A 34-year-old woman presented with a 3-month history of right-sided headaches associated with photophobia and pulsatile tinnitus. Investigations including lumbar puncture revealed elevated opening CSF pressure, increased protein, and presence of monocytosis consistent with an inflammatory/infective process. Brain MRI showed an area of thickened enhancing dura around the venous sinus posteriorly. 67Ga scintigraphy demonstrated focal intracranial uptake in the posterior occipital region, and biopsy confirmed a chronic inflammatory infiltrate with no granulomas. Received for publication September 27, 2018; revision accepted December 24, 2018. Conflicts of interest and sources of funding: none declared. Correspondence to: Robert Mansberg, MBBS, FRACP, FAANMS, Department of Nuclear Medicine, Concord Hospital, Concord, 2139 New South Wales, Australia. E-mail: mansberg@usyd.edu.au. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Τετάρτη 13 Φεβρουαρίου 2019
A Case of Radioactive Iodine Uptake Found in Artificial Eye
Radioactive iodine (RAI) therapy is widely used as an adjunctive treatment in patients with differentiated thyroid cancer. Although 131I has high avidity in the functioning thyroid, and in differentiated thyroid cancer lesions, physiological and nonspecific uptake of 131I in healthy or benign tissue may contribute to false-positive findings on an 131I scan. Here, we present an interesting image of RAI uptake in the eye region post-RAI treatment, which has been identified as tear contamination in the artificial eye. Received for publication October 24, 2018; revision accepted December 25, 2018. Conflicts of interest and sources of funding: none declared. Correspondence to: Young-Sil An, MD, PhD, Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University, 206, World Cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, Suwon 16499, South Korea. E-mail: aysays77@naver.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Multifocal Small Bowel Carcinoid: Evaluation by 68Ga-DOTATATE PET
Carcinoid is a subtype of neuroendocrine tumor, a rare group of tumors that are known to express somatostatin receptor 2. 68Ga-DOTATATE is a somatostatin analog that is specific for somatostatin receptor 2 and therefore allows visualization of neuroendocrine tumors. We present 2 cases of primary multifocal small bowel carcinoid evaluated using 68Ga-DOTATATE PET/CT, along with contrast-enhanced CT corollary findings. Given the increased sensitivity of 68Ga-DOTATATE PET/CT compared with CT and 111In-octreotide scintigraphy, we expect multifocal carcinoid to become increasingly recognized. Received for publication November 21, 2018; revision accepted December 26, 2018. Conflicts of interest and sources of funding: none declared. Correspondence to: Stephen Broski, MD, Department of Radiology, Division of Nuclear Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail: Broski.Stephen@mayo.edu. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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A Case of Intramuscular Cryptococcosis Mimicking a Malignant Tumor on FDG PET/CT
Intramuscular cryptococcosis is extremely rare. In this case, a 76-year-old man with history of acute myeloid leukemia presented a painful mass in the right upper arm. FDG PET/CT demonstrated a low-density irregular-shaped mass in the triceps muscle of the right upper arm with adjacent bone erosion. The lesion presented with significantly increased activity with an SUVmax of 23.4, which could be misdiagnosed as a malignant tumor. The lesion was confirmed as cryptococcosis by periodic acid–Schiff stain and culture of biopsied specimen. Because cryptococcal infection is treatable, it is important to increase awareness of this hypermetabolic benign lesion in the unusual location. Received for publication November 26, 2018; revision accepted December 20, 2018. Conflicts of interest and sources of funding: none declared. Correspondence to: Kun Tang, MD, The First Affiliated Hospital of Wenzhou Medical University, Xuefu North Road, Wenzhou, Zhejiang, 325000, People's Republic of China. E-mail: kuntang007@163.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Meningeal Metastasis Relapse With Focal Involvement of Cranial Bone Flap: A Case Resolved by 18F-DOPA PET/MRI
