Exuberant clinical presentation of probable Malassezia folliculitis in a young nonimmunosuppressed patient

Malassezia folliculitis is an inflammatory disorder observed in both immunocompetent and immunosuppressed patients. The authors describe an unusual and exuberant presumed case affecting the face, trunk and upper limbs of a 12-year-old nonimmunosuppressed patient. Although the agent was not identified by culture, the clinical and histopathological aspects plus the response to specific treatment support the diagnosis of Malassezia folliculitis. The only possible predisponent cause observed on the patient was greasy skin. Repetitive cultures were negative. Treatment with itraconazol promoted apparent cure, however, the patient relapsed twelve months later.

Idiopathic pulmonary hemosiderosis with cystic lesions: A rare presentation

This report describes a case of a 49-year-old man with cough, recurrent hemoptysis, and dyspnea during 18 months, presenting with radiological findings of alveolar infiltrate and cystic lesions in left upper lobe. Laboratory studies revealed normocytic hypochromic anemia and normal coagulation tests. C-reactive protein and mucoproteins were negative. Serum protein electrophoresis and complement, urinalysis, serum creatinine, creatinine clearance, and 24-hour urine protein were normal. Tests for antineutrophil cytoplasmic antibodies and anti-glomerular-basement membrane antibodies were negative. Tests for connective tissue diseases were all negative. Histological findings were consistent with those of idiopathic pulmonary hemosiderosis. Radiological findings are discussed.

Clinical presentation and salivary gland histopathology of paediatric primary Sjogren's syndrome

ObjectiveExplore the presentation, diagnostic criteria and exocrine gland histopathology of paediatric primary Sjogren's syndrome (PPSjS).MethodsA case series of 8 children is reported and American-European Consensus Group (AECG-2002) criteria were examined, as well as minor labial salivary and lachrymal gland biopsies, which were scored by a pathologist blinded to outcome. For all cases, connective tissue diseases and parotid-related infectious disease were excluded.ResultsAge at onset varied from 5-13 years old; 6 were females, all followed from diagnosis up to the last visit (1-10 years). The main features at presentation were recurrent tender parotid swelling and sialectasis imaging, with decreased salivary function assessed by Tc-99 scintigraphy. Mild sicca symptoms were observed in 4/8 cases. Systemic features, including fatigue, myalgia, arthritis, tenosynovitis, joint contractures, transient Raynaud's and high ESR, were recorded at onset. Autoantibody profile was unremarkable for diagnosis, while lymphocytic infiltration of labial salivary glands and sialectasis were observed in all biopsies (8/8). In lachrymal glands, massive lymphocytic infiltration and lymphocytic gastritis were observed during complementary assessment. Flares were treated with low dose steroids and long-term use of hydroxychloroquine (5/8), although only 318 fulfilled AECG-2002 diagnostic criteria, throughout the disease course.ConclusionPPSjS is rare, slowly progressive and its early presentation is variable. Standardised diagnostic algorithms should include recurrent parotid swelling and early diagnosis should rely mostly on salivary and lachrymal gland histopathology in this age group.

Clinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patient

Epidermodysplasia verruciformis (EV) is triggered by a variety of mechanisms that at least partly include genetic background. We present a Brazilian man with a 30-year history of flat, wart-like lesions with clinical, histopathological, and evolutive aspects consistent with papillomavirus (HPV)-associated EV. Histological analysis of the wart lesions showed epidermis with hyperkeratosis, regular acanthosis, hypergranulosis, and cells with abundant basophilic cytoplasm. Moreover, a perivascular lymphocytic infiltrate was found in the superficial dermis, consistent with a viral wart. Type-2-HPV DNA was detected in various fragments of skin-wart lesions using the polymerase chain reaction (PCR). Two years after the EV diagnosis, the patient presented with an anesthetic well-demarcated, erythematous and mildly scaly plaque on his right forearm. A histopathological analysis of this lesion demonstrated the presence of a compact tuberculoid granuloma. Ziehl-Neelsen staining demonstrated the presence of rare acid-fast bacilli and confirmed the tuberculoid leprosy diagnosis. The patient's Mitsuda Intradermal Reaction was positive. To elucidate the possible mechanism involved in this case of EV, we genotyped the HLA genes of this patient. DQB genotyping showed the polymorphic HLA alleles DQB1*0301 and 0501. The patient was treated with a paucibacillary multidrug therapy scheme, and the disease was cured in six months. This report describes an EV patient with an M. leprae infection, confirming that tuberculoid leprosy patients possess a relatively specific and efficient cell-mediated immunity against the bacillus and, therefore, localized forms of the disease. Moreover, we show the possible involvement of the polymorphic HLA alleles DQB1*0301 and 0501 in EV induction mechanisms.

The central repeat domain 1 of Kaposi's sarcoma-associated herpesvirus (KSHV) latency associated-nuclear antigen 1 (LANA1) prevents cis MHC class I peptide presentation

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Autoinflammatory diseases: Mimics of Autoimmunity or part of its spectrum? Case presentation

Introduction: Autoinflammatory diseases are very rare diseases presenting within a wide clinical spectrum. Recognition of the main clinical features are challenging due to overlapping or mimicking with autoimmune diseases. Discussion: A case series is reviewed to illustrate typical and atypical features and the difficulties of these diagnoses in the low prevalence areas-a typical unrecognized case of familial Mediterranean fever (FMF) in a youngster, an atypical adult case with overlapping of IMF with Behcet disease, and an early presentation of FMF in infant presenting with inflammatory colitis, as well as the overlapping features within the cryopirin diseases spectrum in an 8-year-old boy who presented with systemic onset arthritis. Conclusion: These cases may represent examples of a very puzzling relationship among disorders of innate and adaptive immune systems and inflammation.

Late presentation of posterior urethral valve: two case reports

CONTEXTO: Válvula de uretra posterior (VUP) é uma conhecida malformação congênita urinária, geralmente diagnosticada em exames ultra-sonográficos pré-natais ou ao nascimento. Raramente, esta doença pode ser encontrada em adolescentes e em adultos. RELATO DE CASOS: Este artigo mostra dois casos de VUP, encontrados em um adolescente e em um adulto. Ambos apresentavam sinais clínicos de infecção do trato urinário e sintomas obstrutivos infravesicais. Os diagnósticos foram realizados por uretrocistografia miccional e uretrocistoscopia. Fulguração endoscópica das válvulas foi o tratamento de escolha para ambos os casos. O acompanhamento demonstrou melhora importante dos sintomas após o tratamento.

Stress Analysis in Simulation Models With or Without Implant Threads Representation

Purpose: This study aimed to evaluate the influence of implants with or without threads representation on the outcome of a two-dimensional finite element (FE) analysis. Materials and Methods: Two-dimensional FE models that reproduced a frontal section of edentulous mandibular posterior bone were constructed using a standard crown/implant/screw system representation. To evaluate the effect of implant threads, two models were created: a model in which the implant threads were accurately simulated (precise model) and a model in which implants with a smooth surface (press-fit implant) were used (simplified model). An evaluation was performed on ANSYS software, in which a load of 133 N was applied at a 30-degree angulation and 2 mm off-axis from the long axis of the implant on the models, The Von Mises stresses were measured. Results: The precise model (1.45 MPa) showed higher maximum stress values than the simplified model (1.2 MPa). Whereas in the cortical bone, the stress values differed by about 36% (292.95 MPa for the precise model and 401.14 MPa for the simplified model), in trabecular bone (19.35 MPa and 20.35 MPa, respectively), the stress distribution and stress values were similar. Stress concentrations occurred around the implant neck and the implant apex. Conclusions: Considering implant and cortical bone analysis, remarkable differences in stress values were found between the models. Although the models showed different absolute stress values, the stress distribution was similar. INT J ORAL MAXILLOFAC IMPLANTS 2009;24:1040-1044

