Pulmonary blastoma (PB) is a rare thoracic malignancy and preoperative diagnosis is challenging. A young man presented with dyspnea and chest pain for 3–4 months and chest-computed tomography (CT) revealed large mass in the left lung upper lobe and pleural effusion. Repeated CT-guided fine-needle aspiration cytology from the lesion and pleural fluid aspiration was negative for malignancy. F-18-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) revealed heterogeneous tracer avidity in left lung mass with areas of necrosis. Real-time PET-CT-guided biopsy from metabolically active component of the lesion revealed biphasic PB on histopathology.

Trauma during pregnancy deserves special attention because of its management objectives, i.e. wellbeing of both pregnant woman and foetus. Maxillofacial trauma directly affects the nutrition of foetus by interfering with the normal functions in a pregnant woman such as mouth opening, mastication and breathing. Hence early restitution of form and function of maxillofacial skeleton is essential. However, the gravid status is associated with numerous anatomical and physiological changes which present with clinical dilemma related to imaging and treatment. A careful scrutiny of the patient's systemic and gestational status is absolutely essential before, during and after instituting any interventional procedures. We present a case of bilateral condyle fracture in a 30-year-old pregnant woman in the third trimester (32 weeks). She was treated with inter maxillary fixation using orthodontic brackets & elastics. After successful restitution of occlusion, the patient was advised aggressive physiotherapy which ensured normal mouth opening. Two weeks later, the patient delivered uneventfully. The patient was followed up at one month and 3 month and demonstrated restitution of normal occlusion, mouth opening and lower facial height. This article aims at analyzing the contemporary principles in management of maxillofacial trauma in a pregnant woman and clarifying the common misconceptions.

BACKGROUND: Tooth extraction commonly leads to loss of residual alveolar ridge, thus compromising the room available for the implant placement. To combat the post-extraction alveolar loss, alveolar ridge preservation is practiced, with the advent of the biomaterial available. The purpose of this study was to assess the efficiency of calcium phosphosilicate biomaterial in alveolar ridge preservation. Twenty patients indicated for extraction were selected followed by socket grafting using calcium phosphosilicate. Implant placement was done 6 months postoperatively during which a core was harvested from the preserved sockets. Clinico-radiographic measurements of hard and soft tissues were taken at baseline and 6 months post-grafting. RESULTS: There were no significant changes in the radiographic and soft tissue parameters while significant changes in hard tissue parameters with 1.9 mm (p = 0.013) gain in mid-buccal aspect and 1.1 mm (p = 0.019) loss in horizontal bone width were observed. The histomorphometric evaluation depicted the vital bone volume of 54.5 ± 16.76%, non-mineralized tissue 43.50 ± 15.80%, and residual material 2.00 ± 3.37%. CONCLUSION The implants placed in these preserved ridges presented 100% success rate with acceptable stability after a 1-year follow-up, concluding calcium phosphosilicate is a predictable biomaterial in alveolar ridge preservation.

BACKGROUND/AIMS: Classical M1 macrophage activation exhibits an inflammatory phenotype while alternative M2 macrophage activation exhibits an anti-inflammatory phenotype. We aimed to determine whether there are discriminant patterns of macrophage polarization in Crohn's disease (CD) and intestinal tuberculosis (iTB). METHODS: Colonic mucosal biopsies from 29 patients with iTB, 50 with CD, and 19 controls were examined. Dual colored immunohistochemistry was performed for iNOS/CD68 (an M1φ marker) and CD163/CD68 (an M2φ marker), and the ratio of M1φ to M2φ was assessed. To establish the innate nature of macrophage polarization, we analyzed the extent of mitochondrial depolarization, a key marker of inflammatory responses, in monocyte-derived macrophages obtained from CD and iTB patients, following interferon-γ treatment. RESULTS: M1φ polarization was more prominent in CD biopsies (P=0.002) than in iTB (P=0.2) and control biopsies. In granuloma-positive biopsies, including those in CD, M1φ predominance was significant (P=0.001). In iTB, the densities of M1φ did not differ between granuloma-positive and granuloma-negative biopsies (P=0.1). Interestingly, higher M1φ polarization in CD biopsies correlated with high inflammatory response exhibited by peripheral blood-derived monocytes from these patients. CONCLUSIONS: Proinflammatory M1φ polarization was more common in colonic mucosa of CD patients, especially in the presence of mucosal granulomas. Further characterization of the innate immune system could help in clarifying the pathology of iTB and CD.
Biopsy ; Colon ; Crohn Disease* ; Granuloma ; Humans ; Immune System ; Immunohistochemistry ; Macrophage Activation ; Macrophages* ; Monocytes ; Mucous Membrane ; Pathology ; Phenotype ; Tuberculosis*

A female patient aged 48 years presented with sub-acute onset of weakness in right upper and lower limb over the past one month and numbness over left side of body below neck level. Multiple sclerosis (MS) presenting as Brown-Séquard syndrome is very rare. We present a case of hemicord myelitis which presented as Brown-Séquard syndrome as a first manifestation, which was later diagnosed as MS during subsequent relapses.

