Melanoacanthoma Simulating Pigmented Spitz Nevus: an Unusual Dermoscopy Pitfall

BACKGROUND: The starburst pattern is the dermoscopic hallmark of pigmented Spitz nevus, although it has been rarely observed in melanoma as well. OBJECTIVE: To describe a case of melanoacanthoma simulating pigmented Spitz nevus. MATERIAL AND METHODS: Clinical, dermoscopic, and histopathologic examinations were performed for the occurrence of a 4-mm pigmented skin lesion on the hip of a 38-year-old Caucasian woman. RESULTS: Dermoscopy examination of the lesion disclosed a stereotypical starburst pattern characterized by pigmented streaks symmetrically distributed at the periphery. A preoperative diagnosis of pigmented Spitz nevus was made, and the lesion was excised. However, subsequent histopathologic examination revealed a melanoacanthoma. CONCLUSION: The starburst pattern, although diagnostic for pigmented Spitz nevus, can be rarely observed in other benign or malignant pigmented skin lesions. Accordingly, all lesions in adults exhibiting a starburst pattern or other spitzoid features should be excised for histopathologic evaluation.     

Nicotine-induced increases of noradrenaline turnover in discrete noradrenaline nerve terminal systems of the hypothalamus and the median eminence of the rat and their relationship to changes in the secretion of adenohypophyseal hormones

The effects of acute single doses (0.3 and 1 mg/kg) of nicotine on various hypothalamic catecholamine nerve terminal systems and on the secretion of adenohypophyseal hormones in the rat were studied. Nicotine, in a dose of 1.0 mg/kg, increased noradrenaline turnover in the median eminence and in the peri- and paraventricular hypothalamic regions. The dopamine and noradrenaline nerve terminal systems in the median eminence and the dorsomedial hypothalamic nucleus respectively were unaffected. Serum GH levels were decreased and serum prolactin levels increased after a dose of 1 mg/kg. In the presence of tyrosine hydroxylase inhibition, nicotine in a dose of 1 mg/kg, instead increased GH and also LH secretion. It is suggested that the preferential increases of noradrenaline turnover in various hypothalamic noradrenaline nerve terminal systems by nicotine may be partly responsible for the nicotine induced increases of serum prolactin, GH and LH levels observed.     

Effects of Ischemia and Reperfusion on QT Dispersion During Coronary Angioplasty

The effects of ischemia and reperfusion on QT interval dispersion (QTD: QT_max-QT_min in the 12-lead ECG) were analyzed in 15 patients (12 males, 57 ± 13 years) undergoing coronary angiopiasty (PTCA). AH patients had single-vessel coronary artery disease (only one ≥ 85% stenosis in a major coronary artery) and normal left ventricular function. AH were in sinus rhythm with normal atrioventricular and intraventricular conduction on the surface ECG. No patient was on therapy that could affect the QT interval. The ECG was recorded (all 12 leads simultaneously) at 50 mm/s speed before the first balloon inflation, at the end of the first inflation during PTCA, and at 30" and 60" during reperfusion following the first inflation. In order to avoid ischemic preconditioning, only recordings of the first inflation were used. In each tracing QT_max and QT_min were evaluated. All values were rate corrected using a simple linear equation (QT linear corrected = QT + 0.154 [1-RR]). QTD increased significantly during both ischemia and reperfusion. QT_max was not changed by ischemia and was increased by reperfusion. QT_min was reduced by ischemia and increased by reperfusion. These results indicate that both ischemia and reperfusion alter ventricular repolarization, inducing a less homogeneous ventricular recovery pattern.     

N-terminal sequence of some ribosome-inactivating proteins

The N-terminal portion of some type 1 ribosome-inactivating proteins (RIPs) isolated from the seeds of Gelonium multifiorum, Momordica charantia, Bryonia dioica, Saponaria oficinalis and from the leaves of Saponaria oficinalis are reported in the present paper. Their relationship with other RIPS is discussed.     

DIFFERENT AFFINITY OF CORTICAL GHB BINDING SITES IN SARDINIAN ALCOHOL-PREFERRING (sP) AND-NON PREFERRING (sNP) RATS

Specific gamma-hydroxybutyric acid (GHB) binding sites in corticalmembranes of selectively bred alcohol-preferring sP and alcohol-nonpreferring sNP rats were compared using [2,3³H]GHB ligand. ThesP rat line showed an increased affinity (-40% lower K_d) ofboth the high- and low-affinity sites in comparison with thesNP line. No significant difference in GHB receptor density(B_max) was detected between the two rat lines. The results raisethe possibility that differences in GHB binding sites may playa role in the genetic predisposition to ethanol preference inour rat line.     

Radiofrequency Catheter Ablation of the Slow Reentrant Pathway of Sustained Ventricular Tachycardia

The article reports the cases of two patients with severe coronary artery disease and associated recurrent sustained ventricular tachycardia successfully treated with radiofrequency catheter ablation. In the first patient, two different types of ventricular tachycardia (one incessant) were eliminated. In all procedures, an area of slow conduction critical for tachycardia maintenance was localized by endocardial mapping techniques. Radiofrequency energy delivered to this area could permanently modify the anatomical substrate of the arrhythmia. After single follow-ups of 19, 14, and 13 months regarding the arrhythmic entities, the patients are well and free from spontaneous recurrences.     

The "SPEM" (Studio Policentrico Elettrocateteri Membrane): A Multicenter Study on Membrane Leads

SPEM is a multicenter randomized double-blind study performed to test the acute and chronic electrophysiological behavior of three different ventricular leads: (1) an ion exchange membrane with 30-μg dexamethasone elution in a contoured activated carbon tip lead (Membrane 1400T, 30 patients); (2) the same lead design without steroid (Membrane 1401T, 24 patients); and (3) the same lead design without steroid or membrane (control group, 27 patients). Twenty-three of the 81 patients were women; the mean age for all patients was 74 ± 10 years. Parameters are calculated both in uni- and bipolar configuration at implant and at follow-up after 1, 5, 15, 30, 90, 180, and 360 days. Implant threshold (chronaxie = 0.413 ± 0.280 ms, rheobase = 0.264 ± 0.099 V), signal amplitude (13.45 ± 5.87 mV), and slew rate (2.05 ± 1.38 V/s) reveal no significant differences. Pacing impedance values both at implant (unipolar 571 ± 165 Ω; bipolar 605 ± 123 Ω) and at follow-ups (unipolar 480 ± 72 Ω; bipolar 518 ± 75 Ω) are slightly lower in the unipolar configuration. At 15 and 30-day follow-ups, control group and nons-teroid leads show a higher threshold value growth (in unipolar from 0.16 ± 0.11 to 1.19 ± 0.85 μJ; in bipolar from 0.18 ± 0.13 to 1.24 ± 0.88 μJ) than the membrane steriod leads (in unipolar from 0.13 ± 0.11 to 0.70 ± 0.39 μJ; in bipolar from 0.23 ± 0.32 to 0.76 ± 0.36 μJ); the threshold of nonsteroid leads decreases after 1–3 months and it settles at the same threshold level of the leads with membrane and steroid (in unipolar 0.60 ± 0.33 ±J; in bipolar 0.55 ± 0.26 μJ), which has been stable since the first month. The ion exchange membrane is effective in reducing the chronic pacing threshold like acute steroid elution at low doses, but membrane alone does not prevent an acute pacing threshold increase through the first month postimplant.