Chemotherapeutic Agents in Noncytotoxic Concentrations Increase Antigen Presentation by Dendritic Cells via an IL-12-Dependent Mechanism

Antineoplastic chemotherapeutic agents may indirectly activate dendritic cells (DCs) by inducing the release of danger signals from dying tumor cells. Whereas the direct cytotoxic or inhibitory effect of conventional chemotherapy on DCs has been reported, modulation of DC function by chemotherapeutic agents in low noncytotoxic concentrations has not yet been investigated. We have tested the effects of different classes of antineoplastic chemotherapeutic agents used in low noncytotoxic concentrations on the Ag-presenting function of DCs. We revealed that paclitaxel, doxorubicin, mitomycin C, and methotrexate up-regulated the ability of DCs to present Ags to Ag-specific T cells. Stimulation of DC function was associated with the up-regulation of expression of Ag-processing machinery components and costimulatory molecules on DCs, as well as increased IL-12p70 expression. However, the ability of DCs treated with paclitaxel, methotrexate, doxorubicin, and vinblastine to increase Ag presentation to Ag-specific T cells was abolished in DCs generated from IL-12 knockout mice, indicating that up-regulation of Ag presentation by DCs is IL-12-dependent and mediated by the autocrine or paracrine mechanisms. At the same time, IL-12 knockout and wild-type DCs demonstrated similar capacity to up-regulate OVA presentation after their pretreatment with low concentrations of mitomycin C and vincristine, suggesting that these agents do not utilize IL-12-mediated pathways in DCs for stimulating Ag presentation. These findings reveal a new mechanism of immunopotentiating activity of chemotherapeutic agents-a direct immunostimulatory effect on DCs (chemomodulation)-and thus provide a strong rationale for further assessment of low-dose chemotherapy given with DC vaccines for cancer treatment. The Journal of Immunology, 2009, 183: 137-144.

Distinct localization of T cell Agrin during antigen presentation - evidence for the expression of Agrin receptor(s) in antigen-presenting cells

Agrin is over-expressed by activated and autoimmune T cells, and synergizes with the T cell receptor (TCR) to augment cell activation. In the present study, we show that Agrin accumulates to distinct areas of the plasma membrane and that cell activation causes its redistribution. During antigen presentation, Agrin primarily accumulates to the periphery of the mature immunological synapse, mostly in lamellipodia-like protrusions that wrap around the antigen-presenting cell and, conversely, anti-Agrin sera induced a significant redistribution of TCR at the plasma membrane. We also provide evidence for the expression of Agrin receptors in peripheral blood monocytes, dendritic cells and a fraction of B cells. Interestingly, interferon-a treatment, which induces the expression of Agrin in T cells, also augmented Agrin binding to monocytes. Stimulation of monocytes with recombinant Agrin induced the clustering of surface receptors, including major histocompatibility complex class II, activation of intracellular signalling cascades, as well as enhanced dsRNA-induced expression of pro-inflammatory cytokines interleukin-6 and tumour necrosis factor-a. Collectively, these results confirm the location of Agrin at the immunological synapse between T cells and antigen-presenting cells and justify further characterization of its receptors in the immune system.

Reações ácido-base: conceito, representação e generalização a partir das energias envolvidas nas transformações

Undergraduate students on the first year of Chemistry Courses are unfamiliar with the representation of acid-base reactions using the ionic equation H+ + OH- → H2O. A chemistry class was proposed about acid-base reactions using theory and experimental evaluation of neutralization heat to discuss the energy involved when water is formed from H+ and OH- ions. The experiment is suggested using different strong acids and strong base pairs. The presentation of the theme within a chemistry class for high school teachers increased the number of individuals that saw the acid-base reaction from this perspective.

