Partial and total iodide organification defect in different sibships in a kindred.

Identical twins with goiter but without intellectual retardation and with slightly delayed bone age were found to have defective iodide organification as demonstrated by incomplete perchlorate discharge tests. They are grandnieces of a normal member of a sibship which included four children with severe retardation and complete thyroid iodide organification defect. The parents and grandparents are not consanguine. Possible explanations are considered for the problem of why the disorder is manifest completely in one sibship and only partially in the other.     

Deltovertebral flap to cover a large scalp defect: case report.

A deltovertebral flap based on the perforating cutaneous branches of the posterior intercostal vessels (the exact opposite of the deltopectoral flap) was used successfully to cover a large scalp defect. The procedure is a rather hazardous one, due to the numerous stages and the awkward postoperative position. However, it may be used to repair the lateral aspect of the neck or the occipital region when a flap is necessary and other methods are not feasible.     

Congenital partial arhinia: a case report

Purpose

To describe the development of presumed immune-mediated stromal rejection after automated lamellar therapeutic keratoplasty (ALTK) and its reversal after initiation of intensive topical corticosteroid therapy.

Methods

Observational case report.

Results

Stromal edema localized in the graft developed 42 days after ALTK for Avellino corneal dystrophy in a 65-year-old man. After one week of intensive topical corticosteroids, complete reversal of graft edema occurred, with full recovery of visual function.

Conclusion

The clinical appearance and response to therapy in this case supported the diagnosis of immune-mediated stromal rejection. Ophthalmologists should be aware that stromal rejection may occur in lamellar corneal grafts.     

Congenital myasthenic syndrome: a case report

Summary: Congenital myasthenic syndromes (CMS) are diseases of the neuromuscular junction. They usually belong to the disease groups that begin in the infantile or childhood period and carry genetic characteristics. The following is important in establishing the diagnosis of this disease: clinical findings, electromyography, genetic tests, determination of serum acetylcholine receptor antibodies. Acetylcholine esterase inhibitor drugs are used in treatment of CMS. A seven-month old male patient was brought to our department with the complaints of difficult breathing, falling of the eyelids and swallowing difficulty. With clinical and laboratory findings, he was diagnosed with congenital myasthenia and treatment was started. CMS should be suspected in patients with no pathological findings on the physical examination, and normal chest X-rays.     

Multifocal nodular oncocytic hyperplasia in parotid gland: a case report

BACKGROUND: Multifocal nodular oncocytic hyperplasia (MNOH) is a rare lesion of the parotid gland. Fine needle aspiration cytology (FNAC) in MNOH has not been described previously to the best of our knowledge. CASE: A 55-year-old woman presented with a lump at the left angle of her mouth for 2 months. Local examination revealed a hard, nontender parotid mass. FNAC revealed clusters as well as discretely lying oncocytic cells. cells at places showed moderate nuclear pleomorphism. The features were consistent with a diagnosis of oncocytic neoplasm neoplasm; however, because of pleomorphism, a suspicion of carcinoma was offered. The patient underwent superficial parotidectomy, and histopathology examination revealed it to be multifocal nodular oncocytic hyperplasia. CONCLUSION: MNOH is a rare nonneoplastic salivary gland lesion and should be considered in the differential diagnosis of oncocytic neoplasm on FNAC.     

Encephalocraniocutaneous lipomatosis accompanied by maxillary compound odontoma and juvenile angiofibroma: report of a case

BACKGROUND: Encephalocraniocutaneous lipomatosis (ECCL) is a rare neurocutaneous syndrome characterized by congenital cutaneous, ocular, and neurologic abnormalities, which may be pronounced in the head and neck. CASE: In this article we present a well-documented case of a six-year-old boy with ECCL associated with oral manifestations. In this case, typical features such as large lipomatous brown pigmented plaques of the top of the skull with overlying alopecia, ptotic eyelid with decreased function, bulbar conjunctiva lipodermoid, microcalcifications and atrophy of cerebral parenchyma, and the widening of the frontal subarachnoid space and the fissure of Sylvius were accompanied by intraoral lesions, maxillary compound odontoma, and juvenile extranasopharyngeal angiofibroma of the gingiva. CONCLUSIONS: Although cases of odontomas have already been described and angiofibromas are a quite common extraoral finding, to our knowledge this is the first case of intraoral evaluation of both extranasopharyngeal juvenile angiofibroma and maxillary compound odontoma in ECCL syndrome.     

Hepatocellular carcinoma and focal nodular hyperplasia associated with norethandrolone-therapy: a case report

A 33-year-old woman was treated for severe aplastic anemia with norethandrolone over a period of four years, with a cumulative dose of 25 g. In the fifth year of therapy two intrahepatic tumors were detected and were classified as hepatocellular carcinoma and as focal nodular hyperplasia, respectively.     

Congenital Plasmodium vivax malaria mimicking neonatal sepsis: a case report

A recently published comment on a report of Plasmodium knowlesi infections in Vietnam states that this may not accurately represent the situation in the study area because the PCR primers used may cross-hybridize with Plasmodium vivax. Nevertheless, P. knowlesi infections have been confirmed by sequencing. In addition, a neighbour-joining tree based on the 18S S-Type SSUrRNA gene shows that the Vietnamese samples clearly cluster with the P. knowlesi isolates identified in Malaysia and are distinct from the corresponding P. vivax sequences. All samples came from asymptomatic individuals who did not consult for fever during the months preceding or following the survey, indicating that asymptomatic P. knowlesi infections occur in this population, although this does not exclude the occurrence of symptomatic cases. Large-scale studies to determine the extent and the epidemiology of P. knowlesi malaria in Vietnam are further needed.     

