Rare lymphatic malformation of external ear canal with history of sclerotherapy

An 8-year-old boy with history of conductive hearing loss, presented with a 3.1 x 3.1 x 2 cm left postauricular mass diagnosed as lymphatic malformation on imaging. Treatment with bleomycin sclerotherapy led to successful improvement of the malformation. Seven months post-treatment, he presented to his audiologist with several months of intermittent bleeding and pain from the ear. Upon examination by otolaryngology, a 0.5 cm papillary lesion was discovered in the external ear canal which had not been identified previously. A biopsy demonstrated a papillary proliferation of dilated thin walled lymphatic channels expanding multiple dermal papillae, consistent with lymphatic malformation. We propose that this lesion could represent extension of the original lesion or a new lesion secondary to regional lymphatic damage from prior sclerotherapy. Lymphatic malformation is rare within the external ear canal. Moreover, this case developed after treatment by regional sclerotherapy. To our knowledge, this sequela has not been previously documented in the literature but may be underreported. Therefore, routine regional follow up may be warranted in any periauricular sclerotherapy for lymphatic malformation

Pili multigemini of the eye: unusual and rare presentation

Pili Multigemini (PM) is an uncommon, pilar dysplasia characterized by clusters of hair shafts emerging from a single follicle. We present a rare and unique case of PM involving the eye. A 43 year old Caucasian male, presented with a prolonged history of a recurrent lesion at the right upper eyelid, present for two years. Clinical examination revealed a subcutaneous cyst with a prominent follicular pore with a differential diagnosis of epidermoid cyst, nevus and pili bifurcati. Excisional biopsy was performed and microscopy showed a benign malformed hair follicle containing multiple different hair shafts enclosed in a common outer root sheath; consistent with the diagnosis of Pilli Multigemini. Pili Multigemini was first described by Flemming in 1883 and is frequently found in the beard of adults and scalp of children. To our knowledge, this is the first case of Pilli Multigemini involving the eye. its noteworthy to consider during diagnostic workup; as well as to exclude other follicular and inflammatory abnormalities involving the eye

Caribou nursery site habitat characteristics in two northern Ontario parks

To prevent further range recession, habitat features essential to the life-history requisites of woodland caribou (Rangifer tarandus caribou) such as calving and nursery sites need to be protected for the persistence of the species. Woodland caribou may minimize predation risk during calving by either spacing out or spacing away from predators in the forest to calve on islands, wetlands, or shorelines. Our objective was to determine the characteristics of shoreline habitats used as calving and nursery sites by female woodland caribou in northern Ontario. Detailed vegetation and other site characteristics were measured at nursery sites used by cow-calf pairs in Wabakimi and Woodland Caribou Provincial Parks for comparison with shoreline sites that were not used by caribou within each park. Differences in habitat variables selected by female caribou in the two study areas reflect broad ecoregional differences in vegetation and topography. In Wabakimi Provincial Park, understorey tree density and ground detection distance played key roles in distinguishing nursery sites from sites that were not used. In Woodland Caribou Provincial Park, groundcover vegetation and shrub density were important in the selection of nursery sites by female caribou. Generally, female caribou in both parks selected nursery sites with greater slope, lower shrub density but thicker groundcover vegetation, including greater lichen abundance, and higher densities of mature trees than shoreline sites that were not used. The identification of these important features for caribou nursery sites provides a basis for improving their protection in future management policies and legislation

Rhabdomyosarcoma with epithelioid morphology: A challenging cytologic diagnosis in a pleural effusion

Rhabdomyosarcomas (RMS) are rare malignant skeletal muscle tumors that present more commonly in pediatric populations. The WHO currently classifies RMS into four types, embryonal, alveolar, pleomorphic, and spindle cell/sclerosing variants. Epithelioid rhabdomyosarcoma (EpiRMS) is another rare, recently described subtype of RMS presenting in older patients with a male predominance and has a rapidly progressive clinical course with frequent metastases. EpiRMS closely mimics poorly differentiated carcinoma or melanoma, demonstrating discohesive large epithelioid cells with abundant eosinophilic cytoplasm, frequent glassy cytoplasmic inclusions, large vesicular nuclei, and prominent nucleoli. We present a case of metastatic rhabdomyosarcoma with features reminiscent of EpiRMS presenting as a pleural effusion, closely followed by an inguinal lymph node biopsy. The malignant cells in the pleural fluid were diffusely positive for desmin, negative for MyoD1, myogenin, S100 and SOX10, and retained INI-1 expression. Subsequent lymph node biopsy demonstrated identical malignant epithelioid cells that were positive for desmin, myoD1 and myogenin, and a cytological diagnosis of metastatic rhabdomyosarcoma, favor epithelioid rhabdomyosarcoma was given considering the concurrent lymph node biopsy morphology and immunoprofile. A diagnosis of rhabdomyosarcoma, though rare and challenging, should not be overlooked when considering malignant cells with an epithelioid morphology in cytology specimens

