White Deposits Research Articles

The ad 79 Vesuvius eruption revisited: Plinian and post-Plinian falls

The well-exposed Plinian fall deposit of the ad 79 Vesuvius eruption is herein divided into 12 lithostratigraphic units: seven units in the white pumice deposit and five units in the grey pumice deposit. These distinct units are distinguished by significant variations in grain size and the ratio of lithic to juvenile clasts, enabling us to reconstruct the highly fluctuating dynamics of the eruptive column during the Plinian phase of the ad 79 eruption with previously undetected detail. These characteristics allow their distributions around the vent to be mapped, showing that the plume fluctuated between 14 and 34 km in height, depositing 6.4 km 3 of tephra in 17 h. To broaden the scope of our investigation, we extended our research to encompass five lithic-rich fall layers that occurred after the Plinian phase, providing information on the dispersion and eruptive parameters of these late fallout phases. Post-Plinian sustained column pulses persisted for several tens of minutes, with the first pulse being the longest, lasting for 44 min. This initial pulse possibly facilitated the attempts made by numerous Pompeians to flee the city following the arrival of the first two weak pyroclastic density currents.

Synthesis of silane-modified styrene-acrylic ester emulsion and its inhibition mechanism on whitening of calcium aluminate cement mortar

A new polymer, triethoxyvinylsilane-modified styrene-acrylic ester emulsion (TMSA), was synthesized through emulsion polymerization. The effect of TMSA on the whitening of calcium aluminate cement (CAC) mortar was investigated. The results showed that TMSA had an excellent inhibition effect on the whitening of the CAC mortar with only 0.8 % - 1.6 % addition. Analysis of the micro-morphology and Raman spectra revealed that the white deposits on the surface of the mortar were C4AC(_)H11 and CaCO3, whereas TMSA addition effectively inhibited the formation of C4AC(_)H11 and reduced the occurrence of CaCO3. Through investigating the hydration, Ca2+ concentration, capillary water absorption and pore structure, it was found that the effect of the CAC hydration on the whitening of the mortars was inessential, whereas there was a strong link among whitening, capillary water absorption and macro-capillary pores. The addition of TMSA not only reduced the concentration of Ca2+ which was the source of the whitening, but also reduced the formation of macro-capillary pores in the CAC mortar that led to a significant reduction in the capillary water absorption, thus weakening the mobility of pore solution in the mortar and hindering the migration of Ca2+ to the mortar surface. Based on these two aspects, TMSA effectively inhibited the whitening of the CAC mortar.

A preliminary approach for blooming removal in polyurethane-coated fabrics

Coated fabrics with thermoplastic polyurethane (TPU) are largely found in fashion and design collections in imitation leathers and glossy-look fabrics. Unfortunately, blooming is a common damage in aged TPU, appearing as white crystalline deposits at the surface. These deposits have been generally identified as adipic acid and mainly affect ester-based aromatic TPU. The white colour of adipic acid often leads to the complete unrecognition of the cultural item, highly decreasing its values. Strategies to remove blooming are still absent in the literature, resulting in a lack of action by conservators. The Glossy Surfaces project addressed this issue through preliminary research on cleaning strategies to remove adipic acid. Dry and wet methods were tested on two fabrics showing blooming and different surface cohesion. Non-confined and confined liquids in hydrogels were included and assessed by digital microscopy, colourimetry, and infrared spectroscopy. The best results were achieved with agar-agar, but limitations were also recognized.

Repeat Femtosecond-Assisted Anterior Lamellar Keratoplasty for Recurrence of TGF B I Dystrophy in Eyes After Previous FALK.

