Activity

Retroperitoneal fibrosis (RPF) causing large vessel stenosis and thrombosis is rare but well-described. We describe a 50-year-old man with rapid progression of central venous thrombosis in the presence of RPF and exogenous testosterone use. Therapeutic anticoagulation was initiated and catheter directed thrombolysis was performed after placement of an inferior vena cava (IVC) filter. Repeat venogram revealed severe focal retrohepatic IVC stenosis, which was treated with serial venoplasty and stenting. Clinical improvement was significant 48 hours after intervention. This case represents a rare presentation of IVC occlusion in the setting of RPF and exogenous testosterone administration successfully treated with endovascular interventions.Persistence of mycobacteria in the hostile environment of human macrophage is pivotal for its successful pathogenesis. Rapid adaptation to diverse stresses is the key aspect for their survival in the host cells. A range of heterogeneous mechanisms operate in bacteria to retaliate stress conditions. Small RNAs (sRNA) have been implicated in many of those mechanisms in either a single or multiple regulatory networks to post-transcriptionally modulate bacterial gene expression. Although small RNA profiling in mycobacteria by advanced technologies like deep sequencing, tilling microarray etc. have identified hundreds of sRNA, however, a handful of those small RNAs have been unearthed with precise regulatory mechanism. Extensive investigations on sRNA-mediated gene regulations in eubacteria like Escherichia coli revealed the existence of a plethora of distinctive sRNA mechanisms e.g. base pairing, protein sequestration, RNA decoy etc. find more Increasing studies on mycobacterial sRNA also discovered several eccentric mechanisms where sRNAs act at the posttranscriptional stage to either activate or repress target gene expression that lead to promote mycobacterial survival in stresses. Several intrinsic features like high GC content, absence of any homologue of abundant RNA chaperones, Hfq and ProQ, isolate sRNA mechanisms of mycobacteria from that of other bacteria. An insightful approach has been taken in this review to describe sRNA identification and its regulations in mycobacterial species especially in Mycobacterium tuberculosis. © 2020 Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd.Leishmaniasis is a vector borne zoonosis which is classified as a neglected tropical disease. Among the three most common forms of the disease, Visceral Leishmaniasis (VL) is the most threatening to human health, causing 20,000 to 30,000 deaths worldwide each year. Areas where VL is mostly endemic have unprotected dogs in community and houses. The “presence of dogs usually increases VL risk for humans since dogs are the principal reservoir host for the parasite of the disease. Based on this fact, most earlier studies consider culling dogs as a control measure for the spread of VL. A more recent control measure has been the use of deltamethrin-impregnated dog collars ( D I D C s) to protect both humans and dogs by putting D I D C s on dogs neck. The presence of dogs helps to grow the sandfly population faster by offering a more suitable blood-meal source. On the other hand, the presence of D I D C s on dogs helps to reduce sandfly population by the lethality of deltamethrin insecticide. This study brings an ecological perspective to this public health concern, aiming to understand the impact of an additional host (here, protected dogs) on disease risk to a primary host (here, humans). To answer this question, we compare two different settings a community without dogs, and a community with dogs protected with D I D C . Our analysis shows the presence of protected dogs can reduce VL infection risk in humans. However, this disease risk reduction depends on dogs’ tolerance for sandfly bites. © 2020 The Authors.In recent years, there have been increasingly rapid advances of using bioactive materials in tissue engineering applications. Bioactive materials constitute many different structures based upon ceramic, metallic or polymeric materials, and can elicit specific tissue responses. However, most of them are relatively brittle, stiff, and difficult to form into complex shapes. Hence, there has been a growing demand for preparing materials with tailored physical, biological, and mechanical properties, as well as predictable degradation behavior. Chitosan-based materials have been shown to be ideal bioactive materials due to their outstanding properties such as formability into different structures, and fabricability with a wide range of bioactive materials, in addition to their biocompatibility and biodegradability. This review highlights scientific findings concerning the use of innovative chitosan-based bioactive materials in the fields of tissue engineering, with an outlook into their future applications. It also covers latest developments in terms of constituents, fabrication technologies, structural, and bioactive properties of these materials that may represent an effective solution for tissue engineering materials, making them a realistic clinical alternative in the near future. © 2020 Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd.Biodegradable magnesium (Mg)-based alloys have aroused great concern owing to their promising characteristics as temporary implants for orthopedic application. But their undesirably rapid corrosion rate under physiological conditions has limited the actual clinical application. This study reports the use of a novel biomimetic polyelectrolyte multilayer template, based on polyvinylpyrrolidone (PVP) and polyacrylic acid (PAA) via layer-by-layer (LbL) assembly, to improve the corrosion resistance of the alloy. Surface characterization techniques (field-emission scanning electron microscopy, Fourier transform infrared (FTIR) spectrophotometer and X-ray diffractometer) confirmed the formation