Infantile Digital Fibroma Treated With Mohs Micrographic Surgery

BACKGROUND: Infantile digital fibroma (IDF) is a rare benign fibrous tumor of childhood that frequently recurs despite local excision. Conservative, nonsurgical management may result in regression and/or joint deformity. OBJECTIVE: To describe the histologic features of IDF and discuss a case excised using Mohs micrographic surgery (MMS). METHODS: Case report and review of the clinical, histologic, and ultrastructural features. RESULTS: Characteristic inclusion bodies of actin were identified with hematoxylin and eosin, Masson's trichrome, and rapid actin immunostain. The tumor was debulked and the majority was removed after one stage of MMS, except where the deep margin approached the joint space. The defect healed by secondary intention. At 2 years the patient had no recurrence or functional joint deformity. CONCLUSION: MMS is a surgical treatment option for IDF.     

An oocentric view of folliculogenesis and embryogenesis

The mammalian oocyte undertakes a highly complex journey to maturity during which it successively acquires a series of characteristics necessary for fertilization and the development of a healthy embryo. While the contribution of granulosa cells to oocyte development has been studied for many years, it has recently become apparent that the oocyte itself plays a key role in directing its own fate as well as the growth and differentiation of the follicle. This regulatory capacity is achieved through the synthesis and secretion of oocyte-specific factors, such as growth and differentiation factor 9 and bone morphogenetic protein 15, which act on granulosa cells to modify their proliferation, function and differentiation, as well as through direct physical contacts that occur at the granulosa cell-oocyte interface. This review describes key mechanisms by which the oocyte manipulates its own environment in order to achieve meiotic and developmental competence. The potential consequences of assisted reproductive technologies, such as in-vitro maturation and cryopreservation, on oocyte-granulosa cell interactions are also discussed, along with the impact of impaired oocyte development on early embryogenesis.     

Perforation Rates for Nonsterile Examination Gloves in Routine Dermatologic Procedures

BACKGROUND: Low cost, nonsterile examination gloves are used routinely to perform various dermatologic procedures. OBJECTIVE: To evaluate the perforation rate of nonsterile examination gloves in routine dermatologic procedures. METHODS: Three hundred fifty nonsterile latex examination gloves used to perform shave biopsies were evaluated for perforations using an air inflation/water submersion method. Ninety gloves, which were intentionally perforated with a 30-gauge needle, were used as controls to assess our evaluation method. RESULTS: Eight of the 350 gloves were found to have a perforation, which corresponds to a 2.3% perforation rate. Seven of the eight perforations were found in the web space between the second and third finger sleeves, with one being an obvious manufacturing error. All 90 perforations of the control group were correctly identified. CONCLUSION: There appears to be a very low risk of glove perforation when nonsterile examination gloves are used in routine dermatologic procedures.