Extensive primary retroperitoneal fibrosis (Ormond’s disease) with common bile duct and ureteral obstruction: A rare case report

AbstractIntroductionIdiopathic retroperitoneal fibrosis (Ormond’s disease) may involve the perirenal tissue, mesentery and biliary system in extremely uncommon situations in addition to classical compression of retroperitoneal structures particularly the ureters.Presentation of caseWe report the case of a 60 year’s old man with clinical manifestation of obstructive jaundice, due to the common bile duct narrowing caused by a primary retroperitoneal fibrosis. Magnetic resonance cholangiopancreatography (MRCP) showed the presence of intrahepatic bile duct obstruction, suggesting the diagnosis of a hilar cholangiocarcinoma. Endoscopic retrograde cholangiopancreatography (ERCP) showed strictures in the proximal common bile duct. A biliary endoprosthesis was inserted at ERCP. Histological investigations as well as CT-scan were compatible with retroperitoneal fibrosis.DiscussionThe main clinical presentation of the Ormond’s disease is compression of the ureters, and less commonly blood vessels and nerves. Our patient presented with obstructive jaundice, due to the common bile duct (CBD) compression, which was unusual. The first description of the extrahepatic biliary obstruction secondary to retroperitoneal fibrosis was made in 1964 and since then only 13 cases have been reported in the medical literature.ConclusionRetroperitoneal fibrosis can cause compression of the CBD and therefore mimic a cholangiocarcinoma. Patients can be successfully managed with long-term CBD stent placement

Exponential inequalities in probability spaces revisited

We revisit several results on exponential integrability in probability spaces and derive some new ones. In particular, we give a quantitative form of recent results by Cianchi-Musil and Pick in the framework of Moser-Trudinger-type inequalities, and recover Ivanisvili-Russell's inequality for the Gaussian measure. One key ingredient is the use of a dual argument, which is new in this context, that we also implement in the discrete setting of the Poisson measure on integers

Cantharidin Poisoning due to Blister Beetle Ingestion in Children : Two case reports and a review of clinical presentations

Cantharidin is an intoxicant found in beetles in the Meloidae (Coleoptera) family. Ingestion may result in haematemesis, impaired level of consciousness, electrolyte disturbance, haematurea and renal impairment. Here, we report two paediatric cases of meloid beetle ingestion resulting in cantharidin poisoning and the clinical presentation of the ensuing intoxication

Liposarcome dédifférencie du cordon spermatique: difficultés thérapeutiques des grosses tumeurs

Le liposarcome du cordon spermatique est une entité rare : environ 100 cas ont été rapportés dans la littérature. Nous rapportons l’observation d’un homme âgé de 42 ans, chez qui a été décelée une masse tumorale développée aux dépens du cordon spermatique droit. Une orchidectomie droite avec exérèse large de la tumeur a été difficilement réalisée en raison de la taille importante de la masse. En post opératoire, le patient a présenté une progression locale et métastatique pulmonaire. Une mono chimiothérapie a été administrée à base d’anthracycline mais le patient a décédé suite à une progression rapide de la maladie. À travers cette observation, nous rapportons brièvement les données de la littérature de cette entité rare. Une exérèse large avec des marges saines, tant que possible, est indispensable pour le contrôle local de la maladie. Néanmoins, en cas de taille tumoral importante, comme le cas de notre patient, une exérèse complète est souvent difficile. Vu le taux élevé de rechute locale, une stratégie combinée associant chirurgie et radiothérapie adjuvante peut être envisagée. Le rôle de la chimiothérapie, bien qu’incertain, garde son indication dans les cas métastatiques, surtout dans les sous types dédifférenciés

The Role of β-Arrestin Proteins in Organization of Signaling and Regulation of the AT1 Angiotensin Receptor

AT1 angiotensin receptor plays important physiological and pathophysiological roles in the cardiovascular system. Renin-angiotensin system represents a target system for drugs acting at different levels. The main effects of ATR1 stimulation involve activation of Gq proteins and subsequent IP3, DAG, and calcium signaling. It has become evident in recent years that besides the well-known G protein pathways, AT1R also activates a parallel signaling pathway through β-arrestins. β-arrestins were originally described as proteins that desensitize G protein-coupled receptors, but they can also mediate receptor internalization and G protein-independent signaling. AT1R is one of the most studied receptors, which was used to unravel the newly recognized β-arrestin-mediated pathways. β-arrestin-mediated signaling has become one of the most studied topics in recent years in molecular pharmacology and the modulation of these pathways of the AT1R might offer new therapeutic opportunities in the near future. In this paper, we review the recent advances in the field of β-arrestin signaling of the AT1R, emphasizing its role in cardiovascular regulation and heart failure

The state of play of blockchain technology in the financial services sector: A systematic literature review

The modern trends of digitalization have completely transformed and reshaped business practices, whole businesses, and even a number of industries. Blockchain technology is believed to be the latest advancement in industries such as the financial sector, where trust is of prime significance. Blockchain technology is a decentralized and coded security system which provides the capability for new digital services and platforms to be created through this emerging technology. This research presents a systematic review of scholarly articles on blockchain technology in the financial sector. We commenced by considering 227 articles and subsequently filtered this list down to 87 articles. From this, we present a classification framework that has three dimensions: blockchain-enabled financial benefits, challenges, and functionality. This research identifies implications for future research and practice within the blockchain paradigm

Actual Management of Anterior Calyceal Diverticular Calculi: A Challenging Flexible Retrograde Endoscopic Approach

Calyceal diverticula is a cavity that communicates with the collecting system through a narrow isthmus of the kidney. The incidence of the formation of stones in calyceal diverticula is 10-50%. This paper reports three cases of two females and one male who presented with calyceal diverticular calculi; the patients have been, arbitrarily, selected between August and February 2019 at the urology department of our university hospital. A minimally invasive treatment includes extracorporeal lithotripsy (ESWL), and F-URS (flexible ureteroscopy) was performed. We report this case series

Bladder tumor discovered by joint pain in the pelvis and functional impotence of the lower limb

Macroscopic hematuria is the most common telltale clinical sign for muscle-infiltrating or non-muscle bladder tumors. Lower urinary tract disorders, pelvic pain or signs related to upper urinary tract obstruction may be associated. In our case, the reason for consultation is sciatica, progressing to functional impairment of the lower right limb without any urological sign

Spermatocytic seminoma of testis associated with undifferentiated sarcoma revealed in metastatic disease: A review and case report analysis

Spermatocytic seminoma is a relatively rare testicular tumor and is characterized by a good prognosis. The discovery of a sarcomatous contingent modifies the prognosis of the indolent neoplasm. Only 20 cases being reported in English literature. We present the case of a 66-year-old man with a two-year history of left-sided scrotal pain and swelling. Tumor markers were normal. Ultrasound demonstrated a very large solid-cystic testicular mass. Orchidectomy was performed. Further imaging investigations revealed lung, vertebra, and retroperitoneal lymph node metastases. Histological examination and immunohistochemistry of the orchidectomy specimen concluded on spermatocytic seminoma associated with undifferentiated sarcoma component