Microbial exposure during early human development primes fetal immune cells.

The human fetal immune system begins to develop early during gestation; however, factors responsible for fetal immune-priming remain elusive. We explored potential exposure to microbial agents in utero and their contribution toward activation of memory T cells in fetal tissues. We profiled microbes across fetal organs using 16S rRNA gene sequencing and detected low but consistent microbial signal in fetal gut, skin, placenta, and lungs in the 2nd trimester of gestation. We identified several live bacterial strains including Staphylococcus and Lactobacillus in fetal tissues, which induced in vitro activation of memory T cells in fetal mesenteric lymph node, supporting the role of microbial exposure in fetal immune-priming. Finally, using SEM and RNA-ISH, we visualized discrete localization of bacteria-like structures and eubacterial-RNA within 14th weeks fetal gut lumen. These findings indicate selective presence of live microbes in fetal organs during the 2nd trimester of gestation and have broader implications toward the establishment of immune competency and priming before birth.

Experimental evolution of a fungal pathogen into a gut symbiont.

Gut microbes live in symbiosis with their hosts, but how mutualistic animal-microbe interactions emerge is not understood. By adaptively evolving the opportunistic fungal pathogen Candida albicans in the mouse gastrointestinal tract, we selected strains that not only had lost their main virulence program but also protected their new hosts against a variety of systemic infections. This protection was independent of adaptive immunity, arose as early as a single day postpriming, was dependent on increased innate cytokine responses, and was thus reminiscent of "trained immunity." Because both the microbe and its new host gain some advantages from their interaction, this experimental system might allow direct study of the evolutionary forces that govern the emergence of mutualism between a mammal and a fungus.

Central Variant of Posterior Reversible Encephalopathy Syndrome - A Rare Case Report.

Posterior Reversible Encephalopathy Syndrome (PRES) is a clinicoradiological condition associated with headache, altered mental status, dizziness and white matter vasogenic oedema in parieto-occipital region. It is often associated with hypertension but can also occur in diverse clinical settings like immunosuppression, eclampsia, etc. It is due to failure of autoregulatory mechanism of posterior circulation in response to change in blood pressure. We hereby report a rare case of central variant of PRES secondary to severe hypertension diagnosed with 3T MRI. Objective of reporting this case was to describe the imaging findings of typical and rare atypical patterns of PRES. A 71-year-old male hypertensive patient was referred for brain imaging with history of short period of loss of consciousness, headache and dizziness. MRI brain showed central variant pattern of PRES with preferential involvement of brainstem, thalami and periventricular white matter with sparing of frontal, parietal and occipital lobes. The patient was treated with anti-hypertensive after which patient's symptoms subsided. The patient was followed up conservatively. Atypical variants of PRES should be borne in mind when pontine hyperintensity is encountered in hypertensive patient.

Congenital Hypertonia of the Temporalis Leading to Trismus Since Birth.

Congenital trismus is quite rare especially when its etiology is not the usual. In our case report an 8 year old female patient with no history of forcep delivery, no history of trauma or infection and a non syndromic presents with trismus since birth. After thorough examination we could conclude that the cause is due to hypertonia of the temporalis muscle and its etiology is discussed.

Chronic Pituitary Failure Resembling Sheehan's Syndrome Following a Bite of Russell's Viper. A Case Report.

Hypopituitarism can be the sequela of a variety of causes like postpartum pituitary necrosis or Sheehan's syndrome, lymphocytic hypophysitis, trauma and encephalitis. A very rare cause is envenomation by a bite of a Russell's viper. Very few cases with documented imaging findings of chronic pituitary failure resulting from snake bite have been reported. We describe a case of hypopituitarism with clinical, endocrine and magnetic resonance (MR) imaging studies occurring as a delayed complication of snake bite.

MRI Eye-of-the-Tiger Sign in Organophosphate Poisoning. A Case Report.