Congenital deformity of the paw in a captive tiger: case report

Background

Although Morbillivirus and Toxoplasma gondii have emerged as important pathogens for several cetaceans populations over the last 20 years, they have never been identified together in a Mysticete. In particular, morbilliviral infection has been never described in the Mediterranean fin whale population.

Case presentation

On January 2011 an adult male of fin whale (Balaenoptera physalus) stranded along the Tyrrhenian coastline of Italy. During necropsy, tissue samples from heart, skeletal muscle, mesenteric lymph nodes, liver, spleen, lung, and kidney were collected and subsequently analyzed for Morbillivirus and Toxoplasma gondii by microscopic and molecular methods. Following the detailed necropsy carried out on this whale, molecular analysis revealed, for the first time, the simultaneous presence of a Dolphin Morbillivirus (DMV) and T. gondii infection coexisting with each other, along with high organochlorine pollutant concentrations, with special reference to DDT.

Conclusion

This report, besides confirming the possibility for Mysticetes to be infected with DMV, highlights the risk of toxoplasmosis in sea water for mammals, already immunodepressed by concurrent factors as infections and environmental contaminants.     

Evaluation of a ventricular septal defect in an orangutan: a case report

A 15-year-old male Sumatran orangutan (Pongo pymaeus abeli) with a history of an interventricular septal defect was evaluated with cardiac catheterization and two-dimensional echocardiography. Results demonstrated that by Homo sapiens standards the right heart pressures were normal. The oxygen saturations were consistent with a small ventricular septal defect. Echocardiography demonstrated a slight enlargement of the right ventricle.     

Infertility in a bull with a nuclear sperm defect: A case report

A Simmental bull with a history of low fertility, both by natural service and artificial insemination, was presented for examination. Two previous semen evaluations had revealed no specific semen abnormalities that would support the breeding history. A comprehensive cytochemical analysis of the bull's ejaculate revealed a complex nuclear lesion affecting over 80% of sperm. This condition was expressed in abnormal shaping of the nuclei, with deficient distribution, condensation and stabilization of the nucleoplasm. These abnormalities were associated with various-sized intranuclear pouches or depressions. The acrosome was moderately involved and the tail was relatively free of abnormalities resulting in normal sperm motility.Two controlled breeding trials utilizing a total of 15 super-ovulated females were conducted to evaluate the bull's fertilization rate. Combined data demonstrated an 18% ($\text{23}\text{128}$) fertilization rate of recovered ova. At the same time, the fertilization rate of seven bulls classified as satisfactory potential breeders was 72% ($\text{353}\text{490}$).Data from two embryo transplant units regarding ova collected from eight donor females inseminated with semen from this bull revealed a fertilization rate of 41% ($\text{30}\text{73}$). Of the fertilized ova, 37% ($\text{11}\text{30}$) were degenerate and were not transferred. A pregnancy rate of 57% ($\text{11}\text{19}$) resulted from the transfer of 19 fertilized ova.A natural breeding pregnancy rate of 5% ($\text{2}\text{42}$) and artificial breeding pregnancy rate of 8% ($\text{15}\text{180}$) support the breeding trial results.     

Discordant lymphoma consisting of mediastinal large B-cell lymphoma and nodular sclerosis Hodgkin lymphoma in the right supraclavicular lymph nodes: a case report

PD-L1 is a glycoprotein from the family of T-cell co-stimulatory molecules that are constitutively expressed by macrophages. Aberrant expression of PD-L1 is observed in human cancers associated with inhibition of the tumor-directed T-cell immune response. There are few reports in the literature evaluating PD-L1 expression in association to prognosis specifically in renal cell cancer clear cell type (RCC-CC). Immunohistochemistry using a PD-L1 polyclonal antibody was performed on a tissue microarray (TMA) that contained 115 surgical specimens of RCC-CC. Cases were classified based on the absence or presence of staining intensity in the cytoplasm and membranes of the tumor cells. Statistical analysis was used to determine the association of PD-L1 expression with classic prognostic factors and tumor recurrence. PD-L1 expression was positive in 56.5 % of tumors. The univariate analysis showed a correlation between PD-L1 expression and nuclear Fuhrman grade (p = 0.021) and microvascular tumor embolization (p = 0.039). One hundred and four patients were monitored for a mean time of 115.7 months. Seventeen patients (16.3 %) suffered tumor recurrence. Negative outcomes were associated with higher nuclear grade tumors, PD-L1 expression, and the presence of microvascular invasion. Our findings confirm that PD-L1 expression is an important prognostic factor in RCC-CC.     

HER-2-positive gastric cancer accompanied by liver metastasis: a case report of a rare complete response and literature review

The prognosis of advanced gastric cancer is poor, and the prognosis of late-stage gastric cancer with expression of human epidermal growth factor receptor 2 (HER-2) is worse. Personalized therapy is based on the specific situation of each patient to determine the best treatment plan. We diagnosed a 36-year-old patient with a HER-2-producing adenocarcinoma of the gastric cardia accompanied by liver metastasis. Sixteen cycles of chemotherapy were consecutively administered to the patient, starting with a three-drug combination, followed by a two-drug combination, and finally a single drug as a chemotherapy regimen. During these treatments, the molecular targeted drug trastuzumab was continuously administered. In the end, the patient experienced a complete response (CR). In clinical practice, advanced gastric cancer is not well controlled in certain patients, due to inadequate first-line chemotherapy and its side-effects. If a patient enjoys a strong performance status (PS), we emphasize the importance of molecular-targeted drugs combined with prolonged administration of chemotherapy.