Colorless Fluid Research Articles

An Arachnoid Cyst Incidentally Found in a Young Man Who Died of Sudden Cardiac Death

An arachnoid cyst is a rare cerebrospinal fluid–filled non-neoplastic cystic lesion. Most arachnoid cysts are asymptomatic; however, depending on their location and size, they may show various clinical symptoms and rarely can cause serious complications. We report a case of an arachnoid cyst incidentally found in a 25-year-old male soldier, which was not the cause of death. A 2.3×1.7 cm unilocular cystic lesion filled with colorless serous fluid was observed near the interpeduncular fossa of the brain. Microscopy revealed the cyst membrane to be lined by a single layer of meningothelial cells with no edema or inflammatory reaction in the surrounding structures. Considering the medical history, circumstances of death, and autopsy findings, the cause of death was determined to be sudden cardiac death, and the cyst found in the brain was consistent with an arachnoid cyst. Reviewing this case and related literature would help to determine the cause and manner of death if an arachnoid cyst is incidentally found during an autopsy.

Pathomorphological and gender-age aspects of echinococosis of the liver

Background. Echinococcosis is a chronic parasitic disease that belongs to zooanthropohelminthosis and is characterized by the development of solitary or multiple cystic formations in the liver, lungs, brain and other organs. Today, the incidence is increasing dramatically in non-endemic countries, and the spread of the disease is largely linked to global population migration. Purpose – To analyze the pathomorphological and sex-age characteristics of operated patients with echinococcosis of the liver for the period 2011–2021. Materials and Methods. Medical documentation and autopsy material of all cases of surgical intervention in patients with liver echinococcosis at the pathology department of the State Institution «Zaycev V.T. Institute of general and urgent surgery of the National Academy of Medical Sciences of Ukraine» for the period 2011–2021. Sex-age characteristics of patients with echinococcosis were studied. A pathomorphological study of the postoperative material was carried out, taking into account the size and type of cysts, and the location of their formation. The preparations were stained with hematoxylin and eosin and by the Van Gieson method. Results. During the period 2011–2021, 36 operated patients with echinococcosis were recorded. Liver echinococcosis was mostly detected in men – 52.8% (р ≤ 0.05), the average age of patients was 46.9 ± 3.1 years. Among the operated, the percentage of people under 50 was 69.4%, with a predominance of men (52%). In the case of primary and recurrent echinococcosis of the liver, single cysts were found in most patients, namely in 26 (72.2%) with predominant localization in the right lobe (88.5%). Multiple cysts were found in 10 patients (27.8%); lesions of the right lobe of the liver – 70.0%, left – 10.0%, both lobes – 20.0%. It was established that the average diameter of echinococcal cysts was 13.8 ± 2.5 cm, individual cysts reached 17 cm. The thickness of all layers of the cyst wall was 1.3 ± 0.3 cm. The outer acellular layer of the cyst wall was 0.8 ± 0.1 cm. In most cases (61.1%, p ≤ 0.05), the parasite was alive, as evidenced by the clear, colorless cyst fluid with the presence of single daughter cysts with a diameter of 0.1 to 2 cm, which had the same macro- and microscopic characteristics as the mother cyst structure The color of the entire membrane of the parasite was white-pink. Conclusions. Over a 10-year period, 36 patients operated on for echinococcosis of the liver were recorded, the majority of cases were men (52.8%, p ≤ 0.05). The average age of the patients was 46.9 ± 3.1 years and ranged from 26 to 69 years. Among those operated on, the percentage of people under 50 was 69.4%, with a predominance of males in the gender structure. In the case of primary and recurrent echinococcosis of the liver, single cysts were found in most patients, namely in 26 (72.2%) with predominant localization in the right lobe (88.5%). Multiple cysts were found in 10 patients (27.8%); lesions of the right lobe of the liver – 70.0%, left – 10.0%, both lobes – 20.0%. The average diameter of echinococcal cysts was 13.8 ± 2.5 cm, individual cysts reached 17 cm. The thickness of all layers of the cyst wall was 1.3 ± 0.3 cm. The outer acellular layer of the cyst wall was 0.8 ± 0.1 cm In most cases, the parasite was alive (61.1%, p ≤ 0.05).

