Spindle cell myoepithelial tumours of the parotid gland with extensive lipomatous metaplasia

We report four cases of parotid gland tumours composed predominantly of spindle-shaped myoepithelial cells and mature adipocytes. The central portion of one tumour showed extensive adipose differentiation, whereas in the peripheral parts there were small foci of ductal epithelium arranged in cords and tubules within an abundant myxoid stroma. The other cases were adipose spindle cell myoepitheliomas without an obvious glandular component. Under high-power examination, a transition between modified spindle-shaped myoepithelial cells and adipocytes was observed, and this was confirmed with immunohistochemistry. Ultrastructurally, the modified myoepithelial cells showed intracytoplasmic tonofilaments, bundles of actin microfilaments and lipid droplets. A possible pathogenesis is proposed of true metaplastic transformation of myoepithelial cells to adipocytes. This lesion is important to identify correctly, as inadequate surgery can lead to recurrence.     

Prevalence and psychological correlates of occasional and repetitive deliberate self-harm in adolescents

OBJECTIVE: To determine the prevalence and the associated psychological and social factors of occasional and repetitive deliberate self-harming behavior in adolescents. DESIGN: Cross-sectional self-report survey. SETTING: One hundred twenty-one schools in Germany. PARTICIPANTS: A representative sample of 5759 ninth-grade students was studied between 2004 and 2005. OUTCOME MEASURES: Deliberate self-harm (DSH) and suicidal behaviors, emotional and behavioral problems (Youth Self-Report), living standard, family composition, parental conflict and illness, school type and performance, relationship to peers, bullying, body satisfaction and dieting, media consumption, smoking, and alcohol and drug use. RESULTS: Occasional forms of DSH within the previous year were reported by 10.9% of the ninth-grade students. Four percent of the students reported repetitive forms of DSH. Suicidal behavior was strongly associated with repetitive DSH, an association that held for both subtypes of DSH. The findings also indicated that social background factors were important concomitants of occasional DSH but were not related to an increased likelihood of repetitive DSH. Symptoms of depression/anxiety and delinquent/aggressive behavior were associated with self-harming behavior in both adolescent girls and boys. CONCLUSIONS: The data suggest that there is a link between social factors and occasional DSH and, especially in repetitive DSH, that there is a strong association between DSH and suicidal behavior as well as DSH and emotional and behavioral problems. These findings indicate a different pathway in the development of DSH in adolescents. The results support a need to investigate the possible neurobiological underpinnings of DSH within a longitudinal model to enhance the knowledge of this poorly understood behavior.     

Urothelial signet-ring cell carcinoma of the renal pelvis with collagenous spherulosis: a case report

We present a unique case of urothelial carcinoma of the right renal pelvis. It occurred in a 58-year-old woman. The tumor was located in the renal pelvis with extension into the adjacent renal medulla and cortex. Two years after surgical excision the patient is free of recurrence and metastasis. The tumor was well demarcated, without capsule, firm, solid, and whitish on the cut surface. It was 3x4 cm in largest diameter and without signs of necroses and hemorrhages. The tumor did not infiltrate the ureter. Histologically the predominant pattern of the tumor was adenocarcinomatous differentiation, and only very rare foci of urothelial carcinoma composed of typical transitional cells were found. No signs of intestinal type of metaplasia and adenocarcinoma, changes similar to the cystitis cystica or cystitis glandularis, were found in the tumor or in its vicinity. Most of the tumor looked like solid nests composed of cells with intracytoplasmic lumens. The resulting appearance was that of typical signet-ring cell change. These solid nests were usually surrounded by columnar epithelium, which in many areas formed papillary structures. A very striking feature was formation of collagen spherules. Small collagen spherules were often surrounded by a layer of the neoplastic cells so that collagenous rosettes were formed. In some areas these collagenous spherules clustered together so that they formed areas of collagenous spherulosis. The collagen in the spherules reacted positively with collagen IV. Ultrastructurally these spherules were formed by basal membrane-like material. Intracytoplasmic lumens of the signet-ring cell change were endowed by slender microvilli at ultrastructural level.     

Severe dilated cardiomyopathy as a consequence of Ecstasy intake

Dilated cardiomyopathy (DCM) is one of the most common causes of heart failure with a prevalence of 1:2500. There are several primary and secondary etiologic factors, including gene mutations, infection agents, particularly viruses, toxins, autoimmune, and systemic disorders, and pheochromocytoma, neuromuscular, metabolic, mitochondrial, and nutritional disorders. However, a precise diagnosis can be reached only in no more than 50% of all cases. Herein, we report a rare case of hepatic damage and severe DCM as a consequence of relatively popular socially used narcotic-Ecstasy (3,4-methylenedioxy-N-methylamphetamine [MDMA]).     

