Effect of Light Emitting Diodes (LED) Exposure on Vitreous Metabolites-Rodent Study.

The exposure to blue and white Light emitting diodes (LED) light leads to damage in the visual system with short-term LED light exposure. Chronic exposure, adaptive responses to light, and self-protective mechanisms against LED light exposures need to be explored, and it would be essential to understand the repercussions of LED radiation on vitreous metabolites. A total of 24 male Wistar rats were used in this study, divided into four groups (n = 6 in each group). Three experimental groups of rats were exposed to either blue, white, or yellow LED light for 90 days (12:12 light-dark cycle routine) with uniform illumination (450−500 lux). Standard lab settings were used to maintain control rats. Vitreous fluids were subjected to untargeted metabolomics analysis using liquid chromatography-mass spectrometry (LC/MS). PLS-DA analysis indicated significant the separation of m metabolites among groups, suggesting that LED exposure induces metabolic reprogramming in the vitreous. Amino acids and their modifications showed significant alterations among groups which included D-alanine, D-serine (p < 0.05), lysine (p < 0.001), aspartate (p = 0.0068), glutathione (p = 0.0263), taurine (p = 0.007), and hypotaurine. In chronic light exposure, the self-protective or reworking system could be depleted, which may decrease the ability to compensate for the defending mechanism. This might fail to maintain the metabolomic structural integrity of the vitreous metabolites.

Mucoepidermoid carcinoma - A common neoplasm at an unusual site, mimicking a benign cyst on cytology: Diagnostic pitfall!

Mucoepidermoid carcinoma (MEC) is known to be a relatively common neoplasm of the major and minor salivary glands that can secondarily involve skin. The clinical manifestations, diagnostic cytology and histopathology of MEC presenting as a clinically benign periauricular cystic nodule have been analyzed. The challenge of accurate diagnosis can be illustrated by the fact that initially, on cytology, this tumor was misdiagnosed as a benign epidermal inclusion cyst due to the presence of mucin-filled cells which were misinterpreted as cyst macrophages. This case report emphasizes the need to include parotid tumors in the differential diagnosis of all periauricular cyst-like expansions. We also briefly discuss the reasons for false-positive cytology in this case. Delay in accurate diagnosis may result in larger surgical procedures, such as radical neck dissection, that may otherwise be avoided.

Blue Light-Induced Retinal Neuronal Injury and Amelioration by Commercially Available Blue Light-Blocking Lenses.

Blue light exposure-induced retinal damage has been extensively studied. Although many in vitro studies have shown the benefits of blue light-blocking lenses (BBL) there have been few comprehensive in vivo studies to assess the effects of BBL. We investigated the influence of blue light exposure using light-emitting diodes on retinal histology and visual cortex neurons in rodents. We also considered whether retinal and cortical changes induced by blue light could be ameliorated with blue light-blocking lenses. A total of n = 24 (n = 6 in each group; control, light exposure without lenses, two different BBLs)) male Wistar rats were subjected to blue light exposure (LEDs, 450-500 lux) without or with BBLs (400-490 nm) for 28 days on a 12:12 h light-dark cycle. Histological analysis of retinae revealed apoptosis and necrosis of the retinal pigment epithelium (RPE), photoreceptors, and inner retina in the light exposure (LE) group, along with increase caspase-3 immunostaining in the ganglion cell layer (p < 0.001). BBL groups showed less caspase-3 immunostaining compared with the LE group (p < 0.001). V1-L5PNs (primary visual cortex layer 5 pyramidal neurons) demonstrated reduced branching and intersections points for apical (p < 0.001) and basal (p < 0.05) dendrites following blue light exposure. Blue light-blocking lenses significantly improved the number of basal branching points compared with the LE group. Our study shows that prolonged exposure to high levels of blue light pose a significant hazard to the visual system resulting in damage to the retina with the associated remodeling of visual cortex neurons. BBL may offer moderate protection against exposure to high levels of blue light.

Vascular Strip Cholesteatoma-A Case Report.

