Epidermoid cyst of the buccal mucosa—An uncommon entity: Case report and literature review

Epidermoid cyst of the buccal mucosa is rare. Nevertheless, it must be included in the differential diagnosis of swelling in this area. The diagnosis is based on anatomopathological examination. The surgical enucleation is the gold standard of treatment.     

A review of the contemporary evidence on rescue cervical cerclage

Background

Rescue cervical cerclage (RCC) is essentially a salvage procedure to prolong pregnancy in women with advanced cervical changes and prolapsed membranes in the second trimester. However, its effectiveness and safety remain controversial.

Objectives

To provide a comprehensive review of the contemporary evidence on RCC and evaluate which treatment modalities can be offered to pregnant women based on the best available evidence.

Search strategy

A PubMed search of published studies on RCC and perinatal outcome was conducted using defined keywords.

Selection criteria

Clinical studies were included with priority for level I evidence (randomized controlled trials [RCTs]) followed by other evidence levels.

Data collection and analysis

Abstracts of 141 articles were screened and 40 articles were selected.

Main results

Evidence from retrospective and nonrandomized prospective trials shows a benefit of RCC. It may prolong pregnancy by an average of 4–5 weeks, with a 2-fold reduction in the chance of preterm birth before 34 weeks. A higher chance of failure is expected if cervical dilatation exceeds 4 cm or if membranes are bulging into the vagina.

Conclusions

The decision for an RCC should be individualized after comprehensive counseling by a senior obstetrician. Further research in the form of robust RCTs is recommended.     

The Role of Nitrogen Availability for the Salt-Tolerance of Two Different Varieties of Durum Wheat

Salt stress tolerance of durum wheat was assessed in control and 200 and 300 mM NaCl-exposed seed of two cultivars (BidiAP4 and Azizi). These salt treatments were accompanied by different levels of nitrate (Ca(NO₃)₂) added to the media (0.1, 3, 10 mM). The data showed that NaCl stress increased Na⁺ and Cl^? contents and lowered K⁺ and NO₃ ^? levels in seeds of BidiAP4 cultivar. In Azizi seeds exposed to NaCl, Na⁺ and K⁺ were highly accumulated while low levels of NO₃ ^? and Cl^? were detected. Those findings highlight the difference in the salt stress tolerance of these two durum wheat cultivars also depending on nitrogen (N) availability, Azizi cultivar being less sensitive to NaCl treatment than BidiAP4. These data also suggested a relationship between salt tolerance capacity and enhancement or maintenance of nitrogen and carbon metabolisms enzyme activity.     

Cutaneous tuberculosis in Tunisia

Introduction

Tuberculosis is endemic in Tunisia. Pulmonary tuberculosis is the most common presentation in our country. Cutaneous presentations are rare (1–2% of cases). The diagnosis of cutaneous tuberculosis (CT) is difficult. Histological and clinical presentations are polymorphous, many differential diagnoses are available, and it is difficult to isolate Mycobacterium.

Objective

We had for aim to study the epidemiological and clinical features of CT in Tunisia, and to compare presentations before and after 1990.

Patients and methods

We conducted a retrospective study between January 1991 and December 2011, in which we included all cases of CT observed at the Infectious Diseases and Dermatology Units of the Tunis la Rabta Hospital.

Results

Hundred and thirty-seven patients were included, with a mean age of 43.8 years; 72.3% were female patients. Hundred and fifty locations were observed, most of which on the head and neck. Scrofuloderma was the most frequent presentation, observed in 65% of cases. The diagnosis was confirmed by histology and/or microbiology in 75.8% of cases. The treatment was prescribed for a mean 11.3 months, leading to full recovery in most cases.

Conclusion

CT is still reported in Tunisia. The diagnosis relies mainly on histology. Controlling this mutilating tuberculosis requires a global control of this disease, and especially lymph node location, given the high rate of scrofuloderma.     

