A cartridge based sensor array platform for multiple coagulation measurements from plasma

This paper proposes a MEMS-based sensor array enabling multiple clot-time tests for plasma in one disposable microfluidic cartridge. The versatile LoC (Lab-on-Chip) platform technology is demonstrated here for real-time coagulation tests (activated Partial Thromboplastin Time (aPTT) and Prothrombin Time (PT)). The system has a reader unit and a disposable cartridge. The reader has no electrical connections to the cartridge. This enables simple and low-cost cartridge designs and avoids reliability problems associated with electrical connections. The cartridge consists of microfluidic channels and MEMS microcantilevers placed in each channel. The microcantilevers are made of electroplated nickel. They are actuated remotely using an external electro-coil and the read-out is also conducted remotely using a laser. The phase difference between the cantilever oscillation and the coil drive is monitored in real time. During coagulation, the viscosity of the blood plasma increases resulting in a change in the phase read-out. The proposed assay was tested on human and control plasma samples for PT and aPTT measurements. PT and aPTT measurements from control plasma samples are comparable with the manufacturer's datasheet and the commercial reference device. The measurement system has an overall 7.28% and 6.33% CV for PT and aPTT, respectively. For further implementation, the microfluidic channels of the cartridge were functionalized for PT and aPTT tests by drying specific reagents in each channel. Since simultaneous PT and aPTT measurements are needed in order to properly evaluate the coagulation system, one of the most prominent features of the proposed assay is enabling parallel measurement of different coagulation parameters. Additionally, the design of the cartridge and the read-out system as well as the obtained reproducible results with 10 μl of the plasma samples suggest an opportunity for a possible point-of-care application.

Abdominal wall endometriosis following cesarean section: report of five cases

BACKGROUND

Endometriosis is the presence of endometrial tissue outside the uterus. Abdominal wall endometriosis is a very rare location of this pathology. We aimed to report a series of five cases of abdominal wall endometriosis following cesarean section at our clinic.

CASE REPORT

All of our cases had had previous cesareans section and complained of pain at the pfannensteil incision scar. The cases presented palpable and tender masses near the scar. After excision of the masses histopathology reported the masses as endometriosis.

CONCLUSION

Abdominal wall endometriosis is a rare condition. Clinicians should be aware of this pathology especially in women presenting with a painful mass near the scar of a previous cesarean section.

Necrotizing (malignant) otitis externa: An unusual localization of mucormycosis

Malignant otitis externa (MOE) is a severe infection of external auditory canal and skull base. A 17-year-old diabetic girl was admitted with diabetic ketoacidosis. Cellulitis of her right ear occurred on the second day of hospitalization and a black necrotic scar in the same region appeared on the next day. The lesion rapidly invaded to right side of neck and surrounding tissue of the patient. Therefore, antimycotic therapy was started. Unfortunately the patient died on seventh day of hospitalization because of probably extensive fungal invasion. Physicians should suspect MOE connected to mucormycosis especially in patients with cutaneous lesions of ear unresponsive to antibiotic therapy.

Mucosal malignant melanoma in upper aerodigestive tract: report of two cases

Primary malignant melanoma has been seen in virtually all sites and organ systems where neural crest cells migrate. Upper aero-digestive tract is the unusual site. We presented two cases of mucosal malignant melanoma. A 59-year-old female patient had been suffering from nasal airway obstruction and headache for three months, and was admitted to our clinic. There was an upper cervical lymphadenopathy 5 cm in diameter ipsilaterally. Computerized tomography presented a nasal mass originating from the left maxillary sinus, and extending into nasal cavity and the left lateral wall of nasopharynx. Left total maxillectomy and radical neck dissection was performed. Postoperative radiotherapy was applied. A 68-year-old male patient suffering from nasal airway obstruction, hypernasality, dysphagia, and oral bleeding was admitted to our clinic. Oral examination revealed the tumoral mass protruding downward through oropharynx. The second patient referred to medical oncology. There was no recurrence in the first patient 18 months later. And the second patient died one year later. We believe that nasal mucosal malignant melanoma was rare, and carefully evaluated since it may be amelanotic lesion. Nasopharyngeal mucosal malignant melanoma is very rare, and has worse prognosis.

Pyogenic granuloma appearing on port-wine stain: a case report

BACKGROUND

Pyogenic granuloma has been reported to be associated with hemangiomas and hamartomas, including port-wine stain. It has been suggested that the spontaneous development of pyogenic granuloma in port-wine stain might be associated with microscopic arteriovenous anastomoses in highly vascularized areas such as the fingers, hands, lips, tongue and face.