To report the management of recurrent TGF BI dystrophy after prior femtosecond-assisted anterior lamellar keratoplasty (FALK) with repeat FALK. Clinical and histopathological study of 2 eyes of 2 patients with a recurrence of TGFBI dystrophy. Patient 1 had Reis-Buckler corneal dystrophy, and patient 2 had granular corneal dystrophy GCD type 1. Patient 1 had FALK 8 years ago, when she was 23 years old. Patient 2 had FALK 7 years ago at the age of 24 years. Slit-lamp examination showed recurrence in the subepithelial layer of the anterior lamellar graft as confluent chalky white granular deposits. Anterior segment optical coherence tomography highlighted the deposits in the subepithelial region of the anterior lamellar graft. The anterior lamellar graft with deposits was removed and replaced with another graft created using femtolaser dissection of a healthy donor. The parameters for femtosecond laser-assisted donor dissection was similar to the size and depth as the previously used donor. The best-corrected visual acuity was restored to 20/30 in patient 1 and 20/25 in patient 2. The histology of the anterior lamellar graft showed eosinophilic deposits between the epithelium and the Bowman layer in both samples. In addition, the corneal sample from patient 2 revealed Bowman layer breach at some places and few deposits at 1 edge of the lamellar graft. Repeat FALK with a healthy donor is effective in the management of recurrence of deposits. The histology of the recurrence in the anterior lamellar graft revealed eosinophilic deposits predominantly between the epithelium and Bowman layer.

Ex Vivo Histological Analysis of Corneas with Manually Implanted Intracorneal Stromal Ring Segments.

Backgrond: Intracorneal ring segments (ICRSs) are utilized to correct refractive changes impacting visual acuity, commonly implanted via femtosecond laser but can also inserted manually. Corneal deposits alongside the ICRS channels are seen commonly. Methods: This study explores the histological characteristics of corneal deposits following manual ICRS implantation, comparing them to previously published articles describing femtosecond laser-assisted cases. Results: This is a retrospective analysis of three cases involving manual ICRS implantation, accumulation of whitish deposits and later explanation of the corneas due to penetrating keratoplasty (PKP). Patient demographics, ocular history, and surgical details were collected. Histological analysis employed Hematoxylin and Eosin (H&E) and Masson's trichrome staining. Whitish deposits along ICRS tracts were observed in all cases, with minimal fibroblastic transformation of keratocytes adjacent to the segments. Comparing these cases of manual to femtosecond laser-assisted ICRS implantation, in most cases, similar deposits were identified, indicating the deposits' association with the stromal tissue reaction to the ring segment and not to the surgical technique. Conclusions: This study contributes insights into the histopathology of manually implanted ICRS, emphasizing the shared nature of deposits in both insertion methods. The findings highlight the link between deposits and the stromal tissue reaction to the ring segment, irrespective of the insertion technique.

Origin and modern microbial ecology of secondary mineral deposits in Lehman Caves, Great Basin National Park, NV, USA.

Lehman Caves is an extensively decorated high desert cave that represents one of the main tourist attractions in Great Basin National Park, Nevada. Although traditionally considered a water table cave, recent studies identified abundant speleogenetic features consistent with a hypogenic and, potentially, sulfuric acid origin. Here, we characterized white mineral deposits in the Gypsum Annex (GA) passage to determine whether these secondary deposits represent biogenic minerals formed during sulfuric acid corrosion and explored microbial communities associated with these and other mineral deposits throughout the cave. Powder X-ray diffraction (pXRD), scanning electron microscopy with electron dispersive spectroscopy (SEM-EDS), and electron microprobe analyses (EPMA) showed that, while most white mineral deposits from the GA contain gypsum, they also contain abundant calcite, silica, and other phases. Gypsum and carbonate-associated sulfate isotopic values of these deposits are variable, with δ34SV-CDT between +9.7‰ and +26.1‰, and do not reflect depleted values typically associated with replacement gypsum formed during sulfuric acid speleogenesis. Petrographic observations show that the sulfates likely co-precipitated with carbonate and SiO2 phases. Taken together, these data suggest that the deposits resulted from later-stage meteoric events and not during an initial episode of sulfuric acid speleogenesis. Most sedimentary and mineral deposits in Lehman Caves have very low microbial biomass, with the exception of select areas along the main tour route that have been impacted by tourist traffic. High-throughput 16S rRNA gene amplicon sequencing showed that microbial communities in GA sediments are distinct from those in other parts of the cave. The microbial communities that inhabit these oligotrophic secondary mineral deposits include OTUs related to known ammonia-oxidizing Nitrosococcales and Thaumarchaeota, as well as common soil taxa such as Acidobacteriota and Proteobacteria. This study reveals microbial and mineralogical diversity in a previously understudied cave and expands our understanding of the geomicrobiology of desert hypogene cave systems.