P27 A case of unilateral scleritis and biopsy proven retinal vasculitis in an elderly woman with rheumatoid arthritis and previous retinal detachment surgery with silicone oil band

P27 A case of unilateral scleritis and biopsy proven retinal vasculitis in an elderly woman with rheumatoid arthritis and previous retinal detachment surgery with silicone oil band

Green synthesis of silver nanoparticles mediated Azadirachta indica extract and study of their characterization, molecular docking, and antibacterial activity.

The green production of silver nanoparticles (AgNPs) produces AgNPs with minimum influence on the environment by using plant components such as alkaloids, carbohydrates, lipids, enzymes, flavonoids, terpenoids, and polyphenols as reducing agents. In the present investigation, Azadirachta indica leaf extract was used to form AgNPs from a 1 mM silver nitrate solution. The plan proved to be incredibly straightforward, cost-effective, and effective. The production of the nanoparticles was observed visually, where the colorless fluid turns into a brown-colored solution. Further research was carried out using x-ray diffraction, Fourier-transform infrared analysis, scanning electron microscopy, and transmission electron microscopy (TEM) in addition to UV-visible spectroscopy. The size range of AgNPs determined by TEM was 10-30 nm. When the diffusion technique was employed to demonstrate the antibacterial effect of AgNPs on various pathogens, the zones of inhibition for Staphylococcus aureus, Bacillus cereus, and Escherichia coli, when 50 g of AgNPs were used were 16, 12, and 17 mm, respectively. By examining the leakage of reducing sugars and proteins, the mechanism by which nanoparticle antibacterial properties were explored, showed that AgNPs were capable of lowering membrane permeability.

Evaluation of FNAC Thyroid Smears Using Bethesda System For Reporting Thyroid Cytopathology Nomenclature With Clinicopathological Correlation

Background: The study aimed to interpret thyroid cytology by the Bethesda System for reporting thyroid cytology (TBSRTC) and to analyze the distribution of lesions under various diagnostic categories and subcategories.
 Methodology: This study was conducted as an observational study at tertiary care centre on patients with thyroid lesions. After history taking and detailed local, general and systemic examination, thyroid function tests were conducted. Apart from this, ultrasonography of lesion was done. Patients were subjected to FNAC and after fixation smears were stained with Papanicolaou stain.
 Results: About 53% thyroid lesions were hemorrhagic, followed by 17% blood mixed colloid and 4% colorless serous fluid. Sample adequacy was noted in 93.5% cases in our study. According to Bethesda system of classification, majority of lesions were benign (81.5%) whereas 6.5% lesions were unsatisfactory. Only 6% lesions were categorsied as malignant.
 Conclusion: FNAC is widely accepted as the most accurate, sensitive, specific, and cost- effective diagnostic procedure in the preoperative assessment of thyroid nodules. It is the first line of investigation and can differentiate benign nodules from malignant nodules of the thyroid in 95% cases. Applying a standard reporting system for thyroid cytology may enhance the communication between pathologists and clinicians, assists them to find out the rate of malignancy in each cytological group, and facilitating a more reliable approach for patient management.

Sosialisasi Personal Hygiene Untuk Pencegahan Keputihan Yang Dapat Menyebabkan Infeksi Pada Kalangan Remaja Tahun 2023

Adolescence experiences physiological, psychosocial, cognitive, moral and sexual development. Physiological changes in adolescence are the result of hormonal activity under the influence of the central nervous system. Physical differences between the sexes are determined on the basis of primary sex characteristics, namely the internal and external organs that carry out reproductive functions, such as the ovaries, uterus, breasts and penis. puberty and fat accumulation) but do not play a direct role in reproduction (Wong, 2015) Leucorrhoea in medical circles is known as leukore or fluor albus, which is discharge from the vagina. Leucorrhoea is a candida yeast infection in female genitalia and is caused by a yeast-like organism, namely candida albicans. Under normal circumstances, the vagina produces a clear, odorless, colorless fluid, the amount is not excessive and is not accompanied by itching. Leucorrhoea is the most common complaint in women. Leucorrhoea can occur under normal circumstances (physiological), but can also be a symptom of a disorder that must be treated (pathological) (Clayton, 2018). The method of carrying out this activity is: education in carrying out proper personal hygiene in adolescents to prevent abnormal vaginal discharge which is characterized by itching, odor, and green color so that it has an impact on infection. This activity began with the preparation of proposals and administration of activities in February 2023.

