Twin pregnancy: Live fetus with complete hydatidiform molar-A case report.

Gestational trophoblastic disease encompasses a range of lesions, each culminating in varied clinical manifestations. Among these, the simultaneous occurrence of molar changes within the placenta and a viable fetus remains a particularly elusive and challenging presentation, posing intricate dilemmas for obstetricians. In this article, we delineate a distinct case involving a 21-year-old woman with a history of consanguineous marriage. She was referred from Médecins Sans Frontières to the Rafic Hariri University Hospital during her 19th week of gestation. With an unremarkable medical history and uncomplicated previous pregnancies, her presentation to the Rafic Hariri University Hospital was punctuated by symptoms of premature labor. Clinical evaluations revealed ruptured membranes, a fetus-positioned breech, and discernible complications tied to the placental morphology. Given these clinical findings, a decision was made in favor of a Cesarean delivery. Prior to this, the patient had been administered corticosteroids and tocolytics. Subsequent delivery produced a live male infant at 34 + 5 gestational days, and further assessment unveiled a complete molar pregnancy. The coexistence of a viable fetus alongside a complete molar pregnancy is an infrequently documented phenomenon, underlining the clinical significance of this case. A comprehensive literature survey reinforced the exceptional nature of our findings. Postpartum, both the mother and neonate were monitored for a month, ensuring their well-being. This case accentuates the paramountcy of prompt and precise diagnostic interventions when faced with atypical presentations. It further underscores the imperative for obstetricians to possess nuanced expertise in confronting the intricate challenges posed by gestational trophoblastic disease, ensuring optimal maternal and neonatal outcomes.

Paraneoplastic Pemphigus as a First Manifestation of an Intra-Abdominal Follicular Dendritic Cell Sarcoma: Rare Case and Review of the Literature.

BACKGROUND: Follicular dendritic cell sarcoma (FDCS) is an extremely rare malignant tumor caused by proliferation of antigen-presenting follicular dendritic cells. The tumor most commonly arises in lymph nodes, with fewer than 30% of cases originating in extranodal sites. CASE PRESENTATION: We report the case of a 39-year-old previously healthy male patient who presented with paraneoplastic pemphigus in the setting of a large intraperitoneal mass with no associated lymphadenopathy. The biopsy results showed a cellular proliferation of mildly to moderately atypical oval-to-spindle-shaped cells admixed with a variably dense lymphoplasmacytic infiltrate suggestive of FDCS versus inflammatory myofibroblastic tumor. A pathology review following total resection of the abdominal mass confirmed the diagnosis of FDCS. The tumor cells showed positivity for CD35, CD21, CD45, and CD68, negative ALK staining, and limited smooth muscle actin immunoreactivity. The surgery was complicated by severe pneumonia and acidosis, resulting in a prolonged ICU stay and death. CONCLUSION: It is essential to maintain a high index of suspicion for FDCS and include it in the differential diagnosis of a spindle cell neoplasm, especially in the setting of paraneoplastic pemphigus. The histological and immunohistochemical features should be sufficient to confirm the diagnosis of FDCS.

Expression of eukaryotic initiation factor 4E and 4E binding protein 1 in colorectal carcinogenesis.

Cap dependent translation is mainly regulated at the level of the eukaryotic initiation factor 4E (eIF4E), the activity of which is controlled by phosphorylation and sequestration by its well established regulator, 4E binding protein 1 (4E-BP1). Both eIF4E and 4E-BP1 have been shown to be involved in the malignant progression of multiple human cancers, including colorectal cancer. However, the data on determining the expression of eIF4E, 4E-BP1 and their phosphorylated forms simultaneously in a single patient with colorectal cancer is lacking. Therefore the aim of our study was to explore the roles of these factors in colorectal carcinogenesis by immunohistostaining colorectal tissues (normal, low grade adenoma, high grade adenoma, and adenocarcinoma). Our results showed that the expression levels of eIF4E increased steadily as the cancer progressed from the case of benign dysplasia to an adenocarcinoma; all the while maintaining an unphosphorylated form. On the other hand, total expression levels of 4E-BP1 increased only in the premalignant state of the disease and decreased (but highly phosphorylated or inactivated) or abolished upon malignancy. Taken together, our findings suggest that strong correlations exist between the expression of eIF4E (not p-eIF4E) and tumor grade providing evidence that eIF4E expression plays a pivotal role in the malignant progression of colorectal cancer. Moreover, 4E-BP1 showed a bi-phasic level of expression during carcinogenesis, which is expressed only in hyperplasic or dysplastic tissues as an endogenous tumor suppressor molecule.