Impairment of a cortical event-related desynchronisation during a bimanual load-lifting task in children with autistic disorder

In autism, the abilities of communication are affected, associated with abnormalities of cognitive, sensorial and motor development. In a previous study based on a load-lifting task, we showed impairment of anticipation in children with autism as evidenced by kinematics and eletromyographic recordings [Neurosci. Lett. 348 (2003) 17]. In the present study, we assessed the cortical counterparts of the use of anticipatory postural adjustments in a group of control children and in a group of children with autism. The tasks required maintaining a stable forearm position despite imposed or voluntary lifting of an object placed either on the controlateral forearm or on a support. We investigated the differences between the two groups of children on the Event-Related Desynchronisation (ERD) which precedes movement onset in adults [Electroencephalogr. Clin. Neurophysiol. 46 (1979) 138]. Electroencephalogram (EEG) power evolution of a 6-8-Hz frequency band was averaged before and after imposed or voluntary movement onset. EEG reactivity of control and autistic children did not differ during the imposed unloading condition, but significant differences appeared in the voluntary unloading situations. Before lifting the object, control children showed an ERD above the left motor areas. An ERD also occurred above the right motor areas when the object was placed on their forearm. This indicates that the ERD can also translate the use of anticipatory postural adjustments. By contrast, children with autism did not show an ERD in the two voluntary situations. This suggests a central deficit of anticipation in both postural and motor control in children with autism.     

Influence of ultra-long-term fatigue on the oxygen cost of two types of locomotion

The aim of this study was to examine the effects of fatigue induced by a 65-km ultramarathon on the oxygen cost of running (C_r) and cycling (C_cycl). The day before and immediately after the race, a group of nine well-trained male subjects performed two sub-maximal 4-min exercise bouts: one cycling at a power corresponding to 1.5 W · kg⁻¹ body mass on an electromagnetically braked ergometer, and one running at 11 km · h⁻¹ on a flat asphalt roadway. Before oxygen cost determinations, the subjects performed 12 “ankle” jumps at a given frequency that was fixed by an electronic metronome (2.5 Hz). From the non-fatigued to the fatigued condition, there was a significant increase in minute ventilation for both running (P < 0.01) and cycling (P < 0.0001). Significant changes were also found in respiratory exchange ratio both for running (P=0.01) and cycling (P < 0.0001). However, running and cycling differed in that C_cycl increased significantly by [mean (SD)] 24.2 (11.5)% (P < 0.001), suggesting an alteration of muscle efficiency, while C_r did not change with fatigue [186.8 (14.1) mlO₂ · kg⁻¹ · km⁻¹ vs 186.8 (18.7) mlO₂ · kg⁻¹ · km⁻¹]. In addition, contact times during hopping increased significantly from 0.173 (0.019) ms to 0.194 (0.027) ms (P < 0.01). Analysis of the factors that determine C_r indicate that the subjects modified their movement pattern in order to decrease the mechanical cost of running in such long-term fatigue conditions. Accepted: 7 August 2000     

Genetic association study between T-786C NOS3 polymorphism and essential hypertension in an Algerian population of the Oran city

BackgroundEssential hypertension is an important risk factor for the development of cardiovascular disease. Important candidate genes such as NOS3 gene have been widely studied and reported to be associated with essential hypertension (HTN) in human populations.AimWe aim in this study to analyze the relationship between NOS3 -786T/C, a common genetic variant and HTN in a sample of the Algerian population of the Oran city.MethodsA case-control study has been performed in 154 subjects including 77 hypertensives and 77 normotensives. The recruitment of these subjects was done in local Health Centers of the city of Oran, West Algeria. HTN was defined as elevated systolic blood pressure SBD$\ge$140 mmHg and or sustained diastolic blood pressure DBP≥90 mmHg, measured using an Omron^® Automatic BP Monitor - M-3W machine. Consents were obtained from all participants. Polymerase chain reaction (PCR) combined with restrictive fragment length polymorphism (RFLP) was used to genotype the NOS -786T/C variant.ResultsThe distribution of the allelic frequencies did not differ between cases and controls (OR = 1.48; 95%CI [0.94–2.32], P = 0.09). However, after adjustment with the age, sex, and body mass index, we observed significant association between NOS -786C allele and HTN status (OR = 2.08; 95%CI [1.18–3.66], P = 0.01).ConclusionOur results indicate that the C allele of the NOS3 gene is associated with increased risk of essential hypertension in this sample of the Algerian population of the Oran city. Further validation in larger samples is needed to confirm this finding.