A 63-year-old woman was referred to our PET/MRI platform to evaluate the possible relapse of a meningeal metastasis, complicating an invasive ductal carcinoma of the left breast. This metastasis was diagnosed on a left hemiparesis and treated by surgery and radiation therapy. One year later, the same symptoms led to another brain MRI examination that found a contrast-enhanced lesion in the operating site. We decided to perform a 18F-DOPA PET/MRI to document this lesion, which confirmed the diagnosis of a probable relapse and revealed a focal uptake on the bone flap. Received for publication December 3, 2018; revision accepted December 18, 2018. Conflicts of interest and sources of funding: none declared. Correspondence to: Nicolas Louarn, MD, SyMPTOm PET/MRI Platform, Nuclear Medicine Department, Henri Mondor University Hospital, AP-HP, 51 Ave, du Maréchal de Lattre de Tassigny, 94000 Créteil, France. E-mail: n.louarn@gmail.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Concurrent Pancreatic Metastasis From Lung Adenocarcinoma and Primary Cholangiocarcinoma on FDG PET/CT Imaging
A 67-year-old man with a history of left upper lobe resection of poorly differentiated adenocarcinoma 1 year ago underwent FDG PET/CT for restaging. The images demonstrated a round cystic lesion with peripheral FDG uptake and centrally photopenic region. Additional focus of increased activity was detected in the left lobe of the liver. The patient underwent the Whipple and partial hepatectomy. The surgical pathology demonstrated concurrently the metastasis to the pancreas from the lung adenocarcinoma and a primary moderately differentiated cholangiocarcinoma. Received for publication December 19, 2018; revision accepted December 31, 2018. Conflicts of interest and sources of funding: Jigang Yang was supported by National Natural Science Foundation of China (no. 81771860) and National Key Research and Development Plan (no. 2017YFC0114003). None declared to all other authors. Correspondence to: Jigang Yang, MD, PhD, Department of Nuclear Medicine, Beijing Friendship Hospital of Capital Medical University, 95 Yong An Rd, Xi Cheng District, Beijing 100050, China. E-mail: 13681221974@163.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Novel Functional Renal PET Imaging With 18F-FDS in Human Subjects
The novel PET probe 2-deoxy-2-18F-fluoro-D-sorbitol (18F-FDS) has demonstrated favorable renal kinetics in animals. We aimed to elucidate its imaging properties in 2 human volunteers. 18F-FDS was produced by a simple 1-step reduction from 18F-FDG. On dynamic renal PET, the cortex was delineated and activity gradually transited in the parenchyma, followed by radiotracer excretion. No adverse effects were reported. Given the higher spatiotemporal resolution of PET relative to conventional scintigraphy, 18F-FDS PET offers a more thorough evaluation of human renal kinetics. Due to its simple production from 18F-FDG, 18F-FDS is virtually available at any PET facility with radiochemistry infrastructure. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Received for publication November 27, 2018; revision accepted December 31, 2018. Conflicts of interest and sources of funding: This work was supported by the Competence Network of Heart Failure funded by the Integrated Research and Treatment Center of the Federal Ministry of Education and Research, NIH R01-HL131829, and German Research Council (DFG grant HI 1789/3-3). This project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement no. 701983. None declared to all authors. Correspondence to: Takahiro Higuchi, MD, PhD, Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacherstr. 6, 97080 Würzburg, Germany. E-mail: thiguchi@me.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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99mTc-LLEC Renal Dynamic Scan in a Patient With Pelvic Neuroblastoma
A 5-month-old boy with ultrasonography showing bilateral hydronephrosis, referred for renal scan. On 99mTc-L,L,ethylenedicysteine (99mTc-LLEC) renal scan, tracer blush in flow images in the region of urinary bladder was seen and tumor mass was suspected. Contrast-enhanced CT showed a soft tissue mass in sacrococcygeal region. Histopathological examination of biopsy tissue revealed malignant round cell tumor and immunohistochemistry consistent with neuroblastoma. 131I-MIBG scan revealed uptake in the pelvic mass with no distant metastasis. Received for publication November 11, 2018; revision accepted December 30, 2018. Conflicts of interest and sources of funding: none declared. Correspondence to: Konudula Sreenivasa Reddy, MD, Department of Nuclear Medicine, AIIMS, Room 902, Hostel 18, Masjid Moth Campus, New Delhi, India. E-mail: drksrjipmer@gmail.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Inflammatory Activity of Tumoral Calcinosis in a Patient With Fever of Unknown Origin
Unexpected inflammatory activity of tumoral calcinosis periarticular to the shoulders and hips in a man with recurrent fever of unknown origin and dialysis-dependent kidney insufficiency was revealed by FDG PET/CT. In absence of other pathologies, the calcinosis was deemed to be the cause of the fever. An infectious or malignant disease could be ruled out, so further therapeutic steps were enabled. Received for publication August 9, 2018; revision accepted January 2, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Martin Freesmeyer, MD, Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany. E-mail: martin.freesmeyer@med.uni-jena.de. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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18F-Choline PET/CT Imaging for Intracranial Hemangiopericytoma Recurrence