Optical fiber-based sensor for in situ monitoring of cadmium sulfide thin-film growth.

This work presents a scheme for in situ monitoring of thin-film growth. A fiber-optic sensor based on Fabry-Perot interferometric technique has been established for the first time to monitor in situ growth of thin films. This was applied for determining thickness of cadmium sulfide (CdS) thin films during growth. The fabrication process of CdS film was carried out in 30 mM cadmium acetate and thioacetamide solution at 60°C temperature. The estimated thickness determined during the growth was verified by scanning electron microscopy. This study shows that in situ measurement of the thickness of thin films is feasible by this new technique, and a close match of the estimated thickness was achieved.

Kinetics and time dependence of the differential agglutination of acetone [AC]- and formalin [HS]-fixed Toxoplasma tachyzoites by serum of mice with experimental toxoplasmosis.

Researches to specify a serologic diagnostic test capable of determining the stage of toxoplasmosis, whether recent or latent, have been hampered by lack of knowing the real time of infection. Studying the precise kinetics of the differential agglutination of acetone [AC]-fixed versus that of formalin [HS]-fixed tachyzoites (differential agglutination test or AC/HS test) by sera of mice during the course of toxoplasmosis and assessment of its value in the differentiation between recent and latent infections in mice were the aims of the present work. Experimental toxoplasmosis was induced in mice, sera were collected sequentially and AC/HS test, FAST-ELISA to determine levels of IgM and IgG and microscopic examination of brain for Toxoplasma cysts were done. Both AC and HS specific patterns in the AC/HS test were noted to be dependent on the time from the onset of infection. Acute patterns of the AC/HS test were observed early in infection till before the appearance of brain cysts. Non-acute patterns were obtained late on 28th day post infection coinciding with the disappearance of IgM, persistence of IgG and presence of cysts in brains. The AC antibody was high in the recent phase of infection, and then it declined to be replaced by high sustained level of HS antibody late in infection. In conclusion, in the presence of both IgM and IgG, the appearance of either equivocal pattern or the non-acute pattern in the AC/HS test is significant in ruling out acute infection in mice.

Cryopreservation of Trichomonas vaginalis: a trial of using four different cryoprotectants.

To reach the maximum survival rate of Trichomonas vaginalis after cryopreservation, four substances: dimethylsulphoxide (DMSO), glycerol, egg yolk and horse serum were used as cryoprotectants. T. vaginalis trophozoites, in the logarithmic phase, cultured on TYM-S medium were used. Rapid and slow freezing schedules were followed. Examinations for viable organisms were done after a month duration in liquid nitrogen. Immediate and delayed thawing were tried. Viability scores depended on the presence of live organisms in the thawed parasite suspensions determined by the presence of motile trophozoites under microscopic examination, by dye uptake and by re-suspension of the organisms in fresh TYM-S and watching for parasite growth and multiplication. Rapid freezing protocol failed to cryopreserve T. vaginalis with any cryoprotectant. DMSO was superior to glycerol especially in 10% conc. by slow freezing. Viable organisms were more when the suspensions were immediately thawed without delay.

Molecular identification of coproantigens of Cryptosporidium parvum compared to conventional staining techniques.

To compare the immunologic techniques to the conventional staining methods (mainly modified Ziehl Neelsen = MZN), 93 children (65 immunocompromised and 28 immunocompetent) potentially at risk of Cryptosporidium parvum were studied. Using MZN, a prevalence of 10.7% in diarrhoeic children was found. ELISA coproantigen and detection of 23 KDa band of immunoblotting by serum IgG were sensitive and specific. They gave 85.7% sensitivity, 100% specificity, 100% diagnostic accuracy, 100% positive predictive value and 98.9% negative predicttive value. ELISA detection of serum IgG gave 85.7% sensitivity, 97.7% specificity, 96.8% diagnostic accuracy, 75% positive predictive value and 98.9% negative predictive value. So, 23KDa band determined by ELISA is a valuable sensitive and specific mean of diagnosing cryptosporidiosis as this antigen is a consistent target of humoral immune response.