Luciano de Sousa Pereira

Giant cell arteritis in Asians: a comparative study

Background Giant cell arteritis (GCA) is a common systemic vasculitis, with a presumed Caucasian predominance. The occurrence of GCA in Asians has rarely been addressed. This study aims to assess the incidence of giant cell arteritis in Asians. Methods In this retrospective review, the self-reported ethnicities of patients with biopsy-proven GCA at the University of California–San Francisco (UCSF) were recorded. Ethnic distribution of the patient population served by UCSF was estimated from an age- and sex-matched control group. The odds ratio for each ethnicity (Asian and Caucasian) was determined and compared using Fishers exact test and logistic regression analysis. Results The ethnic distribution of the 38 patients with positive temporal artery biopsies were as follows: Caucasian n=31 (81.6%), Asian n=1 (2.6%) and other n=6 (15.8%). The ethnic distribution of the patient population served by UCSF was as follows: Caucasian 42%, Asian 28% and other 30%. The difference in the proportion of GCA in Asians and Caucasians was statistically significant (OR 0.049 (95% CI 0.0065 to 0.374), p=0.0036). Conclusions In our patient population, GCA was seen 20 times less frequently in Asian than Caucasian patients. Although this difference is significantly different (p=0.036), given the small sample size and wide CI this should be viewed as a rough estimate.

Levator Superioris Muscle Function in Involutional Blepharoptosis

PURPOSE To assess the role of muscular degeneration, we evaluated the correlation between ptosis severity and levator muscle function. DESIGN Retrospective cohort study. METHODS The medical records of 136 patients (53 men and 83 women; mean age, 67 years) with acquired blepharoptosis were reviewed for levator function (LF), margin reflex distance (MRD), age, and gender. Multivariate linear regression was performed for statistical analysis. RESULTS A significant correlation (P < .001) was seen between MRD (mean, 1.0 + 1.0 mm; range, -3.0 to 3.0 mm) and LF (mean, 15.0 + 1.0 mm; range, 11.0 to 20.0 mm). On average, a 0.5-mm reduction in LF was observed for each 1.0-mm decrease in MRD. This was independent to other variables assessed. CONCLUSIONS In patients with involutional blepharoptosis, a directly proportional decrease in levator function and eyelid height was observed. This may implicate an abnormality of the levator muscle itself as a contributing factor in the development of involutional blepharoptosis.

Tumor neuroectodérmico primitivo periférico primário da órbita: relato de caso

The authors present a case of primary peripheral primitive neuroectodermal tumor of the orbit in a 10-month-old girl, which is the first case in the Brazilian literature. Clinical, radiologic and histopathologic features are discussed. The diagnosis was confirmed by immunohistochemical analysis which is essential to the diagnosis of small round cell tumors in the orbit.

Vitreitis and movement disorder associated with neurosyphilis and human immunodeficiency virus (HIV) infection: case report

In this report, we describe an unusual patient with a choreiform movement disorder, misdiagnosed as Huntington disease, who later developed dense vitreitis leading to the identification of Treponema pallidum as the underlying pathogen of both abnormalities.

Marsupialization of Orbital Conjunctival Inclusion Cysts Related to Strabismus Surgery

A 52-year-old woman presented with a giant conjunctival cyst related to strabismus surgery that was adjacent to the medial rectus muscle. Management consisted of excision of the anterior cyst wall with suturing of the remaining cyst lining to overlying conjunctiva. Following marsupialization, the cyst did not recur with persistence of the conjunctival drainage site.

Perineural arachnoidal gliomatosis: case report

Gliomas are the most common infiltrative neoplasms of the optic nerve and can present as two distinct growth patterns: intraneural glial proliferation and perineural arachnoidal gliomatosis (PAG). It has been suggested that perineural arachnoidal gliomatosis is seen almost exclusively in the setting of neurofibromatosis type 1 (NF1). We describe a child with perineural arachnoidal gliomatosis occurring without neurofibromatosis type 1, supported by both radiographic and histological findings. A 4-year-old female without neurofibromatosis type 1 presented with rapidly progressive right-sided proptosis. Magnetic resonance imaging (MRI) revealed an enhancing fusiform intraconal lesion, which was hypointense on T1 and hyperintense on T2-weighted images: characteristic of perineural arachnoidal gliomatosis, the optic nerve was visualized coursing the tumor. Histopathologic study was consistent with perineural arachnoidal gliomatosis. Perineural arachnoidal gliomatosis can develop independent of neurofibromatosis type 1, as demonstrated by this case.

Purification, biochemical characterization, and antimicrobial activity of a new lipid transfer protein from Coffea canephora seeds

Coffee, an agronomical crop of great economic importance, is also among the most commonly traded commodities in worldwide markets. Antimicrobial peptides, which play a role in plant defense, have been identified and isolated particularly from seeds. We isolated and immunolocalized Cc-LTP2, a new lipid transfer protein (LTP) from Coffea canephora seeds. We report its antimicrobial activity against various phytopathogenic fungi of economic importance, and against the bacterium Xanthomonas euvesicatoria. Peptides from C. canephora seeds were initially extracted using acid buffer and subjected to ion-exchange and reverse-phase chromatographies. A purified peptide of approximately 9 kDa, which we named Cc-LTP2, was then subjected to amino acid sequencing. The analyses showed that it was similar to LTPs isolated from various plants. The tissue and subcellular localization of C. canephora LTPs indicated that they were located in cell walls and intracellular palisade parenchyma, mainly in large vacuoles. The results of immunohistochemistry and histochemistry superposed from C. canephora seed tissues showed that LTPs and lipid bodies are present in organelles, supporting the hypothesis that LTPs from seeds are involved in lipid mobilization during germination. Cc-LTP2 did inhibit the development of the phytopathogenic fungi Colletotrichum lindemuthianum, Colletotrichum gloeosporioides, Fusarium solani, Fusarium lateritium, and Colletotrichum sp, but did inhibit X. euvesicatoria. Cc-LTP2 also increased membrane permeability and induced endogenous production of reactive oxygen species in all the fungi tested.

Fibro-histiocitoma maligno da pálpebra: relato de caso

Fibrous histiocytomas represent 1% of all orbital masses and may be classified into benign, locally aggressive and malignant - these representing nearly 11% of the total. In this study, the authors describe an unusual case of malignant fibrous histiocytoma of the eyelid, discussing clinical and histological features of this neoplasm.