INTRODUCTION: The incidence of cholesteatoma occurring as a result of tympanoplasty is extremely rare. Understanding the cause and preventing its occurrence in the future is the main intention of highlighting this peculiar presentation. CASE REPORT: A 25-year-old woman presented with progressive hearing loss and blocked sensation in the left ear of one and a half months duration. Past history revealed a history of left myringoplasty six years prior to presentation. Clinical examination of the ear revealed a smooth, soft epithelium covered bulge in the lateral one-third of the floor and posterior wall of the left external auditory canal. HRCT and MRI of the temporal bone confirmed the presence of a soft tissue density in the mastoid. Pure tone audiometry revealed conductive hearing loss. She underwent mastoid exploration, removal of sac with soft wall reconstruction. CONCLUSION: Proper placement of the vascular strip with the skin lining the external auditory canal with approximation of the incision margins is essential to prevent iatrogenic cholesteatoma formation. Close follow-up is essential to prevent any recurrence and diffusion weighted MRI plays a vital role in detection of recurrence.

Nodular Fasciitis - Fine Needle Aspiration Cytology Diagnosis and Its Pitfalls, with Review of Literature.

BACKGROUND AND OBJECTIVE: Nodular fasciitis (NF) is a self-limiting, transient neo- plasm composed of fibroblasts and myofibroblasts. Since it regresses spontaneously, diagnosis by fine needle aspiration (FNA) cytology plays a major role in its management. METHODS: We present a series of 8 cases with either FNA or biopsy diagnosis ofNF, and study the major cytological features with a review of literature on diagnostic criteria and its pitfalls. RESULTS AND CONCLUSION: The 8 cases occurred in patients between the age of 14 to 72 years, with equal sex distribution. FNA diagnosis concurred in 4 cases. Causes of wrong diagnosis included lack of clinical information and paucicellular smear. FNA cytology is an important tool in the diagnosis of nodular fasciitis, in appropriate clinico-radiologicalsetting.

Myeloid sarcoma: A clinicopathological study with emphasis on diagnostic difficulties.

BACKGROUND: Myeloid sarcoma (MS) is a rare tumor composed of proliferation of myeloid precursors at extramedullary sites. They can arise de-novo or in association with hematological malignancies, most commonly acute myeloid leukemia. Clinically, it can masquerade as an abscess, cutaneous ulcer, or mass lesion. Morphologically, MS can mimic a variety of small round cell tumors including lymphomas and rhabdomyosarcoma. AIMS: (1) To study the clinical presentations and laboratory findings in patients with MS; (2) to revisit the histomorphological findings and the differential diagnosis of MS; (3) to evaluate the diagnostic role of immunohistochemistry (IHC) and determine the useful markers for accurate diagnosis of MS. MATERIALS AND METHODS: We reviewed cases of MS reported in our institution over a 10-year period from January 2004 to December 2013. The clinical presentations, laboratory data, and histopathological and immunohistochemical findings were studied. RESULTS: There were nine cases in our database, none of which were clinically suspected to be MS. Age ranged from 3 to 55 years, with a slight female preponderance. Cervical lymph nodes were the most common site involved. Histologically, the common finding was the presence of medium- to large-sized cells with fine granular chromatin, small nucleolus, and scant cytoplasm along with scattered eosinophil precursors. Myeloperoxidase was the most useful IHC marker. All cases were also positive for leukocyte common antigen contributing to the diagnostic confusion with lymphoma. CONCLUSION: The possibility of MS should be considered when dealing with unusual lymphoma-like neoplasms that cannot be categorized as any of the Non-Hodgkin lymphoma subtypes.

Blastoid Variant of Mantle Cell Lymphoma with Leukemic Presentation - A Rare Case Report.