DRIED SALIVARY SPOT AS A DIAGNOSTIC AIDA REVIEW

Saliva is a colourless,watery and complex fluid secreted by the salivary glands into the oral cavity.It plays an important role in maintaining the moisture and well being of the oral cavity.In recent years,Saliva has been used by the researches, as it is non invasive technique, limited training required, potentially valuable for children and elderly patients, cost effective, eliminates the risk of infection and screening in large population. Collecting dried salivary sample is still being a greater challenge in the forensic. The process of identifying a disease, condition, or injury from its signs and symptoms is referred as diagnosis and diagnostic tool helps in simplifying the clinical findings to obtain a reasonable and relevant differential diagnosis. Recently, Dried salivary spot has been most commonly used among Forensic Odontology which can be used as an efficient diagnostic aid.This article aims to review the updates and significance of dried saliva spot and sampling in forensic odontology.

A Dorsal Epidural Herniated Disc Fragment Initially Presenting as Guillain-Barré Syndrome

Guillain-Barré syndrome (GBS) is a rare autoimmune disorder that presents with neurological symptoms that can mimic other conditions. This mimicry can hide other important neurological diagnoses. Here, we present a rare case of thoracic myelopathy secondary to a sequestered dorsal epidural herniated disc fragment that initially presented with the classic findings of GBS.A 58-year-old female presented with progressing bilateral lower extremity weakness, paresthesias, and absent bilateral lower extremity deep tendon reflexes. Lumbar magnetic resonance imaging (MRI) findings were disproportionate to presentation, and lumbar puncture fluid analysis revealed clear, colorless fluid with albuminocytological dissociation. The patient was diagnosed with GBS and treated with a short course of intravenous steroids followed by intravenous immunoglobulin. The patient later developed new-onset ulnar distribution paresthesias, lower extremity spasticity, constipation, and urinary retention that caused a decline in functional progress. Further investigation prompted evaluation with cervical and thoracic MRIs, which revealed a left dorsal epidural lesion at the T9-T10 level causing severe cord compression. The patient was definitively treated with a T9-T10 laminectomy and excision of the offending lesion. Pathology revealed collagenous tissue with fibroblastic proliferation, consistent with a sequestered fragment of the herniated intervertebral disc. The patient was further treated with both acute and subacute rehabilitation. She was eventually discharged home and was able to ambulate independently with a walker.Dependency on positive albuminocytological dissociation in cases of potential GBS can lead to errors in diagnostic accuracy and delay appropriate treatment. Clinicians should remain mindful that GBS is a diagnosis of exclusion and MRI of the entire spine should be considered when the diagnosis of GBS is uncertain.

A Machine Vision-Based Pipe Leakage Detection System for Automated Power Plant Maintenance.

Industrial pipework maintenance inspection can be automated through machine vision-based effusion monitoring. However, colorless effusions such as water can be difficult to detect in a complex industrial environment due to weak illumination and poor visibility of the background. This paper deploys the reflective characteristics of effusion and its lower temperature compared to the environment in order to develop an automatic inspection system for power plant pipeworks’ maintenance. Such a system is aimed at detecting the colorless fluid effusion based on dual source images and a contour features algorithm. In this respect, a visible light source unit highlights the reflective features of the effusion edge. Meanwhile, high-definition images of the potential effusion are acquired under both visible and infrared lights. A customized image processing procedure extracts the potential effusion features from the infrared image to retrieve the region of interest for segmentation purposes and transfer such information to the visible light image to determine the effusion contour. Finally, a decision-making support tool based on the image contour closure is enabled for classification purposes. The implementation of the proposed system is tested on a real industrial environment. Experimental results show a classification accuracy up to 99%, demonstrating excellent suitability in meeting industrial requirements.