Don’t shake it! Mechanical stress testing of mRNA-lipid nanoparticles

Shaking stress studies are typically performed during formulation development to test the liability of a drug product towards interfacial stress occurring during transport, especially if a liquid formulation is desired. We evaluated various shaking procedures using a polyA-surrogate solution and verified our findings by eGFP-LNP cell-expression experiments. Shaking on an orbital shaker in vertical and horizontal orientations at increasing speeds from 300 to 600 rpm resulted in decreasing levels of encapsulated nucleic acid content, larger LNP sizes, and decreasing PDI. We report that vertical and horizontal shaking of both polyA- and eGFP-LNPs led to white deposits on the inner glass vial surface, depending on time, rpm, and temperature. Increasing the fill volume/smaller headspace (0.3 versus 0.9 mL fill) did not mitigate this phenomenon in the studied configuration, and the use of hydrophobic primary packaging even accelerated the formation of white deposits. In contrast, we demonstrated that a lyophilized polyA-LNP dosage form was less susceptible to shaking and maintained cake integrity and product properties. Multiple vortexing steps resulted in an increase in LNP size, PDI, and a decrease in encapsulated polyA content. We conclude that shaking experiments of nucleic acid-loaded LNPs in their final configuration at intended transport conditions need to be considered during technical development.

MANAGEMENT OF COATED TONGUE RESEMBLES PSEUDOMEMBRANOUS CANDIDIASIS IN A MULTIDRUG-THERAPY PATIENT

Introduction: Coated tongue or tongue coating is characterized by white deposit covering dorsum of the tongue. The thick-coated tongue almost resembles oral candidiasis. It is challenging to make the diagnosis and provide the proper treatment especially when supporting examination tools are unavailable. Objective: To discuss the diagnosis making and management of coated tongue with suspicion of pseudomembranous candidiasis with a lack of supporting examination tools. Case(s): A 61-year-old man was referred to the Oral Medicine Clinic for oral examination. No complaints of pain in the oral cavity. He had a history of type-2 diabetes mellitus, coronary heart disease (CHD), and pleuritis and was taking medication. During hospitalization, never cleaned his oral cavity. Case Management: Intraorally, white plaque covering almost the entire dorsum of the tongue, which could be scraped off on the anterior 1/3 but not on the posterior 2/3. The diagnosis was suspected coated tongue with oral candidiasis as the differential diagnosis. The treatments were compressing the tongue using gauze soaked in 3% hydrogen peroxide (H2O2) solution, scrapping off using a tongue scraper, then rinsing with water. The thick-coated tongue can be easily removed. He was also given 0,2% chlorhexidine gluconate (CHX) mouthwash as an antiseptic and petroleum jelly for dry lips. The tongue condition improved on 2nd day therapy after rinsing regularly using 0,2% CHX. Conclusion: Recognizing the signs, symptoms, and associated factors of Candida infection is important. Coated tongue which resembles pseudomembranous candidiasis was successfully treated using 3% H2O2 compresses, tongue scraping, and 0.2% CHX mouthwash. Keywords: Chlorhexidine gluconate, Coated tongue, Hydrogen peroxide, Infection, Oral candidiasis

Clinical, phenotypic and genetic characteristics of macula‐sparing stargardt disease