Mantle Cell Lymphoma (MCL) is a type of Non-Hodgkin's lymphoma and has a wide spectrum of histopathological subtypes of which the blastoid or the blastic variant constitutes 10-15% of all cases. It is difficult to diagnose blastoid variant of MCL on the basis of morphology alone as it mimics lymphoblastic lymphoma and centroblastic large cell lymphoma, hence additional analysis like immunophenotyping and molecular studies aid in its diagnosis. We present a case of 45-year-old male who presented to medicine OPD with chief complaints of fever, fatigability and inguinal swelling. Complete blood count, peripheral smear and bone marrow examination was performed. Peripheral smear showed thrombocytopenia along with 53% abnormal cells. On bone marrow examination 43% abnormal lymphoid cells were seen. This case was diagnosed as blastoid variant of MCL on the basis of routine morphology and immunohistochemistry on bone marrow biopsy and flow cytometric immunophenotyping on peripheral blood.

Spinal Intradural Schwannoma with Acute Intratumoural Haemorrhage: Case Report and Review.

Schwannomas account for around half of all intradural spinal tumours, with chronic progressive symptoms as the most common presenting features. Intratumoural haemorrhage as a presenting feature of spinal schwannoma is very rare and only 11 cases have been reported till date. Authors here report a previously asymptomatic 40-year-old male who presented with acute onset paraplegia 12 hours after a minor trauma. MR imaging revealed a C7-D3 intradural-extramedullary lesion with features of acute blood and showing no enhancement. Emergency laminectomy and complete removal of the mass was performed and histopathology revealed features of schwannoma with haemorrhage. Patient had modest improvement of his neurological deficits at a follow-up of 6 months. Pertinent literature is reviewed in brief.

Ovarian Sertoli-Leydig Cell Tumour with Heterologus Elements Masquerading as Mucinous Tumour on Frozen Section: A Case Report.

Sertoli-Leydig cell tumour (SLCT) is an extremely rare ovarian neoplasm. This tumour is characterized by excessive proliferation of normal testicular structures sertoli and leydig cells. These cells are seen in varying proportions and exhibit varying degrees of differentiation. We report a case of primary ovarian SLCT with heterologus elements in a 17-year-old girl which was misdiagnosed on frozen section as mucinous cystic neoplasm. We discuss the clinicopathologic features of SLCT along with the unusual features seen in this case.

Synthesis, characterization, and preclinical evaluation of new thiazolidin-4-ones substituted with p-chlorophenoxy acetic acid and clofibric acid against insulin resistance and metabolic disorder.

We synthesized twenty thiazolidin-4-one derivatives, which were then characterized by standard chromatographic and spectroscopic methods. From the in vitro glucose uptake assay, two compounds behaved as insulin sensitizers, where they enhanced glucose uptake in isolated rat diaphragm. In high-carbohydrate diet-induced insulin resistant mice, these two thiazolidin-4-ones attenuated hyperglycemia, hyperinsulinemia, hypertriglyceridemia, hypercholesterolemia, and glucose intolerance. They raised the plasma leptin but did not reverse the diabetes-induced hypoadiponectinemia. Additionally, compound 3a reduced adiposity. The test compounds were also able to reverse the disturbed liver antioxidant milieu. To conclude, these two novel thiazolidin-4-ones modulated multiple mechanisms involved in metabolic disorders, reversing insulin resistance and thus preventing the development of type-2 diabetes.

A rare presentation of splenic tuberculosis with a pseudocyst.

Splenic tuberculosis is an unusual manifestation of extrapulmonary tuberculosis, especially in immunocompetent hosts. It often poses diagnostic difficulties as microbiological confirmation is not easy. In this case report, we describe a case of pseudocyst of the spleen due to tuberculosis, which is a rare clinical presentation with only one case having been reported previously. A 24-year-old immunocompetent woman presented with pain in the abdomen, vomiting and fever. On evaluation the patient was found to have a cyst arising from the spleen. Splenectomy was performed. Pathological examination of the specimen revealed a pseudocyst with granulomas and giant cells consistent with tuberculosis. Cyst fluid analysis revealed lymphocyte predominance with high adenosine deaminase levels. The patient was started on 6 months of antituberculous therapy postoperatively. On follow-up, the patient was found to have gained weight and showed signs of well-being.

