Hepatic Amyloidosis: Something That Can camouflage and Deceive our Perception!

Amyloidosis is a multi-systemic diffusely infiltrating disease due to extracellular deposition of protein-mucopolysaccharide complexes. The type of protein deposited determines the subgroup of amyloid. Hepatic amyloidosis is a rare infiltrating disease affecting the hepatic parenchyma. A wide range of clinical presentation and atypical imaging findings delay the diagnosis of amyloidosis, while tissue biopsy demonstrating amyloid deposits is vital for a definitive diagnosis.

Pilomatricoma: a tumor with hidden depths.

BACKGROUND: Pilomatricoma is a benign tumor of hair matrix differentiation and has been classically described as comprising of basaloid and shadow cells admixed with multinucleated giant cells and areas of calcification. However, there are a diverse range of histologic features this tumor displays that are often unrecognized. AIMS: This study was undertaken to record the histopathologic features of pilomatricoma with an emphasis on the occurrence of other forms of differentiation. METHODS: The study included all skin biopsy specimens over a 13-year period from 1995 to 2007 that had a histologic diagnosis of pilomatricoma. Hematoxylin and eosin-stained slides were reviewed. RESULTS: This study included 21 cases of pilomatricoma. Supramatrical differentiation was seen in all cases and three-quarters of the cases showed matrical differentiation. Also observed in some of the cases were clear cell differentiation toward the outer root sheath, infundibular differentiation, calcification, ossification and secondary inflammation with a foreign body giant cell reaction. Epidermal induction in the form of a downward plate-like growth of the epidermis was seen in a few cases. CONCLUSION: Pilomatricoma, although considered a tumor of hair matrix differentiation, can show cellular evolution toward the other parts of the hair follicle, such as the outer and inner root sheaths, sebaceous and infundibular components and, therefore, can be considered a panfollicular neoplasm.

Nanocomposite based on modified TiO2-BSA for functional applications.

A novel nanocomposite based on TiO(2)-protein for functional applications was prepared and characterized. The composite was made by covalent immobilisation of bovine serum albumin (BSA) on to the TiO(2) particles. BSA was attached to the TiO(2) powder through a three-step process. This involves the functionalization of the TiO(2) particles with silane and the subsequent coupling by glutaraldehyde to free NH(2) groups of the protein. Formation of Schiff's base was confirmed by IR spectroscopy and the optimum loading of the BSA was found to be 73.61%. Surface morphology of the composite was studied by SEM and TEM. Thermal analysis of TiO(2)-BSA composite was carried out by TGA and DSC. Structural variation of the BSA after immobilisation was studied by CD spectra.

Clinicopathologic analysis of 21 cases of nevus sebaceus: a retrospective study.

BACKGROUND: Nevus sebaceus (NS), otherwise designated as 'organoid nevus', involves proliferative changes of the sebaceous glands, sweat glands, and the hair follicles. It displays a range of appearances, depending on the lesion's age. AIMS: To study the histopathological features of NS and correlate these with clinical findings. METHODS: All skin biopsy specimens over a 12-year period from 1995 to 2007 which had a diagnosis of NS were included. Clinical data with follow-up notes and histopathology were reviewed. RESULTS: Half of the cases had a verrucous clinical appearance, while the rest presented as papules, plaques, or patches. All the cases showed immature hair follicles, and 24% of cases showed immature sebaceous glands. Normal terminal hair follicles were characteristically absent in the lesion. Nineteen percent of the cases showed dilated apocrine glands, and 14% showed hyperplasia of eccrine glands. Epidermal changes in the form of acanthosis, papillomatosis, and hyperkeratosis were seen in 86% of cases. Dilated keratin-filled infundibula were observed in 24% of cases. One case was associated with a squamous cell carcinoma. CONCLUSIONS: Nevus sebaceus is a cutaneous hamartoma, consisting of various elements indigenous to the organ. Normal terminal hair follicles are characteristically absent in the lesion although the same may be seen in rest of the epidermis, a feature of diagnostic importance, not usually highlighted in literature. The divergent differentiation observed in NS is consistent with the common embryologic origin of the folliculosebaceous-apocrine unit and should not mislead the pathologist.

Hydrophobic grafted and cross-linked starch nanoparticles for drug delivery.

