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Corpus callosum dysgenesis (CCD) describes a collection of brain malformations in which the main fiber tract connecting the two hemispheres is either absent (complete CCD, or ‘agenesis of the corpus callosum’) or reduced in size (partial CCD). Humans with these neurodevelopmental disorders have a wide range of cognitive outcomes, including seemingly preserved features of interhemispheric communication in some cases. However, the structural substrates that could underlie this variability in outcome remain to be fully elucidated. Here, for the first time, we characterize the global brain connectivity of a mouse model of complete and partial CCD. We demonstrate features of structural brain connectivity that model those predicted in humans with CCD, including Probst bundles in complete CCD and heterotopic sigmoidal connections in partial CCD. Crucially, we also histologically validate the recently predicted ectopic sigmoid bundle present in humans with partial CCD, validating the utility of this mouse model for fine anatomical studies of this disorder. Taken together, this work describes a mouse model of altered structural connectivity in variable severity CCD and forms a foundation for future studies investigating the function and mechanisms of development of plastic tracts in developmental disorders of brain connectivity.

Authors and clinicians advocate lipase as the preferred serological test for the diagnosis for acute pancreatitis. While acute pancreatitis is among the differential diagnosis for elevated lipase levels, several other causes of elevated lipase levels have been identified including several reports Salmonella species as a causative agent. There also have been retrospective studies that have reported clinical pancreatitis associated with Salmonella infection. These studies concluded that clinical pancreatitis should be considered as a complication of Salmonella infections. However, Salmonella infections may induce elevated pancreatic enzyme levels without clinical pancreatitis or morphological pancreatic abnormalities through a variety of proposed mechanisms. The following is a case that describes a patient who developed Salmonella colitis and demonstrated elevated serum lipase levels without clinical pancreatitis.

Extracorporeal membrane oxygenation (ECMO), as a supportive modality for cardiopulmonary failure, is increasing in its use due to improved advances in technology and experience lending to availability and ease of implementation. Complications with ECMO are quite common, and with increasing use, an increase in complications are a natural result. These complications can be from the underlying disease process or from the ECMO process itself, including cannula insertion. One such complication includes perforation of surrounding structures at site of insertion. We will present a case of right atrial perforation after single lumen cannula insertion, which led to development of cardiac tamponade and subsequently cardiac arrest. In addition to cannula design, lack of wire rigidity can play a role in wire migration and injury to surrounding structures. We emphasize the importance of ultrasound guidance and surveillance with echocardiogram or fluoroscopy during ECMO cannulation, regardless of cannula type, to prevent fatal complications.

Lactic acidosis is a common metabolic acidosis characterized by increased serum lactate and is usually associated with a decreased blood pH. Lactic acidosis has many different causes but has been differentiated into type A, hypoxic causes, and type B, non-hypoxic causes. Tissue hypoxia, type A, is the most common cause, usually secondary to processes such as sepsis and multi-organ failure. Type A must be differentiated from type B in the correct clinical setting as treatments are vastly different. Type B causes may include drug side-effects, toxins, enzymatic defects, inherited or acquired, any of which may lead to overproduction or underutilization of lactate. However, as most clinicians are more familiar, and likely more initially concerned with hypoxic etiologies, evaluation is directed toward finding the source of hypoperfusion or hypoxia, and thus generally leading to a delay in discovering a type B cause (or mixed type A and type B). Here we describe a case of lactic acidosis in the setting of thiamine deficiency thought to be secondary to advanced lung cancer. The purpose of this paper is to bring awareness to the clinician to consider other causes of lactic acidosis when evaluating a patient.

Carotid artery dissection is a significant cause of ischaemic stroke in all age groups and accounts for a large percentage of strokes in young patients. Carotid dissection can be caused by trauma, underlying connective tissue disease, hypertension, mechanical injury or can be spontaneous. We present an exceedingly rare case of carotid dissection caused by an elongated styloid process, causing direct mechanical damage to the carotid artery.

Corpus callosum dysgenesis (CCD) is a congenital disorder that incorporates either partial or complete absence of the largest cerebral commissure. Remodelling of the interhemispheric fissure (IHF) provides a substrate for callosal axons to cross between hemispheres, and its failure is the main cause of complete CCD. However, it is unclear whether defects in this process could give rise to the heterogeneity of expressivity and phenotypes seen in human cases of CCD. We identify incomplete IHF remodelling as the key structural correlate for the range of callosal abnormalities in inbred and outcrossed BTBR mouse strains, as well as in humans with partial CCD. We identify an eight base-pair deletion in Draxin and misregulated astroglial and leptomeningeal proliferation as genetic and cellular factors for variable IHF remodelling and CCD in BTBR strains. These findings support a model where genetic events determine corpus callosum structure by influencing leptomeningeal-astroglial interactions at the IHF.

Anaphylaxis is a potentially life threatening, type I hypersensitivity reaction which can occur within seconds to minutes after exposure to an allergen. Sulfites have been implicated in causing such reactions with symptoms ranging from mild to potentially life threatening. Here we present a patient who had an anaphylactic reaction secondary to exposure to sulfites found in sparkling water.

Low-molecular-weight heparin, including enoxaparin, has efficacy comparable to that of unfractionated heparin and is considered the first-line option for thromboprophylaxis due to a decreased risk profile. This paper presents a rare case of epigastric artery rectus sheath hematoma following enoxaparin injection, resulting in multiorgan failure secondary to hemorrhagic shock. Discussion of this case may assist clinicians in the recognition and treatment of similar cases.

The patient's vitals were remarkable for blood pressure of 129/63mmhg, pulse of 111 beats per minute, temperature of 102.2°F (oral), and respiratory rate of 19 breaths per minute. Prospective studies are needed to accurately assess the risk of fungal infections presenting with hepatitis in immunocompromised patients. PubMed PMID: 16477560 2 S.T. Darling, A protozoan general infection producing Pseudotubercles in the lungs and focal necrosis in the liver, spleen and lymph nodes, JAMA, Vol. 46, 1906,...

Diagnostic imaging findings on CT include an intimal flap, and is pathognomonic, or eccentric mural thrombus in the celiac lumen, which should raise suspicion for dissection [4]. The natural progression of spontaneous celiac artery dissection is poorly understood and severe sequelae is possible including pancreatitis, hepatic and splenic infarct, intraperitoneal hemorrhage and intestinal ischemia [1,3]. Because the progression is not fully understood and because of the limited number of reported cases, there are no set guidelines in management or treatment. Medical therapy includes strict blood pressure control, including the use of beta blockers to decrease arterial shear stress. Surgical treatment has been indicated in situations such as unstable hemodynamics, failure to control blood pressure, failure of medical therapy, persistent abdominal pain, prevention of aneurysm rupture, progression of the dissection and in intestinal ischemia [1-3]. [...]as technology improves and incidence increases with more reported cases, there will be a clearer understanding of the disease progression and an understanding of the appropriate management. 1 Ernesto Lima Araujo Melo, Rainne André Siqueira, Francisco Thiago Martins De Paula, Spontaneous dissection of the celiac trunk: report of three cases and review of the literature, J Vasc Bras, Vol. 13.2, 2014, 150-154, (Web) 2 S. Vaidya,...