Co-existing Paraganglioma, Cholesteatoma, and Otomastoiditis With Overlapping Imaging Features: A Diagnostic Challenge.

Head and neck paragangliomas are rare neuroendocrine tumors arising from the autonomic nervous system. Imaging hallmarks of paragangliomas of the head and neck include an enhancing soft-tissue mass in the carotid space, jugular foramen, or tympanic cavity on computed tomography; a salt-and-pepper appearance on standard spin-echo magnetic resonance imaging; and an intense blush on angiography. Imaging studies depict the location and extent of tumor involvement, help determine the surgical approach, and predict operative morbidity and mortality. However, an atypical presentation of paragangliomas, especially when co-existing with other middle ear pathologies that have overlapping imaging findings, can often be misleading. Here, we report a case of simultaneous occurrence of paraganglioma, cholesteatoma, and otomastoiditis in a young adult female.

Atypical Hepatic Hemangioma With Progressive Centrifugal Enhancement Pattern Mimicking Malignant Liver Lesion.

Hepatic hemangioma is a common benign vascular hepatic lesion with typical imaging features. However, hepatic hemangiomas with atypical radiological characteristics can sometimes be diagnostically challenging. Here, we report a case of an elderly patient with colonic adenocarcinoma who was incidentally found to have an atypical hepatic hemangioma showing a progressive centrifugal enhancement pattern instead of a typical centripetal pattern on contrast-enhanced computed tomography mimicking a malignant liver lesion.

Magnetic resonance angiography determined variations in the circle of Willis: Analysis of a large series from a single center.

OBJECTIVE: The purpose of this study is to evaluate and describe the prevalence and patterns of arterial variants in the circle of Willis (CW) seen in noncontrast three-dimensional time-of-flight magnetic resonance angiography in a series of patients with cerebral vascular accidents (CVAs). MATERIALS AND METHODS: A descriptive study was undertaken in 200 patients who presented for screening for CVA in the Department of Radiodiagnosis and Imaging, St. John's Medical College Hospital, Bengaluru, from September 2014 to September 2016. RESULTS: The most common types of CW in a single subject were anterior variant Type A and posterior variant Type E. Type A in the anterior circulation is the normal adult pattern. There is a single anterior communicating artery. The internal carotid artery bifurcates into the precommunicating segment of the anterior cerebral artery and middle cerebral artery. Type E in the posterior circulation is hypoplasia or absence of both posterior communicating arteries and isolation of the anterior and posterior parts of the circle at this level. Overall, CW variants were slightly more common in women than in men. CONCLUSION: Our findings show that the configuration of the CW may vary greatly in the general population. The wide range in the morphology of CW warrants further research on various races and larger populations to confirm the influence of genetic, regional, environmental, and hemodynamic factors or their combination.

Among the fibers: A multimodality imaging review of intramuscular mass lesions.

The common presentations of patient complaints regarding the musculoskeletal system, such as pain, swelling, and restriction of movement, lead to the imaging discovery of various lesions often located in, or arising from, skeletal muscle in the region of interest. Knowledge of the patients' clinical history, laboratory parameters, and various imaging characteristics of the implicated lesions would assist the radiologist in coming to a timely, reasonably accurate conclusion about the etiology of the patient's complaints, the severity of disease, and in directing patient therapy.

Oxidative stress and antioxidant defense responses of Etroplus suratensis to acute temperature fluctuations.

Fishes are always exposed to various environmental stresses and the chances of succumbing to such stresses are of great physiological concern. Any change in temperature from the ambient condition can induce various metabolic and physiological changes in the body. The present study evaluates the effects of temperature induced stress on the antioxidant profile of Etroplus suratensis such as superoxide dismutase, catalase, glutathione peroxidase and lipid peroxidation. Fishes of same size were kept in a thermostatized bath at three different temperature regimes viz 16°C, 27°C (ambient temperature) and 38°C for 72h. These temperatures were selected based on the CT Max (Critical Thermal Maximum) and CT Min (Critical Thermal Minimum) exhibited by E. suratensis. Superoxide dismutase and catalase activity was found maximum in brain and muscle respectively during the 48th hour of exposure in fishes kept at 38°C. At 16°C the antioxidant response of glutathione peroxidase was maximum in muscles, whereas the lipid peroxidation rate was found to be high in gills compared to other tissues. The profound increase in the levels of oxidative stress related biomarkers indicate that the thermal stressors severely affected oxidative state of E. suratensis by the second day of experiment. Such down-regulation of redox state accompanied with the induction of oxidative stress cascade may lead to physiological damage in various tissues in fishes, in vivo. However current data indicate that a transition to low and high temperature environment from ambient condition severely affected the levels and profile of the antioxidant markers overtime in E. suratensis.

Acute Yellow Phosphorus Poisoning Causing Fulminant Hepatic Failure with Parenchymal Hemorrhages and Contained Duodenal Perforation.