STUDY DESIGN: Prospective cohort study. PURPOSE: To evaluate the contribution of upper and lower lumbar segments to flexion and extension of the lumbar spine in normal and diseased spines. OVERVIEW OF LITERATURE: The specific contributions of upper and lower lumbar segments during flexion/extension have rarely been reported. Furthermore, no comparisons between the flexion/extension behaviors of normal and diseased spines have been reported until now. METHODS: Flexion and extension lateral radiographs of 52 adult, asymptomatic volunteers, and 67 adult patients with lumbar spine disc disease were measured using software for total lumbar lordosis, upper lumbar lordosis and lower lumbar lordosis and the intervertebral angles of all segments. RESULTS: In asymptomatic volunteers, the range of movement between flexion and extension was a mean of only 4.2degrees in the lower lumbar spine and a mean of 19.4degrees in the upper lumbar spine. In patients with disc degeneration, the range of movement between flexion and extension was an average 6.5degrees for lower lumbar spine and 15.6degrees for the upper lumbar spine. CONCLUSIONS: The results showed that upper lumbar spine contributes more to the range of motion in flexion and extension than the lower lumbar spine in asymptomatic individuals without lumbar disc disease, as well as in patients with disc degeneration.
Adult ; Animals ; Asian Continental Ancestry Group* ; Cohort Studies ; Humans ; Intervertebral Disc Degeneration ; Lordosis ; Lumbar Vertebrae ; Lumbosacral Region ; Prospective Studies ; Range of Motion, Articular ; Spine* ; Volunteers

Urachal cysts are uncommon. Rarely, these cysts can become infected. Tuberculosis of the urachal cyst is exceedingly rare, with only one case reported previously in the English language literature. Here we report the case of a 23-year-old male who presented with an infra-umbilical mass that turned out to be tuberculosis of the urachal cyst.
Antitubercular Agents/therapeutic use ; Drug Therapy, Combination ; Humans ; Male ; Tomography, X-Ray Computed ; Treatment Outcome ; Tuberculosis/diagnosis/*microbiology/therapy ; Urachal Cyst/diagnosis/*microbiology/therapy ; Young Adult

A 38-year-old man was operated with posterior spinal decompression and pedicle screw instrumentation for his L2 fracture with incomplete neurological deficit. In the recovery, he complained of blindness in both eyes after twelve hours. Computed tomographic scan and magnetic resonance angiography revealed bilateral occipital lobe infarcts. He remained permanently blind even after three years follow-up. Though rare, perioperative vision loss is a potential complication following spine surgery in prone position. We report a rare occurrence of cortical blindness following lumbar spine surgery.
Adult ; Blindness ; Blindness, Cortical ; Decompression ; Eye ; Follow-Up Studies ; Humans ; Magnetic Resonance Angiography ; Occipital Lobe ; Prone Position ; Spinal Injuries ; Spine ; Vision, Ocular

Objective: To evaluate the pharmacognostical study of leaf of Toona ciliate M. Roem. Methods:The qualitative and quantitative microscopy, phytochemical screening, physicochemical evaluation and fluorescence analysis of the plant were done according to the standard procedure recommended in the WHO guidelines. Results: Macroscopic study shows that leaves are compound type, 30-50 cm length, shape: lanceolate, apex: acute and having the entire margin. Stomata present in the leaf are anomocytic type of stomata. Microscopic evaluation of the leaves powder shows the presence of trichomes (multicelluar), lignified vascular bundles and stomata. The transverse section of the leaf shows the presence of epidermis layer followed by cuticle layer, lignified vascular bundles, trichomes, collenchyma, and palisade cells. Conclusion:Various pharmacognostical parameters evaluated in his study help in the identification and standardization of the Toona ciliata M. Roem.

OBJECTIVETo evaluate the pharmacognostic characters of an important medicinal plant, Holoptelea integrifolia (H. integrifolia) Roxb.

METHODSThe pharmacognostic studies were carried out in terms of organoleptic, microscopic, macroscopic and fluorescence analysis.

RESULTSThe characteristic microscopic features of leaves were observed as trichomes, multicellular trichomes, xylem cells, phloem cells, collenchyma, vascular bundles, spongy parenchyma and palisade cells. The characteristic microscopic features of root bark included cork cambium, primary cortex, phloem fibers, medullary rays, endodermis, pericycle and lignified fibers in the transverse section and longitudinal section. The characteristic microscopy of root bark powder showed the presence of cortex cells, sieve tubes, calcium oxalate crystals and lignified fibers. Macroscopic study showed that leaf shape-oval, apex-acute, base-cordate and leaf margin was entire with glabrous surface, bitter taste and characteristic odour. The morphological features of root bark showed deep fissured, rough and firm surface with rhitydome and the periderm parallel to cambium.

CONCLUSIONSVarious pharmacognostic characters observed in this study help in the identification and standardization of H. integrifolia.

Microscopy ; Plant Extracts ; chemistry ; Plant Leaves ; anatomy & histology ; cytology ; Plant Roots ; anatomy & histology ; cytology ; Spectrometry, Fluorescence ; Ulmaceae ; anatomy & histology ; cytology