The synthesis of modified hydrophobic starch nanoparticles using long chain fatty acids was accomplished. Grafting of fatty acid on the starch was done using potassium persulphate as catalyst and the formation of graft polymer was confirmed by FTIR spectra. The thermal properties of the native and grafted starch were investigated using simultaneous TG-DTA and DSC. The graft polymerization was found to be depending on the temperature and the duration of the reaction. The modified starch nanoparticles were cross-linked with sodium tripoly phosphate for better stabilization. Morphology of the grafted starch nanoparticles was studied by SEM and AFM. Drug-loading and the controlled release of the drug from the nanoparticles was studied using indomethacin as model drug.

Manual deep lamellar keratoplasty: alternative methods and air-guided technique.

PURPOSE: To describe the techniques proposed for performing deep lamellar keratoplasty (DLK) and to evaluate the efficacy of a new, modified technique. METHODS: Fourteen eyes in 11 patients with keratoconus of moderate degree were included. All patients underwent a DLK with manual dissection from a limbal side port after an air bubble injection in the anterior chamber. All patients had complete ophthalmologic examination 6 months after the suture removal, evaluating best corrected visual acuity, corneal thickness, endothelial cell count, and topographic astigmatism. RESULTS: One case (7.1%) was converted to penetrating keratoplasty because of microperforation. In the 13 successful cases, 10 eyes (71.4%) achieved 20/30 or better 6 months after suture removal. Mean postoperative pachymetry was 628.39 micro (SD 57.34). Specular microscopy 6 months after suture removal revealed average endothelial cell count of 2261 (SD 287/mm(2)). CONCLUSIONS: Comparing this modified DLK technique with other methods proposed by several authors, air-guided DLK seems to be safe and effective and, after a short learning curve, can be performed with a low risk of conversion to penetrating keratoplasty.

Air-guided manual deep lamellar keratoplasty.

PURPOSE: To evaluate the efficacy of a new modified technique of deep lamellar keratoplasty (DLK). METHODS: Nine eyes of eight patients with keratoconus of moderate degree were included. All patients underwent DLK with manual dissection from a limbal side port after an air bubble injection in the anterior chamber. The patients underwent a complete ophthalmologic examination 6 months after the suture removal, evaluating best-corrected visual acuity, corneal thickness, endothelial cell count, and topographic astigmatism. RESULTS: One case (11.1%) was converted to penetrating keratoplasty because of microperforation. In the eight successful cases, 7 eyes (77.8%) achieved 20/30 or better visual acuity 6 months after suture removal. Mean postoperative pachymetry was 604.76 microm (SD 46.76). Specular microscopy 6 months after suture removal revealed average endothelial cell count of 2273/mm2 (SD 229). CONCLUSIONS: This modified DLK technique is a safe and effective procedure and could facilitate, after a short learning curve, this kind of surgery with a low risk of conversion to penetrating keratoplasty.

Closed-system and open-sky capsulorhexis for combined cataract extraction and corneal transplantation.

We describe a triple procedure combining corneal transplantation, cataract extraction, and intraocular lens implantation in which the continuous curvilinear capsulorhexis (CCC) is performed in a closed system when corneal transparency is sufficient or using an open-sky method when corneal transparency is poor. With the closed system, the CCC is performed first followed by trephination and hydroexpulsion of the nucleus. A Caporossi coaxial forceps is used to reduce the corneal incision to 1.2 mm, preventing the need for sutures. Tunnel formation, which could limit the size of trephination, is avoided. In addition, endothelial cell loss at the periphery of the recipient cornea is reduced. This technique was performed in 10 eyes without intraoperative complications. With the open-sky method, the CCC is created while counterpressure is applied to the center of the lens with a large spatula, reducing posterior pressure and thus the risk of capsule tear. This technique was performed in 9 eyes without intraoperative complications.

Capsular fixation with the Frezzotti-Caporossi intraocular lens.

Fixation within the capsular bag appears to be generally, if not unanimously, accepted for optimal positioning of an intraocular lens. It furthermore seems apparent to us that each lens model relates to a specific position within the eye and fixates better according to its particular geometry. In our opinion, the Frezzotti-Caporossi lens represents one of the better solutions for in-the-bag fixation because of the static action of the haptic and the extended contact between loops and the enclosing structures.