Aims/Purpose: Fundus flavimaculatus and Stargardt's disease are monogenic but heterogeneous disease entities leading to loss of central vision in adolescence, caused by more than 490 mutations in the ABCA4 gene. We herein report the clinical, phenotypic and genetic characteristics of adult onset fovea sparing Stargardt's disease.Methods: Two Caucasian males in their 40s presenting with complaints of paracentral scotomata underwent complete ophthalmic exam, visual field testing, optical coherence tomography (OCT), fundus autofluorescence (FAF), fluorescein angiography (FA), electroretinography (ERG) and genetic testing.Results: Visual acuity was 20/20 in both patients with normal IOP. Anterior segments were unremarkable. Posterior segment examination revealed pigment mottling in the macula with ring‐shaped perifoveal chorioretinal atrophy and numerous white deposits in the mid‐periphery. Visual fields confirmed the paracentral ring scotomata. OCT demonstrated concentric perifoveal loss of outer retinal layers with foveal sparing simulating oedema. Extensive hyperautofluorescence in the area of chorioretinal atrophy was revealed by FAF. Full‐field ERG confirmed incomplete loss of cone bioelectrical activity with preserved morphology of the foveal peak and normal rod function. Genetic testing discovered several pathogenic mutations in both patients with shared ABCA4 c.5603A>T, p.(Asn1868Ile), a risk factor mutation. None of the mutations of our patients were previously reported in foveal sparing Stargardt's disease.Conclusions: The variant ABCA4 c.5603A>T, p.(Asn1868Ile) might be associated with foveal sparing Stargardt's disease. Further population studies are need to confirm this association.

Pathologic Case of Gout Tophi Deposition with a Concurrent Systemic Bacterial Infection in a Leopard Gecko (Eublepharis macularius)

Gout is caused by excessive uric acid in the blood deposited in tissues (visceral gout) or joints (articular gout), leading to severe inflammation and pain. A female leopard gecko was presented to the University Veterinary Hospital, University of Putra, Malaysia, with a history of swelling at the left caudal mandible, inappetence, and weight loss. An oral examination indicated a swollen mouth with scabs on the upper right mandible and multiple whitish deposits inside the mouth. The preliminary diagnosis was mouth rot, and the treatment included metronidazole and a multivitamin supplement. The leopard gecko died 12 days after treatment since there was no improvement. Post-mortem examination revealed that the liver was slightly enlarged with generalized moderate congestion and the presence of whitish deposits, as well as noticeable whitish deposits on the pleural surface of the lungs. Histopathological examination of the lungs revealed a granuloma with an inflammatory reaction predominantly by abundant mononuclear cells and fibrin deposition. An irregular collection of amorphous materials in the visceral pleura suggested gout tophi. The liver was infiltrated with amorphous material and fibrinous tissue, and it had mild congestion, indicating visceral gout and bacterial infection. Klebsiella pneumoniae and Proteus mirabilis were isolated from the lungs and liver samples, respectively. In conclusion, gout tophi is common in reptiles, but visceral involvement is rare, and early detection is critical to avoid secondary bacterial infection, as demonstrated in this case.

Heterogeneity in the progression of retinal pathologies in mice harboring patient mimicking Impg2 mutations.

Biallelic mutations in interphotoreceptor matrix proteoglycan 2 (IMPG2) in humans cause retinitis pigmentosa (RP) with early macular involvement, albeit the disease progression varies widely due to genetic heterogeneity and IMPG2 mutation type. There are currently no treatments for IMPG2-RP. To aid preclinical studies toward eventual treatments, there is a need to better understand the progression of disease pathology in appropriate animal models. Toward this goal, we developed mouse models with patient mimicking homozygous frameshift (T807Ter) or missense (Y250C) Impg2 mutations, as well as mice with a homozygous frameshift mutation (Q244Ter) designed to completely prevent IMPG2 protein expression, and characterized the trajectory of their retinal pathologies across postnatal development until late adulthood. We found that the Impg2T807Ter/T807Ter and Impg2Q244Ter/Q244Ter mice exhibited early onset gliosis, impaired photoreceptor outer segment maintenance, appearance of subretinal deposits near the optic disc, disruption of the outer retina, and neurosensorial detachment, whereas the Impg2Y250C/Y250C mice exhibited minimal retinal pathology. These results demonstrate the importance of mutation type in disease progression in IMPG2-RP and provide a toolkit and preclinical data for advancing therapeutic approaches.

