural autoantibodies. This is approximately one to 2 orders of magnitude lower than typically observed for the highest affinity natural autoantibodies. We propose that the unusually high affinity of O1 and O4 to their targets in myelin contributes to the mechanism by which they signal oligodendrocytes and induce central nervous system repair.

  6. EDITORIAL: Catalysing progress Catalysing progress

    NASA Astrophysics Data System (ADS)

    Demming, Anna

    2010-01-01

    Examples of the merits of blue-sky research in the history of science are legion. The invention of the laser, celebrating its 50th anniversary this year, is an excellent example. When it was invented it was considered to be 'a solution waiting for a problem', and yet the level to which it has now infiltrated our day-to-day technological landscape speaks volumes. At the same time it is also true to say that the direction of research is also at times rightly influenced by the needs and concerns of the general public. Over recent years, growing concerns about the environment have had a noticeable effect on research in nanotechnology, motivating work on a range of topics from green nanomaterial synthesis [1] to high-efficiency solar cells [2] and hydrogen storage [3]. The impact of the world's energy consumption on the welfare of the planet is now an enduring and well founded concern. In the face of an instinctive reluctance to curtail habits of comfort and convenience and the appendages of culture and consumerism, research into renewable and more efficient energy sources seem an encouraging approach to alleviating an impending energy crisis. Fuel cells present one alternative to traditional combustion cells that have huge benefits in terms of the efficiency of energy conversion and the limited harmful emissions. In last week's issue of Nanotechnology, Chuan-Jian Zhong and colleagues at the State University of New York at Binghamton in the USA presented an overview of research on nanostructured catalysts in fuel cells [4]. The topical review includes insights into the interactions between nanoparticles and between nanoparticles and their substrate as well as control over the composition and nanostructure of catalysts. The review also serves to highlight how the flourishing of nanotechnology research has heralded great progress in the exploitation of catalysts with nanostructures ingeniously controlled to maximize surface area and optimize energetics for synthesis

  7. [A case of an anti-Ma2 antibody-positive patient presenting with variable CNS symptoms mimicking multiple system atrophy with a partial response to immunotherapy].

    PubMed

    Shiraishi, Wataru; Iwanaga, Yasutaka; Yamamoto, Akifumi

    2015-01-01

    A 70-year-old man with a 5-month history of progressive bradykinesia of the bilateral lower extremities was admitted to our hospital. At the age of 64, he underwent proximal gastrectomy for gastric cancer. He also had a history of subacute combined degeneration of the spinal cord since the age of 67, which was successfully treated with vitamin B12 therapy. Four weeks before admission to our hospital, he admitted himself to his former hospital complaining of walking difficulty. Two weeks later, however, his symptoms progressed rapidly; he was immobilized for two weeks and did not respond to the vitamin therapy. On admission to our hospital, he showed moderate paralysis of the lower extremities, cog-wheel rigidity of the four extremities, and dystonic posture of his left hand. He also showed orthostatic hypotension and vesicorectal disorders. Blood examination and cerebrospinal fluid analysis revealed no remarkable abnormalities. Electroencephalography showed frontal dominant, high voltage, sharp waves. His brain and spinal MRI revealed no notable abnormalities. We suspected autoimmune disease and commenced one course of intravenous methylprednisolone therapy, resulting in improvement of the parkinsonism and orthostatic hypotension. Based on these results, we investigated possible neural antigens and detected anti-Ma2 antibody. In addition to limbic encephalitis, anti-Ma2 antibody-positive neural disorders are characterized by rapid eye movement sleep behavior disorders or parkinsonism. Here, we report an anti-Ma2 antibody positive patient presenting variable CNS symptoms mimicking multiple system atrophy, who responded to immunotherapy.

  8. Mimicking phosphorylation of αB-crystallin affects its chaperone activity

    PubMed Central

    Ecroyd, Heath; Meehan, Sarah; Horwitz, Joseph; Aquilina, J. Andrew; Benesch, Justin L. P.; Robinson, Carol V.; Macphee, Cait E.; Carver, John A.

