Project description:We present an interesting case of a 2½-year-old child with Tetrology of Fallot with a large intracardiac mass in the left ventricle presenting with fever and bilateral stroke, that resolving with antitubercular therapy alone.
Project description:Anterior neck masses are common and such patients commonly present to ultrasonography units for further evaluation of underlying pathology. We encountered an atypical case of pulsatile anterior neck swelling in a 45-year-old lady. Evaluation of the swelling using neck ultrasonography and color doppler study revealed that the mass was of vascular origin and contrast-enhanced computed tomography of neck confirmed the presence of an aberrant high riding innominate artery. Knowledge of such variants is of great importance and should be reported by the concerned radiologist. Lack of knowledge of such variants may lead to inadvertent surgical complications during procedures and can be life-threatening to the patient.
Project description:BackgroundCardiac foreign bodies (FBs) are rare findings that may present as cardiac masses initially. Here, we present an exceptional and rare case of a hypodermic needle FB that transmigrated to the left atrium and presented as a left atrial mass.Case summaryA 28-year-old woman with multiple psychiatric disorders including intentional FB ingestion and self-inflicting injuries presented to the emergency room with abdominal pain, nausea, vomiting, diarrhoea, and chest pain that radiated to the left arm and face for 2 weeks. An echocardiogram was performed revealing a left atrial mass concerning for myxoma. During the surgical removal of the mass, a hypodermic needle was found attached to the roof of the left atrium surrounded by thrombotic and fibrotic tissue, which was confirmed by pathology.DiscussionCardiac FBs are caused generally by penetrating wounds from direct trauma. Fewer cases have been reported regarding cardiac FB caused by ingestion from migration of the object to the heart. Signs and symptoms for cardiac FB may mimic those of cardiac masses. Cardiac FBs often require surgical intervention to avoid complications.
Project description:Ion-electron reaction based fragmentation methods (ExD) in tandem mass spectrometry (MS), such as electron capture dissociation (ECD) and electron transfer dissociation (ETD) represent a powerful tool for biological analysis. ExD methods have been used to differentiate the presence of the isoaspartate (isoAsp) from the aspartate (Asp) in peptides and proteins. IsoAsp is a ?(3)-type amino acid that has an additional methylene group in the backbone, forming a C(?)-C(?) bond within the polypeptide chain. Cleavage of this bond provides specific fragments that allow differentiation of the isomers. The presence of a C(?)-C(?) bond within the backbone is unique to ?-amino acids, suggesting a similar application of ExD toward the analysis of peptides containing other ?-type amino acids. In the current study, ECD and ETD analysis of several ?-amino acid containing peptides was performed. It was found that N-C(?) and C(?)-C(?) bond cleavages were rare, providing few c and z• type fragments, which was attributed to the instability of the C(?) radical. Instead, the electron capture resulted primarily in the formation of a• and y fragments, representing an alternative fragmentation pathway, likely initiated by the electron capture at a backbone amide nitrogen protonation site within the ? amino acid residues.
Project description:Adrenal hemangioma is an extremely rare benign and non-functioning neoplasm of the adrenal gland. We report a case of a 71-year-old woman admitted for intermittent abdominal pain and abdominal distension associated with vomiting and chronic constipation for 5 years. Physical examination revealed a large abdominal mass. Both computed tomography scan and magnetic resonance imaging suggested hemangioma in the right lobe of the liver. Laboratory examinations and tumour markers were within normal limits, except for hypochromic microcytic anemia. The mass was removed intact by conventional surgery and histopathology revealed a cavernous hemangioma of the adrenal gland with no signs of malignancy. Surgical resection was curative, with no recurrence at the 2-year follow-up.
Project description:Arterial pseudoaneurysms can develop secondary to a vessel injury, for example, an arterial line installation. We present a case of an 18-year-old female with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes syndrome who developed left radial artery and right brachial artery pseudoaneurysms secondary to arterial line placement and repeated blood draws, respectively. The ultrasonographic features of pulsating mass in connection with an artery and the yin-yang sign, combined with the patient's history, allowed accurate diagnosis. She was referred to vascular surgery for definitive treatment.