We report the case of a 50-year-old man, with previous history of grade 3 intracranial hemangiopericytoma with initial complete surgical resection, addressed for local recurrence. Surgical revision performed 18 months after initial surgery allowed only partial resection, leaving residual disease along the optic nerve. Complementary radiotherapy with proton was decided. 18F-FDG PET/CT and 18F-choline PET/CT were both performed for treatment planning. 18F-FDG PET showed no uptake of the residual tumor, whereas 18F-choline depicted highly metabolic residual disease uptake with excellent delineation of local recurrence. 18F-choline PET/CT appears as a useful PET tracer for hemagiopericytoma imaging. Received for publication October 24, 2018; revision accepted January 2, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Nina Jehanno, MD, Institut Curie, 26 Rue d'Ulm, 75005 Paris, France. E-mail: nina.jehanno@curie.fr. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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An Isolated Osseous Rosai-Dorfman Disease Shown on FDG PET/CT
Rosai-Dorfman disease is typically presented as lymphadenopathy, especially in the neck. Extranodal diseases also frequently occur but are generally concurrent with nodal disease. We report FDG PET/CT findings of solitary femoral Rosai-Dorfman disease without any lymphadenopathy in a pediatric patient. Received for publication January 3, 2019; revision accepted January 7, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Hongming Zhuang, MD, PhD, FACNM, Department of Radiology, Children's Hospital of Philadelphia, 34th & Civic Ctr Blvd, Philadelphia, PA 19104. E-mail: zhuang@email.chop.edu. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Hyperfunctioning Papillary Microcarcinoma Diagnosed by 124I PET/Ultrasound Fusion Imaging
A 49-year-old woman presented with a multinodular goiter, causing local symptoms and hyperthyroisdism. Besides a hypofunctioning benign nodule (TIRADS 3, benign in FNAC), the conventional diagnostic revealed another small hyperfunctioning nodule with suspicious ultrasound features (TIRADS 4C). To rule out a trapping-only nodule and topographical misalignments, a 124I PET/ultrasound fusion was performed and confirmed elevated iodine uptake within the suspicious nodule. Further disseminated autonomous areas are suspected to be additionally responsible for the low TSH-level. Because of the local cervical symptoms and the hyperthyroidism, the patient underwent surgery. The small hyperfunctioning nodule turned out to be a classic papillary microcarcinoma. Received for publication October 18, 2018; revision accepted January 10, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Martin Freesmeyer, MD, Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany. E-mail: martin.freesmeyer@med.uni-jena.de. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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18F-FDG PET/CT Demonstrates Renal Cell Cancer in a Transplant With Synchronous Intestinal Infection
We present a case of a 22-year-old man with history of allogenic renal transplantation on immunosuppression, who underwent 18F-FDG-PET/CT to characterize a lesion in the transplanted kidney on ultrasonogram and contrast-enhanced computed tomography imaging. PET/CT revealed FDG avid lesion in the transplanted kidney and mural thickening involving the distal ileum, ileocecal junction, and ileocolic lymph nodes. Subsequent histopathological examination from the renal lesion revealed renal cell carcinoma in the transplanted kidney. Additionally, endoscopic biopsy from the ileal thickening revealed granulomatous inflammation, suggesting tuberculosis, which was missed on both ultrasonogram and contrast-enhanced CT imaging. Received for publication August 25, 2018; revision accepted December 24, 2018. Conflicts of interest and sources of funding: none declared. Correspondence to: Bhagwant Rai Mittal, MD, Department of Nuclear Medicine and PET, Post Graduate Institute of Medical Education and Research, Chandigarh-160012, India. E-mail: brmittal@yahoo.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Effects of pH and bicarbonate on the nutrient status and growth of three Lupinus species
Abstract
Aims
High pH, and high bicarbonate (HCO3−) and calcium (Ca) availability characterise calcareous soils. High [Ca] only partially explains why some Lupinus species are calcifuge, so we explored high [HCO3−] and high pH.