    2006-01-01

    αB-crystallin is a member of the sHsp (small heat-shock protein) family that prevents misfolded target proteins from aggregating and precipitating. Phosphorylation at three serine residues (Ser19, Ser45 and Ser59) is a major post-translational modification that occurs to αB-crystallin. In the present study, we produced recombi-nant proteins designed to mimic phosphorylation of αB-crystallin by incorporating a negative charge at these sites. We employed these mimics to undertake a mechanistic and structural invest-igation of the effect of phosphorylation on the chaperone activity of αB-crystallin to protect against two types of protein misfolding, i.e. amorphous aggregation and amyloid fibril assembly. We show that mimicking phosphorylation of αB-crystallin results in more efficient chaperone activity against both heat-induced and reduc-tion-induced amorphous aggregation of target proteins. Mimick-ing phosphorylation increased the chaperone activity of αB-crystallin against one amyloid-forming target protein (κ-casein), but decreased it against another (ccβ-Trp peptide). We observed that both target protein identity and solution (buffer) conditions are critical factors in determining the relative chaperone ability of wild-type and phosphorylated αB-crystallins. The present study provides evidence for the regulation of the chaperone activity of αB-crystallin by phosphorylation and indicates that this may play an important role in alleviating the pathogenic effects associated with protein conformational diseases. PMID:16928191

  9. Mimicking the Acute Myeloid Leukemia Niche for Molecular Study and Drug Screening.

    PubMed

    Houshmand, Mohammad; Soleimani, Masoud; Atashi, Amir; Saglio, Giuseppe; Abdollahi, Mohammad; Nikougoftar Zarif, Mahin

    2017-02-01

    Bone marrow niche is a major contributing factor in leukemia development and drug resistance in acute myeloid leukemia (AML) patients. Although mimicking leukemic bone marrow niche relies on two-dimensional (2D) culture conditions, it cannot recapitulate complex bone marrow structure that causes introduction of different three-dimensional (3D) scaffolds. Simultaneously, microfluidic platform by perfusing medium culture mimic interstitial fluid flow, along with 3D scaffold would help for mimicking bone marrow microenvironment. In this study TF-1 cells were cocultured with bone marrow mesenchymal stem cells (BM-MSCs) in 2D and 3D microfluidic devices. Phenotype maintenance during cell culture and proliferation rate was assayed and confirmed by cell cycle analysis. Morphology of cells in 2D and 3D culture conditions was demonstrated by scanning electron microscopy. After these experiments, drug screening was performed by applying azacitidine and cytarabine and cytotoxicity assay and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) for B cell lymphoma 2 (BCL2) were done to compare drug resistance in 2D and 3D culture conditions. Our result shows leukemic cells in 3D microfluidic device retaining their phenotype and proliferation rate was significantly higher in 3D culture condition in comparison to 2D culture condition (p < 0.05), which was confirmed by cell cycle analysis. Cytotoxicity assay also illustrated drug resistance in 3D culture condition and qRT-PCR demonstrated higher BCL2 expression in 3D microfluidic device in contrast to 2D microfluidic device (p < 0.05). On balance, mimicking bone marrow niche would help the target therapy and specify the role of niche in development of leukemia in AML patients.

  10. Scleroderma Mimickers

    PubMed Central

    Morgan, Nadia D.; Hummers, Laura K.

    2017-01-01

    Opinion statement Cutaneous fibrosing disorders encompass a diverse array of diseases united by the presence of varying degrees of dermal sclerosis. The quality and distribution of skin involvement, presence or absence of systemic complications and unique associated laboratory abnormalities often help to distinguish between these diseases. It is imperative that an effort is made to accurately differentiate between scleroderma and its mimics, in order to guide long-term management and facilitate implementation of the appropriate treatment modality where indicated. PMID:28473954

  11. Nutrition and fasting mimicking diets in the prevention and treatment of autoimmune diseases and immunosenescence.

    PubMed

    Choi, In Young; Lee, Changhan; Longo, Valter D

    2017-11-05

    Complex and coordinated signals are necessary to initiate and sustain the activation, proliferation, and differentiation of lymphocytes. These signals, which are known to determine T-cell fate and function, also depend on the metabolic state of the organism. Recent studies indicate that both the type and levels of nutrients can influence the generation, survival and function of lymphocytes and therefore can affect several autoimmune diseases. Here, we review the dysregulation of lymphocytes during autoimmunity and aging, the mechanisms associated with loss of immune function, and how fasting mimicking diets and other dietary interventions affect autoimmunity and immunosenescence. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Imaging of Posttraumatic Arthritis, Avascular Necrosis, Septic Arthritis, Complex Regional Pain Syndrome, and Cancer Mimicking Arthritis.

