Atherosclerosis of cavernosal arteries as a cause of erectile dysfunction in an adult: our findings on triplex doppler sonography

A sixty year old man presented to our health facility with a year history of severe erectile dysfunction (International Index of Erectile Function Score of 5 (IIEF-5)). He was also a known hypertensive and currently being managed for hypertensive heart disease by the Cardiologist. Colour Doppler interrogation of the Cavernosal Arteries showed multiple areas of narrowing in both arteries, giving beaded appearance. The peak systolic velocities of the arteries were less than 25cm/s, and there was persistent diastolic flow in the entire spectral recordings, prompting the diagnosis of arteriogenic erectile dysfunction (ED) secondary to atherosclerosis of the cavernosal arteries. He had medical treatment with PGE5-I, and intracavernosal injection of prostaglandin E1 (Caverjet), but all to no avail. He was counselled for penile implant and he is favourably disposed to that but largely being limited by funds.

A cryo-ET survey of intracellular compartments within mammalian axons

The neuronal axon contains many intracellular compartments which travel between the cell body and axon tip. The nature of these cargos and the complex axonal environment through which they traverse is unclear. Here, we describe the internal components of mammalian sensory axons using cryo-electron tomography. We show that axonal endoplasmic reticulum has thin, beaded appearance and is tethered to microtubules at multiple sites. The tethers are elongated, ~7 nm long proteins which cluster in small groups. We survey the different membrane-bound cargos in axons, quantify their abundance and describe novel internal features including granules and broken membranes. We observe connecting density between membranes and microtubules which may correspond to motor proteins. In addition to membrane-bound organelles, we detect numerous proteinaceous compartments, including vaults and previously undescribed virus-like capsid particles. The abundance of these compartments suggests they undergo trafficking in axons. Our observations outline the physical characteristics of axonal cargo and provide a platform for identification of their constituents.

Surgical Site Infections by Mycobacterium after Cesarean Section in Bangladesh: A Case Report

Surgical site infection is very common in Bangladesh which is due to several reasons. During caesareansection it is not unlikely that this type of infection can be happened. In addition to the common bacteriaatypical bacteria sometimes causes the surgical site infection like Mycobacterium species. In this casereport a cesarean section-acquired Mycobacterium surgical site infections has been reported in Bangladeshwhich was presented as repeated abscess formation at the site of the caesarean section. Pus was drainedfrom the abscess and Zeil-Neelsen staining was performed and was found slender rod, beaded appearance Acid-fast bacilli. Then the patient was treated with anti-tubercular drugs and was totally cured.Bangladesh J Infect Dis 2014;1(1):18-21

Platelet demand modulates the type of intravascular protrusion of megakaryocytes in bone marrow

SummaryMegakaryocytes (MKs) generate platelets via intravascular protrusions termed proplatelets, which are tandem arrays of platelet-sized swellings with a beaded appearance. However, it remains unclear whether all intravascular protrusions in fact become proplatelets, and whether MKs generate platelets without forming proplatelets. Here, we visualised the sequential phases of intravascular MK protrusions and fragments in living mouse bone marrow (BM), using intravital microscopy, and examined their ultrastructure. The formation of intravascular protrusions was observed to be a highly dynamic process, in which the size and shape of the protrusions changed sequentially prior to the release of platelet progenitors. Among these intravascular protrusions, immature thick protrusions were distinguished from proplatelets by their size and the dynamic morphogenesis seen by time-lapse observation. In ultrastructural analyses, the thick protrusions and their fragments were characterised by a peripheral zone, abundant endoplasmic reticulum and demarcation membrane system, and random microtubule arrays. Proplatelets were predominant among BM sinusoids in the physiological state; however, during an acute thrombocytopenic period, thick protrusions increased markedly in the sinusoids. These results strongly suggested that BM MKs form and release two types of platelet progenitors via distinct intravascular protrusions, and that platelet demand modulates the type of intravascular protrusion that is formed in vivo.

Angiographic findings in 2 children with cerebral paragonimiasis with hemorrhage

Hemorrhagic events associated with cerebral paragonimiasis are not rare, especially in children and adolescents; however, angiographic evidence of cerebrovascular involvement has not been reported. The authors describe angiographic abnormalities of the cerebral arteries seen in 2 children in whom cerebral paragonimiasis was associated with hemorrhagic stroke. The patients presented with acute intracerebral and subarachnoid hemorrhage. Angiography revealed a beaded appearance and long segmental narrowing of arteries, consistent with arteritis. In both patients, involved vessels were seen in the area of the hemorrhage. The vascular changes and the hemorrhage, together with new lesions that developed close to the hemorrhage and improved after praziquantel treatment, were attributed to paragonimiasis. Further study of the frequency and mechanism of hemorrhagic cerebrovascular complications associated with cerebral paragonimiasis is needed.

Elastofibromatous Polyp of the Sigmoid Colon - A Case Report and Review of Gastrointestinal Elastofibromas

Elastofibromatous change in the gastrointestinal tract is a rarely reported, usually polypoid lesion of unknown etiology with submucosal stromal change that may mimic amyloid deposition. The constituent amorphous material of the polyp stroma has distinctive features that permit an accurate assessment and diagnosis including: distribution of the material predominantly in the submucosa; distinctive fibrillar and granular appearance of the deposits; thick, irregular, haphazardly arranged bundles of elastic fibres positive for Verhoeff’s elastic stain; ultrastructural fibres with an electron dense curvilinear or beaded appearance; lack of amyloid type vascular wall deposits; and lack of amyloid congophilia or crystal violet metachromasia.The clinical, light microscopic, histochemical and ultrastructural characteristics of this deposited material are reviewed in detail in the present report of a patient who presented with an asymptomatic polypoid lesion of the sigmoid colon. Other reported cases are summarized, and their clinical and pathological features are compared with the current case.

Centrifugal innervation of the rat retina

Centrifugal fibers innervating the retina have been shown in all classes of vertebrate, except for mammals where conventional tract-tracing methods have not been able to unmistakably demonstrate their existence. In a previous study, a unilateral, intravitreal injection of 5, 7-dihydroxytryptamine was used to reveal indoleamine-accumulating centrifugal fibers which were visualized by an immunoreaction against serotonin. In the present study, I employed a modification of this method to stain retinopetal neurons in the rat. Terminals were located preferentially in the outer retina; labeled fibers could be traced back along an ipsilateral pathway to somata in the dorso-caudal portions of the chiasm or the medio-lateral preoptic area, and thence towards the suprachiasmatic nuclei. The unique beaded appearance of the fibers distinguishes them from retinal ganglion cell axons. The labeling of central cell bodies strongly suggests that they possess terminals in the retina. Thus, at least some mammalian retinas receive centrifugal innervation. This indoleamine-accumulating retinopetal pathway may be involved in retinal melatonin synthesis, coordination of circadian rhythms, and interocular phenomena.