S1644 A Curious Case of Duodenal Mass Causing Malignant Biliary Obstruction and White Bile

Introduction: We describe a case of a duodenal mass causing malignant biliary obstruction and the use of LAMS cholecystoduodenostomy for gallbladder drainage revealing white bile. Case Description/Methods: An 83 year-old male developed orange colored urine and stool for 3 weeks. CA 19-9 was 8,381 U/mL and direct bilirubin was 43.7 mg/dL. CT Abdomen and Pelvis with contrast showed a dilated common bile duct to 1.6cm with narrowing at the ampulla, dilated intrahepatic ducts, and a duodenal mass. ERCP demonstrated a large duodenal ulcerated mass from D1 to D3 and replaced the medial aspect of the duodenal wall. Despite probing the mass with guidewire, bile duct access was unsuccessful. Biopsies showed poorly differentiated adenocarcinoma with mucinous and signet ring cell features (Figure 1A). EUS showed a 4x6cm obstructing polypoid mass in the duodenum (star) with invasion into the distal common bile duct (arrow) resulting in a dilated common bile duct (circle) (Figure 1B). Subsequent LAMS cholecystoduodenostomy was performed for drainage (arrow) (Figure 1C). White bile (clear bile) was noted upon deployment into the gallbladder (star) (Figure 1D). Discussion: White bile in malignant biliary obstruction occurs because the biliary epithelium secretes mucus into bile despite the obstruction, resulting in colorless fluid. White bile has been associated with worse survival in these patients.Figure 1.: (a) duodenal adenocarcinoma with mucinous and signet ring cell features (b) duodenal adenocarcinoma (star) invading the distal common bile duct (arrow) resulting in a dilated common bile duct (circle) (c) LAMS deployment (arrow) within the dilated gallbladder while creating the cholecystoduodenostomy (d) White bile (star) draining through the LAMS.

VP Shunt With Recurrent Malfunction in Two Pediatric Patients: Is the Hydrocephalus Truly Idiopathic?

VP Shunt With Recurrent Malfunction in Two Pediatric Patients: Is the Hydrocephalus Truly Idiopathic?

Paracetamol Overdose May Cause Transudative Pleural Effusion in Adults

Paracetamol is the most widely used and prescribed drug word-wide. It is the most common cause of the poisoning and of the fatality due to the toxic administration throughout the world. A 34-year-old female patient applied to our ED with the complaint of swallowing 33 g of paracetamol. After routine toxicity treatment, on the third day of the hospitalization, dyspnea and pain on the right hemithorax and right flank occurred. Chest X-ray showed blunted right sinus. CT revealed bilateral pleural effusion. With thoracentesis, clear, colorless and odor-free fluid of about 500cc was drained. Laboratory examination of the fluid confirmed it as transudate. We believed pleural effusion is related to high-dose paracetamol intake and it occurred due to decrease in pleural permeability and the consequent decrease of the fluid absorption. In conclusion, high-dose intake of paracetamol might cause transudative pleural effusion as a complication.

White bile in patients with malignant biliary obstruction is an independent factor of poor survival

Background and study aims White bile is defined as a colorless fluid occasionally found in the biliary tract of patients with bile duct obstruction. Its significance is not clearly established. Our objective was to analyze the prognostic value of white bile in a series of patients with biliary obstruction due to biliary or pancreatic cancer. Patients and methods The study was conducted on a series of consecutive patients with malignant obstructive jaundice. They all underwent endoscopic retrograde cholangiopancreatography with collection of bile and biliary stent insertion. White bile was defined as bile duct fluid with bilirubin level < 20 µmol/L. Univariate and multivariate analyses were performed to identify variables associated with overall survival (OS). Results Seventy-three patients were included (32 pancreatic cancers, 41 bile duct cancers). Thirty-nine (53.4 %) had white bile. The mean bile duct bilirubin level in this group was 4.2 ± 5.9 µmol/L vs 991 ± 1039 µmol/L in patients with colored bile (P < 0.0001). In the group of 54 patients not eligible for surgery, the multivariate analysis demonstrated an association between the presence of white bile and reduced OS (HR 2.3, 95 %CI 1.1–4.7; P = 0.02). Other factors independently associated with OS were metastatic extension (HR 2.8, 95 %CI 1.4–5.7) and serum total bilirubin (HR 1.003, 95 %CI 1.001–1.006). There was a significant inverse correlation between serum and bile duct bilirubin levels (r = –0.43, P = 0.0001). Conclusion White bile in patients with inoperable malignant biliary obstruction is an independent factor of poor survival.