Methods
We grew six Lupinus genotypes in hydroponics with pH 5, 6.5 and 8a (adjusted by KOH), and 8b (adjusted by KHCO3). Leaf symptoms and areas, root appearance and biomass were recorded; whole leaf and root nutrient concentrations, and leaf cellular phosphorus (P), Ca and potassium (K) concentrations were determined using elemental X-ray microanalysis.
Results
Chlorosis was observed in young leaves at high pH for L. angustifolius and L. cosentinii, and P deficiency at high pH for all genotypes. High pH decreased iron (Fe) and zinc (Zn) uptake in all genotypes. It also decreased lateral root growth, the uptake of P, K, Ca, and manganese (Mn) by all sensitive species; and translocation of P, Fe, Zn, Mn, and Ca to leaves in most sensitive species. However, leaf [Ca], leaf [K], [K] within each measured cell type, and translocation of K and Ca to leaves of L. pilosus and L. cosentinii at pH 8 were greater than at pH 5 and 6.5. Compared with pH 8a, all L. angustifolius genotypes translocated more P, Fe, Zn, Mn and K from roots to leaves at pH 8b. High pH did not affect the leaf cell types that accumulated P and Ca, but decreased the leaf cellular [P].
Conclusions
Lupinus angustifolius and L. cosentinii were sensitive to high [HCO3−] and/or high pH; L. pilosus was relatively tolerant. High pH decreased lateral root growth and nutrient uptake, inhibiting growth of sensitive species. High [HCO3−] diminished the negative effect of pH 8 on nutrient translocation to leaves in most L. angustifolius genotypes. This knowledge provides critical insights into the habits of Lupinus species to guide breeding of calcicole plants.
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Waterlogging tolerance of Bidens pilosa translates to increased competitiveness compared to native Bidens biternata
Abstract
Background and aims
Waterlogging is a common natural disturbance that has negative impacts on dry-land plant species. However, few studies have focused on how waterlogging influences the invasiveness of non-native plant species on dry lands. Bidens pilosa is an invasive dry-land plant of the Asteraceae family that causes serious damage to biodiversity and agricultural production in southern China. To date, it remains unclear how waterlogging affects the competitiveness and growth of B. pilosa. The goal of this study is to determine whether waterlogging promotes the competitiveness of invasive B. pilosa.
Methods
The growth and physiological responses of invasive B. pilosa and native B. biternata and the competition effects between them were studied after 0 (control), 5, 10, 15, and 20 days of waterlogging stress (wherein the water level was maintained at the soil surface level).
Results
After short-term waterlogging stress, the competitive balance index of invasive B. pilosa significantly increased, indicating that short-term waterlogging on dry lands could significantly improve the competitiveness of invasive B. pilosa. Invasive B. pilosa maintained more rapid adventitious root generating capacity and higher root dehydrogenase activity under waterlogging conditions than native B. biternata, which allowed B. pilosa to adapt to the anoxic conditions much more rapidly. The smaller reductions in net photosynthetic rate, actual quantum yield of photosystem II and relative growth rate in B. pilosa than in B. biternata showed that invasive B. pilosa had stronger tolerance to waterlogging than native B. biternata.
Conclusion
Our results indicate that invasive B. pilosa has stronger tolerance to waterlogging than native B. biternata and that short-term waterlogging on dry lands can significantly improve the competitiveness of invasive B. pilosa. Short-term waterlogging on dry lands caused by extreme precipitation during the rainy season is expected to promote the invasive potential of exotic B. pilosa.