Inhibiting effect of styrene-butadiene copolymer on the whitening of calcium aluminate cement mortar

This paper was based on the results of the research group's previous research on early whitening of mortars. The inhibition of whitening and changes of white deposit on the surface of calcium aluminate cement (CAC) mortar with styrene-butadiene copolymer (SB) were studied using a long-term accelerated whitening method under conditions of (20 ± 2) ℃ and (60 ± 5)% RH. The whitening phenomenon and white deposits of CAC mortars were studied using digital processing of images, optical microscopy (OM) and scanning electron microscopy (SEM). The results indicate that the white deposit on the surface of CAC mortar primarily consists of newly formed carbonation products, calcium carboaluminate hydrate (C4AC¯H11) and calcium carbonate (CaCO3), and with the extension of this exposure time, C4AC¯H11 will be carbonized to generate CaCO3 and Al(OH)3 (AH3). It is interesting to note that SB reduces the production of C4AC¯H11 and CaCO3 and that at SB dosing levels above 12% the C4AC¯H11 disappears and there is hardly whitening of mortar at this time. The inhibition mechanism of SB on the whitening of CAC mortar was investigated using X-ray diffraction (XRD), capillary water absorption and water contact angle tests. The analysis reveals that hydration product of CAC is mainly CAH10 after curing at 20 ℃ for 1 d, and the addition of SB did not change the type of CAC hydration products. Furthermore, incorporating SB enhances the hydrophobicity and reduces the capillary water absorption in CAC mortar, and forms a polymer film in CAC mortar. They prevent the transfer of ions from the interior of CAC mortar to the exterior and the contact of CO2 from the air with the cement hydrate on the surface of CAC mortar, thus reduces the production of white deposit on the mortar surface and inhibits the whitening of CAC mortar.

Fluid Flow, Alteration, and Timing of Cu-Ag Mineralization at the White Pine Sediment-Hosted Copper Deposit, Michigan, USA

Abstract White Pine, located in Michigan’s Upper Peninsula, is an archetypal sediment-hosted stratiform copper deposit. The Midcontinent rift system is one of only seven basins globally that host a giant sediment-hosted stratiform copper deposit. Despite many similarities with other deposits of this type, White Pine displays some important differences, including the late Mesoproterozoic age, a thick basalt sequence, an apparent lack of evaporites, and a lacustrine depositional setting. This study analyzes paleofluid flow related to the formation of White Pine and places a particular emphasis on structural and diagenetic fluid pathways. Most of the ore is located in a 30-m-wide zone spanning the Copper Harbor Formation red beds and the overlying Nonesuch Formation shales. Sedimentation of these units was accompanied by subtle synsedimentary faulting. Premineralization phases include calcite concretions and nodules, illite and hematite grain coatings, isopachous chlorite rims, emplacement of liquid petroleum (now pyrobitumen), and bleaching. Mineralization introduced native copper into the footwall sandstones and a zoned suite of native copper and sulfur-poor copper sulfide minerals across a migrating redox front in the overlying shales where copper minerals nucleated on authigenic and detrital chlorite grains. Postmineralization phases include quartz cement, calcite cement, and calcite veins that partially overlapped inversion of synsedimentary faults. Contrary to previous studies, we identified evidence for only one phase of mineralization. An Re-Os chalcocite age of 1067 ± 11 Ma places mineralization 11 to 17 m.y. after host-rock deposition. Sulfide δ34S values of –14.0 to 29.9‰ suggest an important contribution from sour gas and thermochemical sulfate reduction of seawater. Carbon (δ13C) and oxygen (δ18O) isotope compositions of five calcite generations range from –15.1 to –1.3‰ and 10.4 to 41.3‰, respectively, and record early meteoric pore water displaced by later seawater. White Pine is both a sediment-hosted stratiform copper deposit and a paleo-oil field. Synsedimentary faults controlled the sedimentological character of the upper Copper Harbor Formation, and together these imparted a strong control on fluid flow and later diagenetic processes. Early oxidized meteoric fluids were displaced by liquid petroleum and sour gas, which were in turn succeeded by metal-rich but sulfate-poor oxidized seawater. Burial compaction during deposition of the overlying Freda Formation drove fluids through White Pine due to its situation on a paleotopographic high near the basin margin. Mineralization occurred at ~125°C at depths of ~2.0 km and spanned incipient basin inversion related to the distal effects of Grenvillian orogenesis. The hightenor copper mineral assemblage is the product of an abundant supply of metal from basaltic volcanic detritus in the Copper Harbor Formation and low seawater sulfate concentrations in late Mesoproterozoic oceans. This demonstrates that viable sediment-hosted stratiform copper systems can form when a readily leachable metal source rock is present, even if hypersaline and sulfate-rich brines are not.