Pathomorphological characteristics of viral hemorrhagic disease of rabbits

The dead animals have a pathomorphological picture with a brightly expressed hemorrhagic diathesis, in many organs there is venous stasis. Blood does not clot for several hours, and at autopsy of organs (heart, lungs, liver, kidneys) it is poured in significant amounts into the body cavity. Macroscopically, the most significant changes are observed in the respiratory system. The lungs are blood-filled, intensely swollen and unevenly colored, have a grayish-pink color with single or multiple spotted and spotted hemorrhages under the pleura. Red or almost colorless liquid flows down from the incision surface, foamy exudate is released from the bronchi when pressed on. There are no patterns in the localization of pathomorphological changes in any part of the lungs (apical, cardiac, diaphragmatic): all parts are damaged at once, or mainly in one or another part. The walls of the trachea, nasal cavities, to a lesser extent the larynx are distinctly hemorrhagic. Their red color is more often caused by venous hyperemia. The lumen of the trachea and larynx is filled with red or colorless foamy fluid. Changes in the liver are constant, but not always the same type and are due to the degree of its blood supply, which causes a change in color, amount and consistency. In the first hours after the death of the animal, the liver is usually completely blood-filled, enlarged, easily torn, has a reddish-brown color with a yellowish tinge in the central parts of the lobes. The capillary network of the body looks like red streaks and dots of irregular shape. Spotted hemorrhages are sometimes observed under the capsule of the organ. The gallbladder contains some bile, its mucous is rough, a bit exfoliated. The spleen is increased in size by 1.5–3 times, swollen, dark cherry in color with a typical purple tinge. The kidneys are completely blood-filled, reddish-brown and increased in several times. The thymus is slightly reddened, often with multiple spotted or spotted hemorrhages in the chest. Lymph nodes are pulpy, grayish-pink, rarely red, not significantly changed in size. The heart (especially its right half) is filled with a large amount of black and red blood, increased in size , the walls of the ventricles are stretched, thin, have flabby consistency. Multiple spotted and spotted hemorrhages under the epicardium and endocardium are common. Changes in the gastrointestinal tract characterize catarrhal (rarely catarrhal-hemorrhagic) inflammation, sometimes hemorrhage in the duodenum and rectum, exfoliation of the gastric mucosa. In the form of hemorrhage, pathological and anatomical changes are found in the uterus and adrenal glands, in the form of congestive hyperemia – in the genitals, goiter, brain.

Bacterial Canker Disease on Populus × euramericana Caused by Lonsdalea populi in Serbia

Populus × euramericana (Dode) Guinier clone (cl.) “I-214” is a fast-growing interspecific hybrid between Eastern cottonwood (P. deltoides Bartr. ex Marsh) and European black poplar (Populus nigra L.). Populus × euramericana was introduced into Serbia in the 1950s and has become one of the most widely grown poplar species. In September 2019, cankers were observed on stems and branches of P. × euramericana cl. “I-214” trees in a two-year-old poplar plantation in the province of Vojvodina, Serbia. The canker tissue was soft and watery, and a colorless fluid that smelled rotten flowed from the cracks in the bark, suggesting possible bacterial disease. After two weeks, diseased trees experienced crown die-back and oozing of foamy, odorous exudates and this study aimed to identify the causal agent of the disease. Canker margins and exudates were collected from 20 symptomatic trees. The associated bacterium was isolated and identified using biochemical characteristics, phylogenetic analyses based on 16S rRNA gene sequences, and multilocus sequence analyses (MLSA) based on partial sequencing of three housekeeping genes (gyrB, infB, and atpD). The pathogen was identified as Lonsdalea populi. Pathogenicity tests were conducted on rooted cuttings of P. × euramericana cl. “I-214” in an environmental test chamber and demonstrated that the isolated bacterial strain was able to reproduce symptoms of softened, water-soaked cankers and exudation. To the best of our knowledge, this is the first report of L. populi causing bacterial canker disease on P. × euramericana cl. “I-214” in Serbia and in southeastern Europe (SEE). It is also the first report of a bacterial disease on hybrid poplars, including P. × euramericana in this country and in SEE. If the disease spreads into new areas, selection for L. populi resistance may need to be integrated into future poplar breeding programs.