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Overexpression of OsLea14-A improves the tolerance of rice and increases Hg accumulation under diverse stresses
Abstract
The group 5 LEA (late embryogenesis abundant) proteins are an atypical LEA protein group, which is associated with resistance to multiple stresses. In this study, OsLea14-A gene was isolated from Oryza sativa L., which encodes a 5C LEA protein with 151 amino acids. The qPCR analysis showed that OsLea14-A expressed in all tissues and organs at all times. The expression of OsLea14-A in the panicles of plumping stage were dramatically increased. The heterologous expression of OsLea14-A in Escherichia coli improved its growth performance under salinity, desiccation, high temperature, and freeze-thaw stresses. The purified OsLea14-A protein can protect LDH activity from freeze-thaw-, heat-, and desiccation-induced inactivation. The overexpression of OsLea14-A in rice improved tolerance to dehydration, high salinity, CuSO4, and HgCl2, but excluding K2Cr2O7. The analysis of metal contents showed that the accumulation of OsLea14-A protein in transgenic rice could increase the accumulation of Hg, but could not increase the accumulation of Na, Cr, and Cu after HgCl2, NaCl, K2Cr2O7, and CuSO4 treatment, respectively. These results suggested that OsLea14-A conferred multiple stress tolerance and Hg accumulation, which made it a possible gene in genetic improvement for plants to acclimatize itself to multiple stresses and remediate Hg-contaminated soil.
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Long-term responses of Scots pine ( Pinus sylvestris L.) and European beech ( Fagus sylvatica L.) to the contamination of light soils with diesel oil
Abstract
Research into trees plays a very important role in evaluations of soil contamination with diesel oil. Trees are ideal for reclaiming contaminated soils because their large biomass renders them more resistant to higher concentrations of pollutants. In the literature, there is a general scarcity of long-term studies performed on trees, in particular European beeches. The aim of this study was to evaluate the responses of Scots pines and European beeches grown for 8 years on soil contaminated with diesel oil. Selected morphological and physiological parameters of trees were analyzed. The biomass yield of Scots pines was not significantly correlated with increasing concentrations of diesel oil, but it was more than 700% higher than in European beeches. Scots pines were taller and had a larger stem diameter than European beeches during the 8-year study. The diameter of trees grown on the most contaminated soil was reduced 1.5-fold in Scots pines and more than twofold in European beeches. The length of Scots pine needles from the most contaminated treatment decreased by 50% relative to control needles. The shortest needles were heaviest. The fluctuating asymmetry (FA) of needle length was highest in Scots pines grown on the most contaminated soil, whereas the reverse was noted in the FA of needle weight. Diesel oil decreased the concentrations of chlorophylls a and b, total chlorophyll, and carotenoids. The Fv/Fm ratio of needles and leaves was influenced by the tested concentrations of diesel oil. The results of the study indicate that the Scots pine better adapts (grows more rapidly and produces higher biomass) to long-term soil contamination with diesel oil than the European beech. In European beeches, growth inhibition and leaf discoloration (a decrease in chlorophyll content) were observed already after the first year of the experiment, which indicates that 1-year-old seedlings of European beech are robust bioindicators of soil contamination with diesel oil.
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Assessment of Euro 5 diesel vehicle NOx emissions by laboratory and track testing
Abstract
The Volkswagen scandal has promoted experimental campaigns worldwide aimed to assess the real exhaust emissions of in-use vehicles. Attention has been paid to diesel vehicle NOx emissions that are much higher than legislative type-approval limits. This paper analysed exhaust emissions of a fleet of ten Euro 5 diesel vehicles. NOx emissions were measured during laboratory and track testing. In both cases, the type-approval test was carried out with cold and warm starts. Moreover, in the laboratory, a modified type-approval test and a real urban driving cycle were executed in order to characterise emissions in multiple operating conditions, outside of the homologation boundaries. The testing environment did not influence the emissions behaviour of the tested vehicles. Track and laboratory results, in fact, were comparable when ambient conditions were comparable. The parameter which played the main role in terms of NOx emissions is the ambient temperature, fixed at 23 °C in laboratory and not controlled on the track. Above 28 °C, NOx emissions were much higher than the approval limit (almost 600 mg/km). Moreover, warm driving cycles always introduced higher NOx emissions than cold ones, because of the partial use and/or deactivation of the EGR circuit (one of effective measures to reduce NOx formation). The ratio between warm and cold emissions ranged from 2 to 5. The engine parameter which helped explain the relationship between NOx emissions and thermal engine status was the intake air temperature. For intake air temperatures below 40 °C, NOx emissions were lower than 0.2 g/km. Above 40 °C, they suddenly increased up to almost 0.6 g/km. Another issue highlighted by the experimental results was that dynamic real driving caused the highest NOx emissions (almost 1 g/km).