Regulation and inhibition of early whitening of calcium aluminate cement/hemihydrate gypsum decorative mortar by polymer emulsion

Whitening of decorative mortar is an important factor hindering its application, which is difficult to mitigate. This paper studied the effect of different polymer emulsions on the early whitening of decorative mortar using calcium aluminate cement (CAC) and hemihydrate gypsum (HH) as cementitious material. The whitening phenomenon and white deposits of CAC/HH decorative mortars were investigated through digital processing of images, optical microscopy (OM), scanning electron microscopy (SEM) and Raman spectroscopy analysis. The results show that the white deposits were mainly ettringite (AFt) and CaCO3, whose quantity and size determined the severity of whitening. The addition of vinyl acetate-ethylene copolymer emulsion (VAE) and poly acrylic ester emulsion (PAE) could inhibit the generation of AFt and reduce the crystal size and amount of CaCO3, thus inhibiting the whitening. In order to reveal the inhibition mechanism of polymer emulsions on the whitening, the effect of polymer emulsions on the cement hydration was studied by hydration heat and X-ray diffraction (XRD), the porosity and capillary water absorption were also tested. It shows that the inhibition of whitening of CAC/HH decorative mortar by polymer emulsions was mainly achieved by reducing the open porosity and capillarity water adsorption, which directly decreased the pathway of the ion transport from the interior to the exterior of the mortar, thereby reducing the generation of the white deposits on the mortar surface and improving the anti-whitening property of CAC/HH decorative mortar.

First report of a nephrite deposit from Somaliland, Africa: Characterization and geological and archaeological implications