of biomineralized Ca-P coating on AZ31 alloy. Both hydrogen evolution and electrochemical corrosion tests demonstrated that the corrosion protection of the polyelectrolyte-induced Ca-P coating on AZ31 alloy. The formation mechanism of biomineralized Ca-P coating was proposed. © 2020 Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd.Purpose To report a case of refractory open angle glaucoma (POAG) in an osteogenesis imperfecta patient who was successfully treated with combination microinvasive glaucoma surgery combined kahook blade goniotomy and ciliary sulcus suprachoroidal microtube insertion. Observation A 57-year-old woman with a history of osteoporosis, breast cancer, osteogenesis imperfecta, with uncontrolled POAG in right more than left. Anterior segment examination revealed thin blue sclera, the optic nerve examination revealed glaucomatous cupping with cup to disc ration of 0.9 in right and 0.7 in left. Her IOP on six (6) medications was 26 mmHg in the right eye. After discussion of the risks and benefits, she agreed to undergo combined kahook blade goniotomy and ciliary sulcus suprachoroidal microtube insertion surgery to lower her intraocular pressure. Her IOP at 6 months follow up was 13 in the right eye and a decrease number of medications from six (6) to three. Conclusion and importance Patients with OI have homogenously thinner sclera and conjunctiva which pose a challenge to traditional subconjunctival surgical methods. Combined kahook blade goniotomy and ciliary sulcus suprachoroidal microtube insertion surgery are bleb sparing operations that enhances aqueous outflow to the aqueous veins and supraciliary space to lower intraocular pressure. © 2020 The Author(s).Purpose To report a rare case of a unilateral choroidal mast cell infiltration in a patient with aggressive systemic mastocytosis (ASM). Observations The patient is a man in his fifties with a diagnosis of ASM. He developed visual complaints in the right eye associated with an area of subretinal fluid on fundus examination. Visual acuity at presentation was 20/150 in the right eye and 20/25 in the left eye. After ophthalmic and radiologic imaging workup, the patient was diagnosed with presumed choroidal mast cell infiltrate. The index of suspicion was high due to the prior ASM diagnosis. External beam radiation and intravitreal injection treatments were offered but the patient declined. The patient was switched from interferon to a new targeted systemic therapy for ASM, midostaurin. Despite some mixed, temporary response in systemic symptoms/signs of ASM at four months, the choroidal lesion and subretinal fluid were stable with visual acuity at 20/125. Conclusion and importance Mast cell choroidal infiltration in ASM should be considered as part of the differential with acute/subacute vision changes. Diagnosis requires exclusion of other possibilities with ocular imaging and in this case, monitoring for development of other malignancies in which there were none. Midostaurin’s ocular response was not on par with systemic response. Additional localized ocular therapies may be required. © 2020 The Author(s).Purpose We evaluated a choroidal macrovessel using optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA). Observations A 79-year-old female presented with blurred vision in both eyes and metamorphopsia of the left eye. Mild cataract was noted in both eyes. Color fundus photography of the left eye revealed a red-orange tortuous vessel originating from the fovea and running in an inferior-temporal direction. Enhanced-depth imaging OCT revealed a large caliber choroidal vascular shadow and ambiguous line of the photoreceptor and retinal pigment epithelium layers. OCTA demonstrated a serpentine-shaped choroidal vessel. This anomalous vessel was seen by early phase ICGA as a rapidly perfused vessel connected to a vortex vein. We diagnosed this anomalous vessel as a choroidal macrovessel. We identified that cataract induced blurred vision in both eyes and choroidal macrovessel induced metamorphopsia in left eye. She was received cataract surgery for both eyes. The degree of metamorphopsia and the choroidal macrovessel of the left eye remains unchanged after a year of follow-up. Conclusions and importance OCTA and ICGA are useful techniques to diagnose choroidal macrovessels. © 2020 The Authors.Purpose To report two cases of LASIK flap stability after severe ocular trauma.Observations Two patients suffered open globe injuries several years after undergoing uneventful LASIK with femtosecond laser corneal flap. Both underwent primary ruptured globe repair, during which no LASIK flap dislocation was identified. Histopathologic examination of one of the cornea specimens confirmed an intact LASIK flap. Conclusion and Importance In these cases, the femtosecond LASIK flap remained in place despite significant injury to the cornea. The presence of a femtosecond LASIK flap did not complicate surgical management of the injury, and did not contribute to the patient’s loss of BCVA.Purpose To report a case of fungal keratitis after corneal collagen crosslinking (CXL) surgery. Observations We report a case of fungal keratitis after CXL for post-refractive surgery ectasia. The patient presented 12 days after surgery with a corneal ulcer that was culture positive for Alternaria species of fungus. She subsequently developed a bacterial superinfection. The keratitis resolved with medical therapy, although the patient required a penetrating keratoplasty (PKP) due to central corneal scarring. Conclusions and Importance To our knowledge, this is the first case of fungal keratitis as a complication after CXL in the United States and the first case of Alternaria infection after CXL using the Dresden protocol. Infectious keratitis is a rare but serious complication of CXL, and we suggest continued innovation of operative techniques that may reduce the risk of infectious keratitis. © 2020 The Authors.