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Endocrinology's best articles of 2018 : Adipose tissue in control of metabolism by Liping Luo and Meilian Liu. Microvesicles and exosomes: new players in metabolic and cardiovascular disease by Charlotte Lawson et al. Insulin resistance and sarcopenia: mechanistic links between common co-morbidities by Mark E Cleasby, Pauline M Jamieson and Philip J Atherton. , Current understanding of metformin effect on the control of hyperglycemia in diabetes by Hongying An and Ling He. , Plasma steroid-binding proteins: primary gatekeepers of steroid hormone action by Geoffrey L Hammond. , Thyroid hormones induce browning of white fat by Noelia Martínez-Sánchez et al. , Sodium butyrate activates NRF2 to ameliorate diabetic nephropathy possibly via inhibition of HDAC by Wenpeng Dong et al. , Leptin stimulates bone formation in ob/ob mice at doses having minimal impact on energy metabolism Kenneth A Philbrick et al. , IGFBP-4 regulates adult skeletal growth in a sex-specific manner b
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Medical Trichology : Trigeminal trophic syndrome simulating pityriasis amiantacea,Nerve sheath myxoma of scalp,Woolly hair nevus type 2,Trichodynia silenced effectively with propranolol,Serum interleukin-15 is a marker of alopecia areata severity,Tubular hair casts in trichoscopy of hair and scalp disorders,Research on the balance of thiol-disulfide in blood serum in women with telogen effluvium,Light microscopic morphology of hair from scalp, eyebrow, axilla, and pubic regions
| COMMENTARY | ||
| Autistic-undisciplined thinking in the practice of medical trichology | p. 1 | |
| Ralph Michel Trueb, Hudson Dutra, Maria Fernanda Reis Gavazzoni Dias DOI:10.4103/ijt.ijt_79_18 Medical trichology is the branch of dermatology that deals with the scientific study of the hair and scalp in health and disease. As any discipline, the practice of medical trichology is not immune to malpractice, either deliberately or carelessly. In his publication "Autistic Undisciplined Thinking in Medicine and How to Overcome It," Swiss psychiatrist Eugen Bleuler describes yet another form of malpractice in medicine reflecting autistic-undisciplined thinking. Autism is not limited to psychopathology, but inherent to the thinking of man throughout history in his drive for knowledge, with thousands of theories lacking any basis in reality. Bleuler recognized the drive character of autistic thinking and how it leads to conclusions that are unshakable because they are determined by, and fulfill, emotional needs, rather than rational argumentation. Even with correct questions, the complexity and incalculability of some problems are often so great that it cannot do justice to realistic thinking and the boundaries between inadequately substantiated hypothesis and autistic sham explanation disappear. Statistics, careful research design, and the attempt to impose stringent methods on our thinking are to be commended. The habituation of the public to useless medicine, to misconceptions, is not hygiene, but negligent endangerment. It has created an industry that largely lives on the autistic thinking of patients and doctors and because it is prosperous, makes propaganda among lay people as well as among doctors that necessarily leads to abuses. This article aims at exposing the most prevalent among abuses in trichological practice due to autistic-undisciplined thinking, specifically: iron supplementation, antiandrogenic treatment, and individualized cell-based therapy in female androgenetic alopecia, treatment of folliculitis decalvans with retinoids, and the value of nutritional therapies. | ||
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| ORIGINAL ARTICLES |  | |
  | Light microscopic morphology of indigenous Ghanaian African hair from scalp, eyebrow, axilla, and pubic regions | p. 8 |