Nephrite jade is of wide interest, not only for its value as a highly valued precious stone, but also for its significance in tracing geological and petrological processes. Here, we report the first discovery of a nephrite deposit in Africa, located in Somaliland. Field investigations revealed that two open nephrite pits at Goodieood and Laasmacaane are composed of a series of discontinuous vein-shaped nephrite bodies stretching for ∼2 km and defining a nephrite belt. Dolomitic marble and epidote-amphibole are the major rock types in this nephrite belt. Most of the nephrites show grayish green color, while a few are grayish white to light-grayish green, with an occasional brownish rind mainly in nephrite gravels from the secondary deposits. The nephrite is composed of tremolite and actinolite with minor diopside, pargasite, edenite, and apatite. Most nephrites display fine fiber microstructures, and the tremolite-actinolite aggregates show crystallographic preferred orientation. Parallel to the nephrite bodies, epidote-amphibole rocks appear as a metasomatic dark-colored boundary zone, composed mainly of actinolite-tremolite, epidote, and titanite with minor rutile, pargasite, edenite, diopside, and zircon. The dolomitic marble displays dolomite replacement partially by antigorite. Textural observations suggest a sequence from Na-, Al-, and Fe-rich toward Mg-rich compositions, leading to the possibility of prospecting for white nephrite. The various features suggest that the deposit belongs to a fluorine-bearing Ca-Fe-P fluid-dominant skarn. This deposit is estimated to have more than 1000 tons of nephrite jade reserves and has important significance for the exploration for more economic nephrite deposits in Africa, South America, and even Antarctica, as well as potentially important archaeological implications in establishing a connection between the nephrite jades and materials for the Hargeisan lithic industries, as part of the social development in eastern Africa. Comparison with a typical white nephrite deposit in Saidikulam provides insights into the formation of white and nonwhite nephrites.

Sister Marie Joseph Nodule in a Polypathological Patient: Study of an Observation at the Dermatology Hospital of Bamako (Mali)

Summary: Sister Mary Joseph nodule is a metastatic localization with a generally abdominal-pelvic origin and secondary to a primary adenocarcinoma in 90% of cases. We report an observation of Sister Mary Joseph nodule revealing a primary adenocarcinoma of the colon in a young adult with multiple pathologies. Observation: A 57-year-old patient, followed for hepatitis B, HIV1+, and benefiting from a therapeutic regimen (Tenofovir+Lamivudine+Dolutegravir) since 2019 and later a hyperthyroidism of incidental discovery. For one year he has had a firm nodular ulceration measuring 07 cm in its longest axis, with a reddish-pink appearance and whitish deposits, a haemorrhagic ooze on contact, and located at the umbilicus. Also, a tongue laden with whitish coatings that are easily removed with a tongue depressor and the inner surface of the cheeks and palate are erythematous. Bilateral exophthalmos abolished vocal vibrations in both lung bases; two hard left inguinal adenopathies adhering to the deep plane, painless, 3 cm in diameter each. He also described episodes of alternating constipation and diarrhoea accompanied by abdominal pain, coughing, physical asthenia and weight loss (40% loss in 2 years). Anatomopathology of a fragment of the nodule revealed a well-differentiated adenocarcinoma whose tumour cells were of colorectal origin and expressed CK20 and CK8/18. Colonoscopy revealed a multilobed polyploid tumour of the ascending colon and histology concluded that it was a liberkuhnian adenocarcinoma. A chest CT scan revealed pulmonary and abdominal-pelvic metastases and the diagnosis of a Sister Mary Joseph nodule revealing a colonic and metastatic adenocarcinoma was made. The patient was referred to the oncology department for palliative care after the surgical opinion. Conclusion: The nodule of Sister Marie Joseph is a cutaneous metastasis revealing a cancer of the abdominopelvic sphere. This rare and characteristic tumour deserves to be known by practitioners .......

Pleural Aspergillosis Complicating Chronic Cavitary Pulmonary Aspergillosis in a Tuberculosis Sequel: About One Case

Introduction: Pleural aspergillosis is a rare pathology; it is defined by an infection of the pleural cavity by an opportunistic fungus of the genus Aspergillus. Observation: We report the case of a 24-year-old female patient treated for pulmonary tuberculosis complicated by a left pyopneumothorax drained for 5 months. The reason for consultation 3 months after stopping the antibacillary treatment was a purulent bronchial syndrome, left chest pain with a tingling sensation and exertional dyspnea. Clinical examination revealed an aerated effusion syndrome in the left hemithorax. Chest imaging showed a left pneumothorax with thickening of the visceral pleura and a left upper lobar alveolar focus with clearing within it. Aspergillus serology was positive. The patient had undergone video-assisted thoracoscopy, which revealed the presence of false membranes and whitish deposits of mycotic appearance. The biopsy of the pseudomembranes was in favor of pleural aspergillosis. The patient was put under antifungal treatment for 6 months with a good clinical and radiological evolution. Conclusion: Aspergillus is a mycelial fungus formed by filaments that penetrate the airways by inhalation of its spores. Pleural localizations are rare. Sequelae of tuberculosis, broncho pleural fistulas, pleural drainage and pulmonary resection are considered the main conditions predisposing to infection of the pleural space by aspergillus. The diagnosis is confirmed by pleural fluid culture or pleural biopsy.