SWEET HYDROTHORAX: A RARE COMPLICATION OF PERITONEAL DIALYSIS

SESSION TITLE: Medical Student/Resident Disorders of the Pleura Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Hydrothorax is a rare complication of continuous ambulatory peritoneal dialysis (CAPD) with an incidence of approximately 2%(1). We present a case of hydrothorax secondary to CAPD. CASE PRESENTATION: 72-year-old female with past medical history of end-stage renal disease requiring peritoneal dialysis 4 times a day and type 2 diabetes mellitus presented with shortness of breath, productive cough, chest congestion and nausea for 2 days. She denied any fevers or chills. Vitals were stable with oxygen saturation of 97% on 2 L nasal cannula. Physical exam was significant for diminished breath sounds at the base of the right lung on auscultation. Electrocardiogram showed normal sinus rhythm with no ST changes. Laboratory results were significant for an elevated creatinine of 6.4 mg/dL whereas white blood cell count, lactic acid and troponins were unremarkable. A comprehensive respiratory panel including Influenza A & B, urine antigen testing for streptococcus pneumonia and legionella were also negative. Chest x-ray PA and lateral showed middle to lower lung lobe infiltrate with pleural effusion. Blood cultures that were obtained on admission did not grow any organisms. Patient was started on antibiotics for presumed community acquired pneumonia. Pulmonology performed right sided thoracentesis and 1600 mL of colorless clear fluid was drained. Patient experienced significant symptomatic relief post thoracentesis. Pleural fluid analysis revealed a pH of 7.3 and a high glucose concentration of 438 mg/dL (simultaneous blood glucose level of 103 mg/dL). Additionally, LDH and protein were suggestive of a transudative effusion as per Light’s criteria. Pleural fluid cultures remained negative. Given that pleural effusion was transudative with an elevated glucose level, the diagnosis of sweet hydrothorax was established. Antibiotics were discontinued. The patient was then transitioned to hemodialysis (HD). DISCUSSION: Sweet hydrothorax most commonly occurs on the right as compared to the left side and is more prevalent in women. Mechanisms of this phenomenon include pleuro-peritoneal pressure gradient, congenital diaphragmatic defects and lymphatic drainage disorders (2). Diagnoses involves thoracentesis with pleural fluid analysis revealing a marked elevation of glucose when compared to serum levels. This finding is pathognomonic for sweet hydrothorax. Imaging modalities used for diagnosis involve demonstrating the transfer of radiopaque dye across the diaphragm e.g. peritoneal scintigraphy, CT and MR Peritoneography, or direct visualization with video-assisted thoracoscopic surgery (VATS) (3). CONCLUSIONS: Management involves temporary cessation of CAPD, therapeutic thoracentesis, short dwell periods or dry days. Video-assisted thoracoscopic pleurodesis may be performed for patients who have failed conservative management. Most patients however end up switching permanently to HD. Reference #1: Szeto CC, Chow KM. Pathogenesis and management of hydrothorax complicating peritoneal dialysis. Current Opinion in Pulmonary Medicine. 2004 Jul;10(4):315-319. DOI: 10.1097/01.mcp.0000127901.60693.d0. Reference #2: Chow, K.M., Szeto, C.C. and Li, P.K.-T. (2003), Review Articles: Management Options for Hydrothorax Complicating Peritoneal Dialysis. Seminars in Dialysis, 16: 389-394. doi:10.1046/j.1525-139X.2003.16080.x Reference #3: Sydney Tang, Wing Hung Chui, Anthony W. C. Tang, Fu Keung Li, Wing Shun Chau, Yiu Wing Ho, Tak Mao Chan, Kar Neng Lai, Video-assisted thoracoscopic talc pleurodesis is effective for maintenance of peritoneal dialysis in acute hydrothorax complicating peritoneal dialysis, Nephrology Dialysis Transplantation, Volume 18, Issue 4, April 2003, Pages 804–808, https://doi.org/10.1093/ndt/gfg042 DISCLOSURES: No relevant relationships by Muhammad Hamza, source=Web Response No relevant relationships by Travis Hanson, source=Web Response No relevant relationships by Touba Naim, source=Web Response No relevant relationships by Muhammad Omar, source=Web Response

Lymphatic Anatomy and Physiology.