    PubMed

    Rupasov, Andrey; Cain, Usa; Montoya, Simone; Blickman, Johan G

    2017-09-01

    This article focuses on the imaging of 5 discrete entities with a common end result of disability: posttraumatic arthritis, a common form of secondary osteoarthritis that results from a prior insult to the joint; avascular necrosis, a disease of impaired osseous blood flow, leading to cellular death and subsequent osseous collapse; septic arthritis, an infectious process leading to destructive changes within the joint; complex regional pain syndrome, a chronic limb-confined painful condition arising after injury; and cases of cancer mimicking arthritis, in which the initial findings seem to represent arthritis, despite a more insidious cause. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Food residue granuloma mimicking metastatic disease on FDG-PET/CT.

    PubMed

    Crucitti, Antonio; Grossi, Ugo; Leccisotti, Lucia; Maggi, Fabio; Ricci, Riccardo; Mazzari, Andrea; Tomaiuolo, Pasquina M C; Giordano, Alessandro

    2013-05-01

    A 31-year-old woman presenting with acute abdomen underwent an emergency Hartmann's procedure for fecal peritonitis due to perforated adenocarcinoma of the left colon. Shortly after a 7-month course of adjuvant chemotherapy, follow-up contrast-enhanced CT showed multiple peritoneal and hepatic nodules, showing focal intense and homogeneous FDG uptake on FDG-PET/CT, highly suspected for recurrence of disease. Excisional biopsy of the nodules revealed foreign body granulomas made up of alimentary materials surrounded by a fibrous wall. We report a unique case of a false-positive finding secondary to food residues mimicking metastatic disease on FDG-PET in a patient with colon cancer.

  14. Metastatic prostate cancer mimicking chronic subdural hematoma: a case report and review of the literature.

    PubMed

    Patil, Shashikant; Veron, Ayme; Hosseini, Pegah; Bates, Rachel; Brown, Benjamin; Guthikonda, Bharat; DeSouza, Rowena

    2010-01-01

    Cancer of the prostate is extremely common and is well known to metastasize to the pelvic lymph nodes and axial skeleton (vertebral column, pelvis, cranium, and proximal femur). However, reports of intracranial metastasis are rare and commonly discovered postmortem. Moreover, metastatic lesions mimicking subdural hematoma are extremely rare and are uncommonly reported in the literature. We found only three such cases in the literature. We present a unique case of metastatic prostate cancer presenting with headaches after head trauma with classic radiologic findings of subdural hematoma. The diagnosis may have been made sooner with preoperative magnetic resonance imaging.

  15. Bioinspired micrograting arrays mimicking the reverse color diffraction elements evolved by the butterfly Pierella luna

    PubMed Central

    England, Grant; Kolle, Mathias; Kim, Philseok; Khan, Mughees; Muñoz, Philip; Mazur, Eric; Aizenberg, Joanna

    2014-01-01

    Recently, diffraction elements that reverse the color sequence normally observed in planar diffraction gratings have been found in the wing scales of the butterfly Pierella luna. Here, we describe the creation of an artificial photonic material mimicking this reverse color-order diffraction effect. The bioinspired system consists of ordered arrays of vertically oriented microdiffraction gratings. We present a detailed analysis and modeling of the coupling of diffraction resulting from individual structural components and demonstrate its strong dependence on the orientation of the individual miniature gratings. This photonic material could provide a basis for novel developments in biosensing, anticounterfeiting, and efficient light management in photovoltaic systems and light-emitting diodes. PMID:25288730

