Blindness from fungal rhinosinusitis of the paranasal sinuses: A case report

@#Objective: To present a unique case of blindness resulting from fungal rhinosinusitis involving multiple sinuses mimicking a malignant process in a pregnant patient. Methods: Design: Case Report Setting: Tertiary Government Training Hospital Patient: One Result: A 36-year-old pregnant woman developed unilateral blindness during her 20th week of gestation with a history of binocular diplopia, unilateral nasal obstruction and anosmia for 13 months during the pre-pregnancy period. Sphenoid sinus malignancy was suspected on imaging. The planned biopsy was intraoperatively shifted to endoscopic sinus surgery when clay-like materials were seen involving the left maxillary sinus and bilateral sphenoid and ethmoid sinuses. Histopathologic examination confirmed fungal growth. Postoperatively, nasal symptoms resolved but blindness of the left eye and blurring of vision of the right eye persisted. Conclusion: Fungal rhinosinusitis rarely occurs in multiple sinuses and is commonly misdiagnosed. It can afflict pregnant patients and mimic a malignant process. A high index of suspicion early on, especially in the presence of nasal congestion and diplopia may prevent potentially irreversible complications.

Memory-related perceptual illusions directly affect physical activity in humans.

Perceptual illusions help us understand deficits in human perception, but they also have the potential to serve as treatment methods; e.g., to alleviate phantom limb pain. Treatment effects are usually the direct result of a mismatch between false visual feedback and somatosensory/proprioceptive feedback. We aimed to influence physical activity (walking distance) using a memory-related perceptual illusion that relies on a mismatch between a spatially manipulated virtual reality environment and a weakness of memory for a similar, previously experienced environment. Participants' main task was to reproduce a baseline distance three times, by walking on a treadmill while moving through a virtual reality environment. Depending on condition, the environment was either stretched or compressed relative to the previous session, but participants were not informed about these manipulations. Because false, suggestive information can lead to alterations in memory, especially when conveyed through 'rich' forms of media such as virtual reality, we expected each manipulation to alter memory for the previous environment(s) and we hypothesized that this would influence walking distance. The results for the first time showed that memory-related perceptual illusions can directly affect physical activity in humans. The effects we found are substantial; stretching previously experienced virtual environments led participants to almost double their initial walking distance, whereas compressing the environments resulted in about half of the initial distance. Possible clinical applications arising from these findings are discussed.

Penile paraffinoma: A surgical challenge

OBJECTIVE: The authors share their experience on four different cases of penile paraffinoma surgically treated at the Bicol Medical Center from January 2011 - September 2014. METHODOLOGY: Four patients with subcutaneous injection of foreign body (Vaseline, petroleum jelly or Baby oil) into their penises were treated. The authors applied two kinds of technique: anterolateral thigh pedicle flap and scrotal advancement flap, depending on the skin defect after excision of the paraffinoma. Outcomes measured were immediate post-operative complications (flap necrosis, hematoma, infection) and 3 months post-operative follow-up (contracture, pain on erection, improvement in sexual function and acceptable cosmetic appearance). RESULTS: All patients had a relatively uneventful post-operative course. There were no instances of flap necrosis, bleeding, hematoma or dysuria. Morbidity was minimal and no secondary surgical intervention was done. All had acceptable cosmetic appearance based on the satisfaction of both the patients and the surgeons. All reported decrease in pain during erection, except for one, who underwent scrotal advancement flap, complaining of vague penoscrotal pain when his penis was erect. CONCLUSION: Penile paraffinoma remains a reconstructive surgical challenge requiring application of varying techniques depending on the pre-operative foreign body involvement.

Mexican Trypanosoma cruzi T. cruzi I strains with different degrees of virulence induce diverse humoral and cellular immune responses in a murine experimental infection model.

It is has been shown that the majority of T. cruzi strains isolated from Mexico belong to the T. cruzi I (TCI). The immune response produced in response to Mexican T. cruzi I strains has not been well characterized. In this study, two Mexican T. cruzi I strains were used to infect Balb/c mice. The Queretaro (TBAR/MX/0000/Queretaro)(Qro) strain resulted in 100% mortality. In contrast, no mortality was observed in mice infected with the Ninoa (MHOM/MX/1994/Ninoa) strain. Both strains produced extended lymphocyte infiltrates in cardiac tissue. Ninoa infection induced a diverse humoral response with a higher variety of immunoglobulin isotypes than were found in Qro-infected mice. Also, a stronger inflammatory TH1 response, represented by IL-12p40, IFNgamma, RANTES, MIG, MIP-1beta, and MCP-1 production was observed in Qro-infected mice when compared with Ninoa-infected mice. We propose that an exacerbated TH1 immune response is a likely cause of pathological damage observed in cardiac tissue and the primary cause of death in Qro-infected mice.

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[Lipid peroxidation, production of PGE2 and cellular mortality induced by UV in cultured human skin fibroblasts]. / Peroxydation lipidique, production de PGE2 et mortalité cellulaire induites par les UV dans des fibroblasts cutanés humains en culture.

UV irradiation induces lipid peroxidation (LPO) and cell damage. The aim of the present work was the study of UVB radiation effects on cultured human skin fibroblasts, concerning LPO, prostaglandine E2 (PGE2) formation and cell viability. The cells were exposed to 50, 100, and 150 mJ/cm2 of UVB irradiation. Cellular TBARS and supernatant fluorescent substances were measured spectrofluorimetrically. PGE2 was measured using an immunoenzymatic method. Cell viability was evaluated by the MTT test. All determinations were done after a 2 h incubation period post-irradiation. TBARS were increased for all doses of irradiation (p < 0.001). Fluorescent substances differed from controls at 50 mJ/cm2 (p < 0.001). UVB at 100 and 150 mJ/cm2 decreased cellular viability (p < 0.001). An increase of PGE2 was observed with UVB at 150 mJ/cm2 (p < 0.001). These results confirm the occurrence of LPO and cytotoxicity after UV irradiation; on the other hand, this study showed the formation of PGE2 induced by UV light on cultured human skin fibroblasts. We propose a relationship between these phenomena.