We describe the eye-of-the-tiger sign on magnetic resonance imaging (MRI) of the brain in a 40-year-old man presenting with extra pyramidal symptoms like chorea, flexion neck dystonia, tongue tremors, dysarthria and postural instability as the sequelae of organophosphorus poisoning six months previously. This typical radiological sign has been described in extrapyramidal parkinsonian disorders including cortical-basal ganglionic degeneration, early onset levodopa-responsive parkinsonism and Steele-Richardson-Olszewski syndrome (progressive supranuclear palsy) but hitherto has not been reported in insecticide poisoning. T2-weighted scans showed low signal intensity surrounding a central region of high signal intensity in the anteromedial globus pallidus (gliosis), producing an eye-of-the-tiger appearance with the central hyperintense signal intensity better appreciated in T2W and fluid attenuated inversion recovery (FLAIR) sequences.

Characteristic MR Imaging Findings of Neurocutaneous Melanosis. A Case Report.

Neurocutaneous melanosis is a type of phakomatosis characterised by dermal, leptomeningeal and parenchymal melanocytic naevi. Here we describe a case of a 13-year-old boy with dermal and brain parenchymal melanosis without any leptomeningeal melanosis.

Radiation-induced mineralizing microangiopathy in a case of recurrent craniopharyngioma. A case report.

Mineralizing microangiopathy is a late complication of radiation-induced brain injury that occurs during the treatment of CNS malignancies in children and adults. Early diagnosis of the radiation-induced brain injury helps to tailor the radiation dose and prevent further complications. Here we describe an operated oatient with craniopharyngioma who underwent external beam radiotherapy. The patient developed gradual loss of vision after two years and a review CT scan revealed the local recurrence of tumour with dystrophic calcification of the basal ganglia, frontal and temporal subcortical regions representing recurrent craniopharyngioma with radiation-induced mineralizing microangiopathy.

Wilson's disease--a rare psychiatric presentation.

The development of extrapyramidal syndrome characterised by rigidity, bradykinesia, dysphagia and dysarthria in a male individual with four distinct episodes of (mania like) behavioural disturbances with fairly good remission in a time frame of five years, in a male individual, was suspected to develop the neurological manifestations of Wilson's disease and was investigated. In the absence of Kayser-Fleischer ring by slit-lamp examination and with normal copper and ceruloplasmin serum levels, the diagnosis was possible because of the positive findings of the magnetic resonance imaging (MRI) studies and increased 24 hours urinary copper levels with the penicillamine challenge test. The findings and its implications are highlighted and discussed.

Typical radiological findings of lipoid proteinosis of urbach and wiethe. A case report.

Lipoid proteinosis is a rare autosomal recessive dermatosis, which can be congenital or have onset in infancy. It is characterized by the progressive deposition of an amorphous hyaline substance with a glycoprotein constitution in the skin and mucous membranes and presents as papular lesions that can aggregate forming plaques with a yellowish discoloration. We present a case of lipoid proteinosis in a seven-year-old boy where characteristic calcifications in the medial temporal lobe helped in early initiation of treatment.

Typical neuroradiological diagnosis of maple syrup urine disease as a precursor to clinical diagnosis. A case report.

Maple syrup urine disease (MSUD) is a rare inherited metabolic disorder. It is due to decreased de-carboxylation of branched-chain amino acids (leucine, valine, and isoleucine) so their accumulation gives a characteristic maple syrup odour in urine and leads to severe neurological deterioration. Early diagnosis and dietary intervention prevent complications and may allow for normal intellectual development. Various types of MSUD exist, classical MSUD being the most common and severe form of this disease. We describe a case of classical MSUD in a four- month-old infant where the MR imaging suggested the diagnosis of MSUD prior to the clinical diagnosis which was further confirmed by laboratory techniques.

Case report: Ocular malformation with a 'double globe' appearance.

Colobomatous cyst of the orbit is a rare congenital cystic malformation associated with ocular maldevelopment. Usually, the cyst is associated with a microphthalmic globe. We present a rare case of a unilateral large colobomatous cyst associated with a normal-sized globe, giving the appearance of a double globe on imaging.