White phosphorus is well known as a potent hepatotoxin and a severe local and systemic toxin causing damage to gastrointestinal, hepatic, cardiovascular, and renal systems. It is used in the manufacture of matches, fireworks, rodenticide, and fertilizers. Death results due to acute liver failure. Management of yellow phosphorus (YP) poisoning is supportive with no antidote available. Here, we present a case of acute YP poisoning in a 25-year-old female presenting with fulminant hepatic failure and duodenal perforation.

Hepatic Pseudolesion in SVC obstruction - 99mTechnetium Sulfur Colloid Scan Equivalent of Quadrate Lobe Hot Spot Sign on Computerized Tomography.

An area of increased activity in segment IV of liver (quadrate lobe) on 99mTc-sulfur colloid (TSC) scans has been well documented in patients with superior vena cava obstruction. Similarly intense enhancement of the quadrate lobe in the arterial phase may be seen on computed tomography in patients of superior vena cava syndrome. We present this imaging finding in a case of malignant thymoma causing superior vena cava syndrome and discuss the physiological cause and importance of this sign.

Effect of Ethanol on Branchial Adenosine Triphosphatases in Oreochromis mossambicus (Peters).

The aim of this work was to determine the toxicity of ethanol in an aquatic system by means of bioassays with Oreochromis mossambicus (Peters) as a test organism. The study revealed changes in the gill ATPase activities. The results obtained indicated that ethanol brought about a decrease in the body weight, followed by significant inhibition on total ATPase, Na(+)/K(+) ATPase, Ca(2+) ATPase and Mg(2+) ATPase activities. The studies also indicated that these can be employed as suitable biomarkers in ethanol related toxicity studies.

Anatomical variations of the aortic knob in chest radiographs

There is a paucity of data regarding the normal anatomical variations of the aortic knob (AK) on routine postero-anterior chest radiographs (PACR). The aims of the present study were to document and analyze the anatomical variations of the AK on PACRs’ in an adult Indian population. This was a crosssectional study of PACRs’ in a tertiary care hospital with attached medical college in Bangalore, India. The AKs’ in 108 (77 males and 31 females) PACRs’ of normal, healthy adults were studied using the following measurements: minimum distance of the left edge of the aortic knuckle from the midline (AKW); straight and curved length of the AK (AKS and AKC). The ratio of the AKC to the AKS was calculated and termed the AK index (AKI). The mean and standard deviation were determined for AKW, AKS and AKI. The unpaired t-test was used to check for significant sex differences in the above parameters. Spearman’s rank order correlation coefficient of the AKW, AKS and AKI with the age, BMI, CD, CA and CTR was calculated. The mean value of the AKW was significantly higher in males as compared to females. The majority of the values of AKI were between 1 and 1.2 in both sexes. The AKW showed significant positive correlations with age, the body mass index and cardiac diameter. The AKI showed a weak, although significant positive correlation with the age and the cardiothoracic ratio. The present study describes the anatomical variations of the AK, using the AKI to quantify its prominence (AU)

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Effects of maternal vitamin A status on kidney development: a pilot study.

Nephron endowment ranges widely in normal human populations. Recent autopsy studies have drawn attention to the possibility that subtle congenital nephron deficits may be associated with increased risk of developing hypertension later in life. Since modest maternal vitamin A deficiency reduces nephron number in rats, we designed a pilot study to determine the prevalence of maternal vitamin A deficiency in Montreal (Canada) and Bangalore (India) and the usefulness of newborn renal volume as a surrogate for nephron endowment. Among 48 pregnant Montreal women, two (4%) had one isolated mid-gestation retinol level slightly below the accepted limit of normal (0.9 mumol/L), whereas 25 (55%) of 46 pregnant women in Bangalore had at least one sample below this limit. Average estimated retinoid intake was correlated with mean serum retinol in pregnant women from Bangalore. In Montreal where maternal vitamin A deficiency was negligible, we found that newborn renal volume (estimated by renal ultrasonography at 2-6 weeks of age) was correlated with surface area at birth and was inversely correlated with serum creatinine at 1 month. Interestingly, renal volume adjusted for body surface area in Montreal (184+/-44 ml/m(2)) was significantly greater than in Bangalore (114+/-33 ml/m(2)) (p<0.01). Definitive studies are needed to establish whether maternal vitamin A deficiency accounts for subtle renal hypoplasia in Indian newborns. If so, there may be important public health implications for regions of the world where maternal vitamin A deficiency is prevalent.

Lysosomal stability in Oreochromis mossambicus (Peters) on exposure to surfactants.

The three commonly used surfactants viz. anionic sodium dodecyl sulfate (SDS), cationic cetyl tri methyl ammonium bromide (CTAB) and non-ionic triton X-100 were toxic even at sub lethal levels (1 ppm for 30 days) to 0. mossambicus. Lysosomal stability index (LSI) was lowest in triton-exposed animals in vitro. In vivo, CTAB was the most toxic. SDS, the anionic surfactant was the least toxic. The possible role of surfactant structure, critical micellar concentration (CMC) and metabolism in influencing the toxicity is discussed and mechanism of action via membrane lipid peroxidation is suggested.