| Yusra Kalmoni, Frederick Kwaku Addai, Saviour Kweku Adjenti, Kevin Kofi Adutwum-Ofosu, John Ahenkorah, Bismarck Afedo Hottor, Richard Michael Blay DOI:10.4103/ijt.ijt_70_18 Context: Relatively scanty literature on autochthonic African Negroid hair morphology provokes research interest for anthropological, forensic, and cosmetic purposes. Aims: This study aimed to contribute basic morphological information on Ghanaian African hairs. Settings and Design: The study was done in selected second-cycle schools in Accra, Ghana, using convenient sampling. Subjects and Methods: Hairs were obtained by pluck method, from 30 males and 30 females aged 15–20 years. Ghanaian African autochthony was established if individuals had two generations of indigenous Ghanaian parentage. Scalp, eyebrow, axilla, and pubic hairs were image captured using a digital light microscope eyepiece connected to a computer. Diameters of hair strands were measured; types of the medulla and the form and shape of the hair roots were studied. Statistical Analysis Used: ANOVA test (SPSS Version 17.0) was used to compare the means of quantitative hair features among the sexes and the four regions of the body studied. Results: Pubic hair shaft was thickest (respective male and female diameters were 100.21 μm, 88.40 μm) and eyebrow hair was thinnest (53.97 and 46.69-μm diameters in males and females, respectively). Axillary and scalp hairs were the closest in diameters with 76.21 and 72.02 μm, respectively, in males and 73.07 and 71.15 μm, respectively, in females. Continuous type medulla was predominant in all hairs, with a trend of percentage occurrence in descending order from the pubic, axilla, eyebrow, and scalp in both sexes. Conclusions: Bodily regional differences in diameter of hair shaft and medullary presence were affirmed. | ||
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 | Tubular hair casts in trichoscopy of hair and scalp disorders | p. 14 |
| Mahesh Mathur, Prakash Acharya, Alina Karki, Jyoti Shah, Nisha Kc DOI:10.4103/ijt.ijt_77_18 Introduction: Hair casts have been reported in a variety of hair and scalp disorders. Trichoscopy allows a quick and noninvasive method for the evaluation of hair and scalp disorders in high magnification. However, the study of hair casts seen in trichoscopy is lacking. Objective: The main objective is to study the occurrence and patterns of tubular hair cast (THC) in different hair and scalp disorders. Patients and Methods: The patients with hair and scalp disorders presenting at the dermatology department of our hospital were evaluated using trichoscopy. Cases of primary parakeratotic disorders and behavioral disorders were excluded. After a detailed history and evaluation of the hair and scalp, histopathology, light microscopic examination, potassium hydroxide examination, and fungal culture were done when necessary. Results: THC was seen in total 21 cases of seven different hair and scalp disorders. Of these, the majority of cases were of discoid lupus erythematosus (DLE) (5/21) and maximum frequency of THCs within a disorder was seen in cases of pemphigus foliaceus (PF) (50%). Proximal casts occurred in 90.47% of cases. Single cast involving two shafts was seen in a case of PF, and two casts within a single shaft were seen in two cases of DLE and one case of alopecia areata. Conclusions: THCs in trichoscopy can be seen in various hair and scalp disorders and their study may help during the diagnosis of those disorders when combined with other trichoscopic features. | ||
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| Research on the balance of thiol-disulfide in blood serum in women with telogen effluvium | p. 20 | |
| Ayşe Akbas, Fadime Kılınç, Sertaç Sener, Akta Akınş, Cemile Bıçer, Orhan Şen DOI:10.4103/ijt.ijt_78_17 Backgrounds: Telogen effluvium (TE) is the most common reason for hair loss in humans. Although the exact etiopathogenesis of TE has not been revealed clearly and completely, multifactorial etiologies are to be blamed. In recent years, since oxidative stress (OS) has been shown to play an important role in the etiopathogenesis of so many diseases, the effects of OS on several skin diseases are researched and analyzed. Thiols are antioxidant components that include sulfur group, and the balance of thiol-disulfide has an important role in the formation and prevention of OS. This balance is destroyed in many diseases and its effect on TE is not clearly understood yet. Objectives: In this study, we aimed to search the thiol–disulfide balance that could reveal OS in patients with TE. Materials and Methods: Fifty-two patients with TE and control group of 46 persons were included in the study. Native thiol, disulfide, and total thiol levels were evaluated by a new, automatic spectrophotometric method. Disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol rates were calculated. Results: There was no statistical difference between TE patients and control group in terms of native thiol, disulfide, and total thiol levels. Thiol–disulfide balance was fixed and not affected in TE patients. | ||
