Superficial basal cell carcinoma of the scalp mimicking seborrhoeic dermatitis.

Superficial basal cell carcinomas (BCC) comprise 9% to 11% of BCC, and are commonly found on the trunk or limbs. We report a case of a superficial BCC on the scalp that was misdiagnosed and treated as seborrhoeic dermatitis. Any erythematous plaque-type lesion of long duration must have superficial BCC considered in the differential diagnosis.     

Pachyonychia congenita type 2, N92S mutation of keratin 17 gene: clinical features,mutation analysis and pathological view

Pachyonychia congenita (PC) type 2 is a rare inherited genetic disease characterized by hypertrophic nail dystrophy, palmoplantar hyperkeratosis and multiple pilosebaceous cysts. In some cases, natal teeth and hair abnormalities may be present. It is caused by mutations in keratin 17 or its expression partner keratin 6b. Here, an N92S (p.Asn92Ser) germline keratin 17 gene mutation in a pachyonychia congenita type 2 female patient is presented. The pedigree includes the 15 members of a family who showed a severe expression of the phenotype for six generations with a similar clinical picture consisting of sebaceous cysts, nail dystrophy, hyperkeratosis, hair abnormalities, natal teeth, hoarseness and hyperhydrosis. In conclusion, we emphasize the importance of diagnosing and managing pachyonychia congenita in childhood for the assistance of affected children and for the development of potential therapies.     

The effects of dexmedetomidine dosage on cerebral vasospasm in a rat subarachnoid haemorrhage model

We investigated the effect of two different doses of dexmedetomidine on vasospasm in a rat model of subarachnoid haemorrhage (SAH). SAH was induced by injecting 0.3 mL blood into the cisterna magna in all rat groups except the control (Group C). At 1 hour and 24 hours after SAH, 5 μg/kg dexmedetomidine was given to group D5, and 10 μg/kg dexmedetomidine was given to group D10. No medication was administered to the haemorrhage group (Group H). Malondialdehyde (MDA) and paraoxonase (PON) levels were measured at 48 hours after SAH. Mean wall thickness (MWT), mean luminal diameter (MLD), and proliferating cell nuclear antigen (PCNA) expression of the basilar artery were evaluated. MDA levels and MWT were lower in the dexmedetomidine groups. The lowest MDA levels and MWT were found in Group D10. The MLD was lowest in Group H. PCNA expression was observed only in Group D10. We concluded that dexmedetomidine reduces oxidative stress and vasospasm following SAH in a dose-dependent manner.     

Primary diffuse leptomeningeal oligodendrogliomatosis causing sudden death

Primary diffuse leptomeningeal oligodendrogliomatosis is a rare malignancy of central nervous system without evidence of a primary intraparenchymal focus. We present a 25-year-old woman with the postmortem diagnosis of primary diffuse leptomeningeal oligodendrogliomatosis. She was paraplegic and had sensory loss at the level of thoracal 8–9 for nearly 15 months. There was no symptom due to increased intracranial pressure. Unexpectedly she died just before biopsy. Autopsy revealed a nodular lesion at the level of thoracal 10 vertebra and diffuse oligodendroglioma throughout the leptomeninges of the brain and spine without intraaxial focus. To our knowledge, this is the first case of primary diffuse leptomeningeal oligodendrogliomatosis causing sudden death in the literature.     

The best immunohistochemical panel for differentiating hepatocellular carcinoma from metastatic adenocarcinoma

It can be difficult to differentiate hepatocellular carcinoma (HCC) from metastatic adenocarcinoma (MA). An appropriate immunohistochemical panel is required for the differential diagnosis. This study aimed at finding the best panel, including hepatocyte-specific antigen (Hepatocyte), pCEA, CD10, Villin, CD34, TTF-1, MOC-31, CK7, and CK20 antibodies. Sixty-eight cases of HCC and 107 cases of MA were investigated. Hepatocyte positivity was seen in 95.6% of HCCs and in 1.9% of MAs. pCEA was expressed in 47.8% of HCCs and in 86.8% of MAs. CD10 stained 73.13% of HCCs and 36.9% of MAs. Villin was positive in 23.5% of HCCs and in 81.0% of MAs. Canalicular staining with pCEA, CD10, and Villin was seen only in HCCs. Sinusoidal CD34 staining was seen only in 42.6% of HCCs. A small subset of HCCs demonstrated cytoplasmic TTF-1 and MOC-31. CK7 was expressed in 29.4% of HCCs and in 29.9% of MAs, whereas CK20 stained 14.7% of HCCs and 62.6% of MAs. In conclusion, Hepatocyte should be combined with pCEA, MOC-31, CD10, and CD34. Canalicular staining with pCEA, CD10, and Villin is specific for HCC. CK7 and CK20 expression may be seen in some HCCs. We suggest that the best panel for discriminating HCC from MA should contain Hepatocyte, MOC-31, pCEA, CD10, and CD34.     

Vector alignment in maxillary distraction osteogenesis

Maxillary distraction osteogenesis is an alternative treatment of cleft patients with severe maxillary hypoplasia. The aim of this paper is to present the combined surgical/orthodontic treatment of a cleft lip and palate patient and to evaluate the maxillary distraction procedure and the distraction vector in high Le Fort I osteotomy.     

Association between varicocele and chronic obstructive pulmonary disease

PURPOSE: To evaluate the relationship between varicocele and chronic obstructive pulmonary disease (COPD) via color duplex sonography. MATERIALS AND METHODS: Forty-four male patients with COPD (age range, 50-89 years; mean +/- SD, 66 +/- 9) and 44 male healthy controls (age range, 47-75 years; mean +/- SD, 65 +/- 6) were evaluated with color duplex sonography for unilateral or bilateral varicocele. RESULTS: The incidence of right, left, and bilateral varicocele was 47.7%, 65.9%, and 38.6% respectively, in the COPD group, versus 22.7%, 52.3%, and 13.6% in the control group. The incidence of right and bilateral varicocele in the COPD group was significantly higher than in the control group (p < 0.05). The incidence of varicocele also increased with increase in COPD severity. CONCLUSIONS: The incidence of varicocele in COPD patients is high. Varicocele might be one of the most important causes of scrotal pain and infertility in COPD patients.