Lymphatics have long been overshadowed by the remainder of the circulatory system. Historically, lymphatics were difficult to study because of their small and indistinct vessels, colorless fluid contents, and limited effective interventions. However, the past several decades have brought increased funding, advanced imaging technologies, and novel interventional techniques to the field. Understanding the history of lymphatic anatomy and physiology is vital to further realize the role lymphatics play in most major disease pathologies and innovate interventional solutions for them.

Sexual dimorphism in the cerebrospinal fluid total protein content.

Objectives Cerebrospinal fluid (CSF) is a clear, colorless body fluid filling the central nervous system. The determination of the CSF total protein (TP) content represents an important screening test of various pathologies. We aimed to address the effect of sex and age on CSF-TP content and the use of the current upper reference limits (URLs). Methods CSF-TP content was analysed in a selected population of 1,252 patients (648 women and 604 men; age 18-89 years) who underwent lumbar puncture as a part of the diagnostic work-up. Samples presenting (i) more than 5 white blood cells (WBC)/µL, (ii) discolorations and (iii) reduced glucose were not included. Results The CSF-TP content median values were significantly higher in men than in women (46 vs. 37mg/dL) even after adjusting for age and different hospital inpatients. CSF-TP content positively correlated with age both in men and in women with a constant difference between sexes of 8.5mg/dL. Applying the most used URLs (mainly 45 and 50mg/dL, but also 60mg/dL), men received a laboratory report suggestive of altered CSF-TP content more frequently than women. The use of age- and sex-calibrated CSF-TP URLs reduced, but not eliminated, this sex-gap. Conclusions Using the current URLs, a condition of "elevated CSF-TP content" may be overestimated in men or, conversely, underestimated in women, regardless of the age and of the diagnosis. These results highlighted the need to apply CSF-TP URLs values ​​normalized for both sex and age.

Cystic Glioblastoma Rupturing into the Ventricle

Cystic tumors, such as craniopharyngiomas and Rathke’s cleft cysts, as well as arachnoid cysts have been reported to rupture occasionally. Approximately 8–10% of glioblastomas (GBMs) are known to have a significant cystic component; however, to the best of our knowledge, no studies have reported cystic rupturing of GBMs. Here, we describe a unique case of cystic GBM rupturing and penetrating into the cerebral ventricle. A 77-year-old man with a right frontal lobe lesion suspected as GBM with a large cyst was referred to our hospital. At admission, disorientation and left facial weakness were detected. Consciousness disturbance worsened on the 8th day of hospitalization. Computed tomography (CT) revealed prominent shrinkage of the tumor and intratumoral cyst. Signs of meningeal irritation were observed, and chemical meningitis due to cystic tumor rupture and leakage of necrotic components into the ventricle was highly suspected. Surgical resection of the right frontal lobe tumor was performed on the 10th day of hospitalization. During the surgery, clear and colorless cerebrospinal fluid was obtained upon penetration of the tumoral cyst, suggesting traffic of tumor cysts and cerebral ventricle. Adjuvant chemoradiation therapy was initiated postoperatively. Local recurrence was noted at the corpus callosum 7 months postoperatively and was treated with a gamma knife. Further therapy was performed after this recurrence. However, his condition gradually deteriorated 15 months postoperatively, and he was subjected to terminal care. To the best of our knowledge, this is the first report on a cystic GBM rupture.

The Effect of Structural Modification on the Blood Brain Barrier Permeation Properties of Allicin

Allicin is found in nursery onion. Allicin is isolated from garlic (Allium sativum). Nutriceutical allicin is an organice compound gotten from garlic. It is also sourced from onions, and different species in the family Alliaceae. It was first isolated and examined in the research facility by Chester J. Cavallito in 1944. This colourless fluid has a distinctively pungent smell. This compound shows antibacterial and anti-fungal properties. Allicin is additionally the garlic's resistance mechanism against assaults by pests. In this investigation, we considered the impact of the substitution of a terminal methyl group of allicin with hydroxyl group. The 2D structure of Allicin and its analogue were designed by utilizing the ChemAxon programming and spared as mrv files. The mrv file were changed over into SMILES strings utilizing the OpenBabel programming and pharmacokinetic parameters were predicted by using the SwissADME server. Results from the investigation demonstrated that the basic change directed at the terminal methyl group of allicin converted into a non neuroactive compound with no capacity to cross the blood brain barrier.