Incidental 'ethmoid sinolith'--an unusual cause of frontal recess obstruction.

We report a case of a middle aged, hypertensive man who presented with nasal obstruction, sneezing spells, headache and nasal discharge of long duration. On evaluation, he was diagnosed to have a deviated nasal septum with allergic rhinosinusitis with sinonasal polyposis. CT of the paranasal sinuses revealed a hyperdense, oval structure suggestive of a sinolith in the right anterior ethmoid sinus. The patient underwent septoplasty with right Draf 2B procedure and extraction of the sinolith from the ethmoid sinus.

Dual pathology of the submandibular gland: plasmacytoma and pleomorphic adenoma.

Synchronous tumours of different histological types involving the salivary gland are very rare. There have been cases reported in the literature of such tumours occurring in the parotid gland. A 52-year-old man presented with a 4-year history of gradually increasing painless swelling in the right submandibular region. The ultrasound scan of the neck showed features suggestive of a submandibular sialadenitis. The right submandibular gland was then surgically excised and sent for histopathological examination. The features showed a unique dual pathology of the submandibular gland, that is, a plasmacytoma and a pleomorphic adenoma. Such a synchronous double pathology involving the submandibular gland has not been reported in the literature. A review of the literature suggests a good prognosis for the extramedullary plasmacytoma, provided multiple myeloma is ruled out. In 18 months of follow-up, the patient has been asymptomatic with a negative myeloma workup.

Desmoplastic small round cell tumour in a young woman with widespread metastasis and peritoneal caking.

Desmoplastic Small Round Cell Tumour (DSRCT) is a rare, highly aggressive, mesenchymal tumour that arises from the peritoneal cavity. It is commonly seen in adolescent and young adult males and its occurrence in females is uncommon. We are reporting here a rare case of DSRCT in a young woman, which clinically masqueraded as an ovarian malignancy, with metastasis to liver, lung, spleen and peritoneum. The cytologic findings, Histomorphological and immunohistochemical features have been discussed, with a brief review of literature.

Ovarian Pregnancy following Intracytoplasmic Sperm Injection and Embryo Transfer: A Case Report.

Ovarian pregnancy is a rare form of ectopic pregnancy following ICSI-ET, and the diagnosis depends on the physicians suspicion and experience. Preservation of ovarian tissue during surgery is of utmost importance to preserve fertility. We present a case of ovarian pregnancy who had a successful treatment preserving the ovary.

Micro-Raman spectroscopy of silver nanoparticle induced stress on optically-trapped stem cells.

We report here results of a single-cell Raman spectroscopy study of stress effects induced by silver nanoparticles in human mesenchymal stem cells (hMSCs). A high-sensitivity, high-resolution Raman Tweezers set-up has been used to monitor nanoparticle-induced biochemical changes in optically-trapped single cells. Our micro-Raman spectroscopic study reveals that hMSCs treated with silver nanoparticles undergo oxidative stress at doping levels in excess of 2 µg/ml, with results of a statistical analysis of Raman spectra suggesting that the induced stress becomes more dominant at nanoparticle concentration levels above 3 µg/ml.

Raman tweezers spectroscopy of live, single red and white blood cells.

An optical trap has been combined with a Raman spectrometer to make high-resolution measurements of Raman spectra of optically-immobilized, single, live red (RBC) and white blood cells (WBC) under physiological conditions. Tightly-focused, near infrared wavelength light (1064 nm) is utilized for trapping of single cells and 785 nm light is used for Raman excitation at low levels of incident power (few mW). Raman spectra of RBC recorded using this high-sensitivity, dual-wavelength apparatus has enabled identification of several additional lines; the hitherto-unreported lines originate purely from hemoglobin molecules. Raman spectra of single granulocytes and lymphocytes are interpreted on the basis of standard protein and nucleic acid vibrational spectroscopy data. The richness of the measured spectrum illustrates that Raman studies of live cells in suspension are more informative than conventional micro-Raman studies where the cells are chemically bound to a glass cover slip.