CASE REPORT

A 25-year-old male patient presented with a history of a reddish, solitary nodule on the posterior cervical area for eight months. There had been an associated port-wine stain at the same localization since birth. Physical examination revealed a solitary, strawberry-like dome-shaped papule, 12 mm in diameter, within a well-demarcated reddish colored surrounding patch which had been present on the posterior cervical area. The lesion was excised, considering pyogenic granuloma arising in a port-wine stain. Histopathologic examination showed a mass of capillaries with variable luminal diameters, infiltration of inflammatory cells, and immature endothelial proliferation in the upper dermis. The capillaries were organized into lobules separated by fibrous stroma and were surrounded by an epithelial collarette. Immunohistochemical staining for factor VIII-related antigen supported all these findings of the port-wine stain.

CONCLUSION

We present a pyogenic granuloma arising in port-wine stain on the posterior cervical area, since the posterior cervical area is not as highly vascular as the fingers, hands, lips, tongue and face. We believed that the collar of the patient's shirt continuously traumatized port-wine stain, and consequently led to the development of pyogenic granuloma.

Bilateral basal cell carcinoma symmetrically appearing on lower eyelids: a case report

Basal cell carcinoma is the most common skin malignancy and is found in skin exposed to the sun. It is rarely seen bilaterally in ears, ankles or breasts. There has been no literature about bilateral basal cell carcinoma of lower eyelids symmetrically. A 68-year-old male patient had been suffering from two lesions on his lower eyelids for two years. The first lesion appeared on the right lower eyelid two years ago and got larger. Then the second lesion occurred on the left lower eyelid a year and a half ago. The patient had worked as a farmer for fifteen years. Physical examination revealed ulcerated lesions, with surrounding hyperemia, 12 x 6 mm in size, on both lower eyelids. Both lesions were excised and repaired with lateral malar flap+mucosal graft. One year later, there no evidence of recurrence, and postoperative scars were functionally and cosmetically acceptable. We present a case of bilateral basal cell carcinoma involving both lower eyelids symmetrically, reviewing the literature.

Syringocystadenoma papilliferum mimicking basal cell carcinoma on the lower eyelid: a case report

BACKGROUND

Syringocystadenoma papilliferum is an unusual benign tumor most commonly located on the scalp or face, which frequently arises from a nevus sebaceous. Transition of SP to basal cell carcinoma and, rarely, to metastatic adenocarcinoma may occur.

CASE REPORT

A 28-year-old female patient had been suffering from a pinkish, painless nodule for 25 years. Physical examination revealed a pinkish, non-tender, painless nodule, 5mm in diameter, on the lower eyelid. The nodular lesion was excised, and the lower eyelid was reconstructed with V-Y advancement flap. Histopathologic examination revealed hyperkeratosis with papillomatosis of epidermis. The dermis showed several cystic invaginations extending downwards from the epidermis. One year later, the postoperative result was cosmetically and functionally acceptable.

CONCLUSION

Syringocystadenoma papilliferum mimicking basal cell carcinoma on the lower eyelid is of interest, since there were scanty skin appendages. Our paper considers the issue of differentiating between SP and BCC, since SP is asymptomatic and may have similar appearance. We believe that SP may be a transitional step from nevus sebaceous to basal cell carcinoma, since molecular studies show PTCH gene in all three lesions, the origins of SP are still debatable, and both SP and BCC can arise in nevus sebaceous of Jadassohn.

Influence of the platelet-activating factor receptor antagonist BB-882 on intra-abdominal adhesion formation in rats

Postoperative intra-abdominal adhesion formation is a major clinical problem. We aimed to examine the preventive effect of treatment with the platelet-activating factor (PAF) antagonist (lexipafant, BB-882) on experimentally induced intra-abdominal adhesion formation in rats. Twenty male Sprague-Dawley rats weighing 250 and 290 g were studied. Generation of adhesions in rats by brushing a 1-cm(2) area of the cecum and the peritoneum on the right side of the abdominal wall was followed by intra-abdominal administration of saline and 5 mg/kg in a volume of 0.2 ml PAF receptor antagonist BB-882. After 45 days, formation of adhesions was graded and histological evaluation was processed. The severity of adhesions was significantly less in the BB-882 group than in the control group (p < 0.001, p < 0.05). The average adhesion scores in the control and BB-882 groups were 3.2 +/- 0.6 and 0.6 +/- 0.6, respectively, and the difference between both groups was found to be significant (p < 0.0001). The number of polymorphonuclear leukocytes and fibrotic areas was significantly decreased in the BB-882 group when compared to the control group (p < 0.001, p < 0.002). In conclusion, this study confirms the efficacy of BB-882 in the prevention of postoperative intra-abdominal adhesions in a rat model.

Cardiac hydatic cyst causing cerebral emboli in a child

Cardiac hydatic cyst is rarely encountered. In this article, a case of hydatid cyst localized in the left ventricle causing cerebral emboli is reported.