CP trajectory diagram - a tool for a pictorial representation of CP and matter effects in neutrino oscillations

We introduce a CP trajectory diagram in bi-probability space as a powerful tool for a pictorial representation of the genuine CP and the matter effects in neutrino oscillations. The existence of correlated ambiguity in the B is uncovered. The principles of tuning the beam energy for a determination of CP-violating phase delta and the sign of Deltam(13)(2) given baseline distance are proposed to resolve the ambiguity and to maximize the CP-odd effect. We finally point out, quite contrary to what is usually believed, that the ambiguity may be resolved with similar to 50% chance in the super-JHF experiment despite its relatively short baseline of 300 km. (C) 2003 Elsevier B.V. B.V. All rights reserved.

Infrared degrees of freedom of Yang-Mills theory in the Schrodinger representation

We set up a new calculational framework for the Yang-Mills vacuum transition amplitude in the Schrodinger representation. After integrating out hard-mode contributions perturbatively and performing a gauge-invariant gradient expansion of the ensuing soft-mode action, a manageable saddle-point expansion for the vacuum overlap can be formulated. In combination with the squeezed approximation to the vacuum wave functional this allows for an essentially analytical treatment of physical amplitudes. Moreover, it leads to the identification of dominant and gauge-invariant classes of gauge field orbits which play the role of gluonic infrared (IR) degrees of freedom. The latter emerge as a diverse set of saddle-point solutions and are represented by unitary matrix fields. We discuss their scale stability, the associated virial theorem and other general properties including topological quantum numbers and action bounds. We then find important saddle-point solutions (most of them solitons) explicitly and examine their physical impact. While some are related to tunneling solutions of the classical Yang-Mills equation, i.e. to instantons and merons, others appear to play unprecedented roles. A remarkable new class of IR degrees of freedom consists of Faddeev-Niemi type link and knot solutions, potentially related to glueballs.

CP and T trajectory diagrams for a unified graphical representation of neutrino oscillations

Recently the CP trajectory diagram was introduced to demonstrate the difference between the intrinsic CP violating effects to those induced by matter for neutrino oscillation. In this Letter we introduce the T trajectory diagram. In these diagrams the probability for a given oscillation process is plotted versus the probability for the CP- or the T-conjugate processes, which forms an ellipse as the CP- or T-violating phase is varied. Since the CP- and the T-conjugate processes are related by CPT symmetry, even in the presence of matter, these two trajectory diagrams are closely related with each other and form a unified description of neutrino oscillations in matter. (C) 2002 Published by Elsevier B.V. B.V.

Husserl on Geometry and Spatial Representation

Husserl left many unpublished drafts explaining (or trying to) his views on spatial representation and geometry, such as, particularly, those collected in the second part of Studien zur Arithmetik und Geometrie (Hua XXI), but no completely articulate work on the subject. In this paper, I put forward an interpretation of what those views might have been. Husserl, I claim, distinguished among different conceptions of space, the space of perception (constituted from sensorial data by intentionally motivated psychic functions), that of physical geometry (or idealized perceptual space), the space of the mathematical science of physical nature (in which science, not only raw perception has a word) and the abstract spaces of mathematics (free creations of the mathematical mind), each of them with its peculiar geometrical structure. Perceptual space is proto-Euclidean and the space of physical geometry Euclidean, but mathematical physics, Husserl allowed, may find it convenient to represent physical space with a non-Euclidean structure. Mathematical spaces, on their turn, can be endowed, he thinks, with any geometry mathematicians may find interesting. Many other related questions are addressed here, in particular those concerning the a priori or a posteriori character of the many geometric features of perceptual space (bearing in mind that there are at least two different notions of a priori in Husserl, which we may call the conceptual and the transcendental a priori). I conclude with an overview of Weyl's ideas on the matter, since his philosophical conceptions are often traceable back to his former master, Husserl.