Pancreatic lymphoepithelial cyst with concurrent HIV infection: A case report and review of the literature

Pancreatic lymphoepithelial cysts are rare, benign, non-neoplastic unilocular or multilocular cystic lesions. These circumscribed pancreatic lesions are filled with keratinous material grossly and exhibit distinct microscopic features. Pancreatic lymphoepithelial cysts are like the more common lymphoepithelial cysts of the parotid glands, which have been associated with the diffuse infiltrative lymphocytosis syndrome often seen in patients with HIV infection. However, pancreatic lymphoepithelial cysts are rare and their association with HIV infection has not been established. The presence of secondary changes in non-neoplastic cysts such as goblet cell metaplasia that was present in our case is an important feature to be included in the differential diagnosis and not to be interpreted as a mucinous neoplasm, particularly on fine-needle aspiration specimen microscopic evaluation that would impact further management. Here we describe the diagnosis and treatment of lymphoepithelial cysts in a patient who was on highly active antiretroviral therapy for HIV infection and we provide a brief literature review. Defining the clinical characteristics of lymphoepithelial cysts in patients with HIV and determining accurate preoperative diagnostic procedures will be critical for establishing effective surgical and medical approaches to treating these cysts, which differ substantially from other more serious pancreatic cystic lesions

Systematic Review of the Measurement Properties of Tools Used to Measure Behaviour Problems in Young Children with Autism

BackgroundBehaviour problems are common in young children with autism spectrum disorder (ASD). There are many different tools used to measure behavior problems but little is known about their validity for the population.ObjectivesTo evaluate the measurement properties of behaviour problems tools used in evaluation of intervention or observational research studies with children with ASD up to the age of six years.MethodsBehaviour measurement tools were identified as part of a larger, two stage, systematic review. First, sixteen major electronic databases, as well as grey literature and research registers were searched, and tools used listed and categorized. Second, using methodological filters, we searched for articles examining the measurement properties of the tools in use with young children with ASD in ERIC, MEDLINE, EMBASE, CINAHL, and PsycINFO. The quality of these papers was then evaluated using the COSMIN checklist.ResultsWe identified twelve tools which had been used to measure behaviour problems in young children with ASD, and fifteen studies which investigated the measurement properties of six of these tools. There was no evidence available for the remaining six tools. Two questionnaires were found to be the most robust in their measurement properties, the Child Behavior Checklist and the Home Situations Questionnaire—Pervasive Developmental Disorders version.ConclusionsWe found patchy evidence on reliability and validity, for only a few of the tools used to measure behaviour problems in young children with ASD. More systematic research is required on measurement properties of tools for use in this population, in particular to establish responsiveness to change which is essential in measurement of outcomes of intervention.PROSPERO Registration NumberCRD4201200222

The increase of the functional entropy of the human brain with age

We use entropy to characterize intrinsic ageing properties of the human brain. Analysis of fMRI data from a large dataset of individuals, using resting state BOLD signals, demonstrated that a functional entropy associated with brain activity increases with age. During an average lifespan, the entropy, which was calculated from a population of individuals, increased by approximately 0.1 bits, due to correlations in BOLD activity becoming more widely distributed. We attribute this to the number of excitatory neurons and the excitatory conductance decreasing with age. Incorporating these properties into a computational model leads to quantitatively similar results to the fMRI data. Our dataset involved males and females and we found significant differences between them. The entropy of males at birth was lower than that of females. However, the entropies of the two sexes increase at different rates, and intersect at approximately 50 years; after this age, males have a larger entropy

MatrixDB, a database focused on extracellular protein–protein and protein–carbohydrate interactions

Summary: MatrixDB (http://matrixdb.ibcp.fr) is a database reporting mammalian protein–protein and protein–carbohydrate interactions involving extracellular molecules. It takes into account the full interaction repertoire of the extracellular matrix involving full-length molecules, fragments and multimers. The current version of MatrixDB contains 1972 interactions corresponding to 4412 experiments and involving 259 extracellular biomolecules

Economic evaluation of propofol and lorazepam for critically ill patients undergoing mechanical ventilation*

The economic implications of sedative choice in the management of patients receiving mechanical ventilation are unclear because of differences in costs and clinical outcomes associated with specific sedatives. Therefore, we aimed to determine the cost-effectiveness of the most commonly used sedatives prescribed for mechanically ventilated critically ill patients

Exploring the error characteristics of thin ice cloud property retrievals using a Markov chain Monte Carlo algorithm

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95385/1/jgrd15111.pd