  16. A case of primary pancreatic non-Hodgkin B-cell lymphoma mimicking autoimmune pancreatitis.

    PubMed

    Anderloni, Andrea; Genco, Chiara; Ballarè, Marco; Carmagnola, Stefania; Battista, Serena; Repici, Alessandro

    2015-06-01

    Non Hodgkin lymphoma frequently involves the gastrointestinal tract, in particular the stomach and the small bowel. Rarely, it can also be a cause of pancreatic masses. Clinical presentation is often non-specific and may overlap with other pancreatic conditions such as carcinoma, neuroendocrine tumours and autoimmune pancreatitis. We report a case of primary pancreatic lymphoma in a young woman with jaundice, fever and abdominal pain mimicking autoimmune pancreatitis. Clinical evaluation included the abdominal Computed Tomography scan, Magnetic Resonance Imaging and an upper gastrointestinal endoscopy that revealed a large duodenal mass. Endoscopic biopsies were performed and eventually histological examination was coherent with a diagnosis of primary pancreatic lymphoma.

  17. Mimicking biopolymers on a molecular scale: nano(bio)technology based on engineered proteins.

    PubMed

    Grunwald, Ingo; Rischka, Klaus; Kast, Stefan M; Scheibel, Thomas; Bargel, Hendrik

    2009-05-13

    Proteins are ubiquitous biopolymers that adopt distinct three-dimensional structures and fulfil a multitude of elementary functions in organisms. Recent systematic studies in molecular biology and biotechnology have improved the understanding of basic functional and architectural principles of proteins, making them attractive candidates as concept generators for technological development in material science, particularly in biomedicine and nano(bio)technology. This paper highlights the potential of molecular biomimetics in mimicking high-performance proteins and provides concepts for applications in four case studies, i.e. spider silk, antifreeze proteins, blue mussel adhesive proteins and viral ion channels.

  18. Speech-activated Myoclonus Mimicking Stuttering in a Patient with Myoclonus–Dystonia Syndrome

    PubMed Central

    Isaacs, David A.; Hedera, Peter

    2016-01-01

    Background Acquired neurogenic stuttering has been considered a fairly uncommon clinical occurrence; speech-activated myoclonus is a rare entity that can mimic stuttering and is caused by a wide array of etiologies. Case Report Here we report a patient with myoclonus–dystonia syndrome (MDS), due to an identified disease-causing mutation, who displayed speech-activated myoclonus mimicking stuttering. Discussion In MDS, myoclonus has only infrequently been reported to affect speech. This case further expands the spectrum of conditions causing the rare clinical phenomenon of speech-activated myoclonus. PMID:27441098

  19. Long-term follow up of renal anastomosing hemangioma mimicking renal angiosarcoma.

    PubMed

    Heidegger, Isabel; Pichler, Renate; Schäfer, Georg; Zelger, Bernhard; Zelger, Bettina; Aigner, Friedrich; Bektic, Jasmin; Horninger, Wolfgang

    2014-08-01

    Anastomosing hemangioma of the kidney is a very rare neoplasm, currently 19 cases have been reported in the literature. First described in 2009, histopathologically anastomosing hemangioma is similar to aggressive angiosarcoma. No long-term follow-up data of anastomosing hemangioma have been described yet. Here, we present the case of a healthy 56-year-old man diagnosed in 2002 with a 7 × 5-cm anastomosing hemangioma mimicking an aggressive renal angiosarcoma. The patient underwent nephrectomy and has been followed up disease free for 13 years.

  20. Papillary fibroelastoma of the anterior leaflet of the mitral valve mimicking vegetation

    PubMed Central

    Prifti, Edvin; Ademaj, Fadil; Ikonomi, Majlinda; Demiraj, Aurel

    2015-01-01

    The papillary fibroelastoma (PFE) is a rare and benign primary cardiac tumor, and the most frequently found tumor occurring in the cardiac valves. With the introduction of echocardiography, the diagnosis of these tumors in living patients has been reported sporadically. The PFEs have been found most often on valve leaflets, chordae tendineae, and both ventricles. We describe an interesting case of the PFE originating from the anterior leaflet of the mitral valve mimicking vegetation. The patient underwent successful surgical removal of the PFE. PMID:26187170