Pseudoexfoliation syndrome in a patient with subluxation of the lens secondary to homocystinuria

This article aims to comprehensively describe a particular case of bilateral intraocular subluxated lens with pseudoexfoliation syndrome in a Moroccan woman with homocystinuria. We report a case of a 56-year-old patient who has a cataractous subluxated lens along with whitish deposits. The association of PEX syndrome with hyperhomocysteinemia has rarely been found. It worsens the lenses' zonular stability and causes multiple complications.

Clinical and Dermoscopic Features of Winer's Nodular Solitary Calcinosis

Aims: Solitary nodular calcinosis of Winer is a rare and benign form of localized idiopathic cutaneous calcinosis. Its dermoscopic features may be useful for early diagnosis, but have never been described in the literature to our knowledge.
 Case Report: A 5-year-old child presented to our clinic with a 2 years history of a painless keratotic and warty nodule located in the helix of the right ear. A wart was suspected and treated without any improvement. Dermoscopy was performed and showed peripheral white deposits suggestive of Winer's calcinosis, motivating an excision whose histological examination confirmed the diagnosis.
 Discussion: The subepidermal calcified nodule has been rarely described in the literature. It is not known to be associated with a disorder of phosphocalcium metabolism or other systemic diseases. Pathogenic hypotheses include calcification of preexisting skin structures, mast cell degranulation with secondary calcinosis, or prior trauma. Surgical excision with histopathological confirmation is necessary to show the dermal calcium deposits, which are usually amorphous and granular and may be surrounded by a lymphohistiocytic infiltrate or giant cells. Nevertheless, dermatoscopic evaluation can aid in rendering a timely diagnosis by showing these whitish dermal deposits.
 Conclusion: The diagnosis of Winer's nodular calcinosis has always been based on histology, but the dermoscopy described here for the first time is so suggestive that it can be used to save time and exclude other differential diagnoses.

Two Cases of Paraproteinemic Keratopathy

Purpose: To report two cases of paraproteinemic keratopathy (PK).Case summary: A 57-year-old man visited the ophthalmology clinic complaining of decreased visual acuity since 1 year earlier. White crystalline deposits were observed on both corneas and the best corrected visual acuity (BCVA) of both eyes was 1.0. After 3 months, the BCVA decreased to 0.8 in the right and 0.6 in the left. Increased corneal deposits were observed. To rule out PK, his medical records were checked. The patient had been diagnosed with lymphoplasmacytic lymphoma 3 years earlier. Diagnosing PK, the patient was referred back to the Hemato-Oncology department. After 3 months of chemotherapy, the corneal deposits decreased and BCVA returned to 1.0. A 69-year-old woman presented complaining of decreased visual acuity for 2 years. The uncorrected visual acuity (UCVA) was 0.4 in the right and finger count at 30 cm in the left. Brown deposits were observed on both corneas and lenses. The serum copper level was elevated. She was referred to the internal medicine department and diagnosed with multiple myeloma. After treatment, the laboratory results returned to normal, but the UCVA decreased to hand motion in the left. A left white cataract was noted and cataract surgery was performed. 1 month postoperatively, the BCVA was 0.9, with no change in the corneal deposits.Conclusions: When there are corneal deposits, we should consider PK in the differential diagnosis. In such cases, systemic treatment is the first line. Therefore, diagnosing and referring PK patients to the internal medicine department is crucial.