Project description:Cardiac tuberculosis is rare. We report an unusual case of cardiac tuberculoma diagnosed in vitam in a 38-year-old woman, with end-stage renal disease and discovered to have mediastinal tuberculosis in 2013. She presented to the emergency department complaining of fever and chills during hemodialysis. A cardiac mass suggestive of tuberculoma was found in the right atrium using echocardiography, computed tomography scan, and cardiac magnetic resonance. Sputum culture was positive for acid fast bacilli. The patient received anti-tuberculosis therapy with improvement of symptoms and reduction of the mass. <Learning objective: Cardiac masses are not infrequently found in right atrium, especially in patients under hemodialysis. In patients known to have tuberculosis the differential diagnosis should include cardiac tuberculoma.>.
Project description:To improve gender equality and tolerance toward lesbian, gay, bisexual, and transgender (LGBT) communities, several nations have promoted the use of gender-neutral pronouns and words. Do these linguistic devices actually reduce biases that favor men over women, gays, lesbians, and transgender individuals? The current article explores this question with 3 large-scale experiments in Sweden, which formally incorporated a gender-neutral pronoun into its language alongside established gendered pronouns equivalent to he and she The evidence shows that compared with masculine pronouns, use of gender-neutral pronouns decreases the mental salience of males. This shift is associated with individuals expressing less bias in favor of traditional gender roles and categories, as reflected in more favorable attitudes toward women and LGBT individuals in public life. Additional analyses reveal similar patterns for feminine pronouns. The influence of both pronouns is more automatic than controlled.
Project description:BackgroundDoubly Uniparental Inheritance (DUI) represents the most outstanding exception to matrilinear inheritance of mitochondrial DNA (mtDNA), typical of Metazoa. In a few bivalve mollusks, two sex-linked mtDNAs (the so-called M and F) are inherited in a peculiar way: both daughters and sons receive their F from the mother, whereas sons inherit M from the father (males do not transmit F to their progeny). This realizes a double mechanism of transmission, in which M and F mtDNAs are inherited uniparentally. DUI systems represent a unique experimental model for testing the evolutionary mechanisms that apply to mitochondrial genomes and their transmission patterns as well as to mtDNA recombination.ResultsA new case of DUI is described in Musculista senhousia (Mollusca: Bivalvia: Mytilidae). Its heteroplasmy pattern is in line with standard DUI. Sequence variability analysis evidenced two main results: F haplotypes sequence variability is higher than that of M haplotypes, and F mitochondrial haplotypes experience a higher mutation rate in males' somatic tissues than in females' ones. Phylogenetic analysis revealed also that M. senhousia M and F haplotypes cluster separately from that of the other mytilids.ConclusionSequence variability analysis evidenced some unexpected traits. The inverted variability pattern (the F being more variable than M) was new and it challenges most of the rationales proposed to account for sex-linked mtDNA evolution. We tentatively related this to the history of the Northern Adriatic populations analyzed. Moreover, F sequences evidenced a higher mutation level in male's soma, this variability being produced de novo each generation. This suggests that mechanisms evolved to protect mtDNA in females (f.i. antioxidant gene complexes) might be under relaxed selection in males. Phylogenetic analysis of sex-linked haplotypes confirmed that they have switched their roles during the evolutionary history of mytilids, at variance to what has been observed in unionids. Consequently, reciprocal monophyly of M and F lineages got easily lost because of role-reversals and consequent losses of M lineages, as already observed in Mytilus.
Project description:A 3-month-old male infant was bought to the emergency department with almost 3 weeks of projectile, bilious emesis after each feed. On presentation, he was cachectic and severely dehydrated and had a palpable olive in the epigastric region. Hypertrophic pyloric stenosis was excluded by abdominal ultrasound. The barium meal demonstrated a massively distended stomach, absence of distal gas, and triple bubble sign. Given the radiological findings, the patient underwent an emergency exploratory laparotomy and a congenital duodenal web (CDW) was discovered. While the clinical picture suggested the diagnosis of HPS, barium meal eventually revealed congenital duodenal web. To our knowledge, no other cases of palpable olive mass as the presenting sign of proximal bowel obstruction have been published.