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 | Serum interleukin-15 is a marker of alopecia areata severity | p. 26 |
| Adel Ali Ebrahim, Rehab Mohammed Salem, Asmaa Adel El Fallah, Esraa Taha Younis DOI:10.4103/ijt.ijt_80_18 Background: Interleukin-15 (IL-15) is a cytokine that is involved in many inflammatory and autoimmune diseases. Although alopecia areata (AA) is an autoimmune disease, serum levels of IL-15 have not been studied well in AA patients. Aim of the Work: We aims at evaluating the serum levels of IL-15 in active AA. Subject and Methods:This case-control study included 40 AA patients and 40 apparently healthy matched controls. Written informed consents were obtained from all the participants. The scalp was examined to assess sites, number, and size of alopecia patches, and the severity of AA lesions was assessed using the Severity of Alopecia Tool score (SALT score) which determine the percentage of hair loss in the scalp. The body was carefully examined to detect any alopecia patches in any hairy area. Nail examination was carried out to detect any nail involvement. Serum IL-15 levels were measured using an ELISA kits. Results: Serum levels of IL-15 in patients were significantly higher than those in the control group (P < 0.001). Serum levels in alopecia totalis were significantly higher than those with one or two patches, and serum levels in patients with both scalp and body involvement were significantly elevated than the levels of patients with either scalp or body involvement. There was a statistically significant positive correlation between SALT score and serum levels of IL-15 (P < 0.001). Conclusion: Serum IL-15 may be a marker of AA severity. | ||
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| CASE REPORTS | | |
 | Trigeminal trophic syndrome simulating pityriasis amiantacea | p. 31 |
| Luisa Groba Bandeira, Maria Cláudia Alves Luce, Bruno De Castro E Souza, Priscila Kakizaki, Neusa Yuriko Sakai Valente DOI:10.4103/ijt.ijt_16_18 We report a case of trigeminal trophic syndrome (TTS) on the scalp of a 69-year-old woman. Initially, the diagnosis of pityriasis amiantacea was considered. The review of pathological antecedents and knowledge of TTS were fundamental for the diagnosis of this illness. We performed a brief review on TTS and differential diagnoses. | ||
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 | Nerve sheath myxoma of scalp: A rare site of presentation | p. 34 |
| Shakti Kumar Yadav, Sompal Singh, Namrata Sarin, Roshina Naeem, Sonam Kumar Pruthi DOI:10.4103/ijt.ijt_45_18 Nerve sheath myxoma, a superficial myxoid tumor, was first described in 1969 by Harkin and Reed. Tumor has cytological and histological resemblance with neurothekeoma, another cutaneous myxoid lesion. Nerve sheath myxoma affects individuals of all age groups and equal predilection for both genders with most favored sites being the fingers and knee. Here, we present a case report of nerve sheath myxoma of the scalp, diagnosed and confirmed with histopathology and immunohistochemistry. | ||
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 | Woolly hair nevus type 2: Rare entity | p. 38 |
| Farhana Tahseen Taj, Shraddha Kologi DOI:10.4103/ijt.ijt_28_18 Woolly hair nevus is a rare non hereditary disorder of scalp characterized by curling and kinking of hair. It can present in childhood or adolescent age. Dermoscopy is a useful noninvasive technique to help in the diagnosis of wolly hair nevus. We report a case of woolly hair nevus associated with linear epidermal nevus. | ||
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| LETTER TO EDITOR | | |
 | Trichodynia silenced effectively with propranolol | p. 41 |
| Piotr Brzezinski, Vijay Zawar, Anca Chiriac DOI:10.4103/ijt.ijt_8_19 | ||
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