A cytogenetic approach to the effects of low levels of ionizing radiation (IR) on the exposed Tunisian hospital workers

Objectives

The aim of this study is to assess chromosomal damage in Tunisian hospital workers occupationally exposed to low levels of ionizing radiation (IR).

Materials and Methods

The cytokinesis-block micronucleus (CBMN) assay in the peripheral lymphocytes of 67 exposed workers compared to 43 controls matched for gender, age and smoking habits was used. The clastogenic/aneugenic effect of IR was evaluated using the CBMN assay in combination with fluorescence in situ hybridization with human pan-centromeric DNA in all the exposed subjects and controls.

Results

The study showed a significant increase of the micronucleus (MN) frequency in the lymphocytes of the exposed workers compared to the control group (13.63±4.9‰ vs. 6.52±4.21‰, p < 0.05). The centromere analysis performed in our study showed that MNs in hospital staff were predominantly centromere negative (72%) and the mean negative labeled micronucleus (C-MN) frequency was significantly higher in the exposed subjects than in the controls (9.04±4.57‰ vs. 1.17±0.77‰). The multivariate regression analysis, taking into account all confounding factors, showed that only the time of exposure to IR had a significant effect on the level of MNs and C-MN.

Conclusion

The present study shows that chromosomal damage leading to the formation of micronucleated lymphocytes is more frequent in the hospital workers exposed to IR than in the controls, despite the low levels of exposure. The results of the study confirm the well-known clastogenic properties of ionizing radiation. In regards to health monitoring, detection of early genotoxic effects may allow for the adoption of preventive biological control measures, such as hygienic improvements in the workplace or reduction of hours of occupational exposure.     

Expression of indoleamine 2,3-dioxygenase in dermal fibroblasts functions as a local immunosuppressive factor

As a possible way of making a non-rejectable skin substitute, here, we ask the question of whether the expression of indoleamine 2,3-dioxygenase (IDO) selectively suppresses immune, but skin, cell proliferation. To address this question, a series of experiments in which adenovirus (Ad-IDO) infected IDO expressing dermal fibroblasts were co-cultured with different types of immune cells were carried out. The immune cells were then harvested and evaluated for propidium iodide (PI) positive cells by FACS analysis. TUNEL assay was also carried out to determine the apoptotic status of these cells. The results showed that the expression of IDO in dermal fibroblasts significantly induces apoptotic death of PBMC, CD4(+)-, CD8(+)- and B cell-riched primary lymphocytes, Jurkat cells, and THP-1 cells. IDO-mediated damage of immune cells was restored by an addition of tryptophan and IDO inhibitor. Using the same approaches, we also demonstrated that skin cells and endothelial cells are remarkably resistant to tryptophan-deficient environment. Furthermore, no significant difference in cell proliferation between Ad-GFP (control)- and Ad-IDO-GFP-infected either keratinocytes or fibroblasts, was found. The results of this study, therefore, suggest that the expression of IDO by dermal fibroblasts mediates immune cell damage and this may shed a new light toward developing a non-rejectable skin substitute in the future.     

Keratinocyte-conditioned media regulate collagen expression in dermal fibroblasts

Excessive extracellular matrix (ECM) production during dermal wound healing often leads to fibrotic conditions such as keloids and hypertrophic scarring (HSc). Type I collagen is the predominant form of collagen in the human skin and is produced mainly by dermal fibroblasts. It has been suggested that abnormalities in epidermal-dermal interaction can lead to excessive production of collagen by fibroblasts. To identify and further characterize any possible keratinocyte-derived collagen-inhibitory factors (KD-CIFs), we investigated the expression of pro-alpha1(I) collagen at the level of mRNA and protein in human fibroblasts that had been either co-cultured with keratinocytes or treated with keratinocyte-conditioned medium (KCM). Fibroblasts in both groups demonstrated a significant reduction in the steady-state levels of collagen mRNA and protein. Further characterization of KD-CIFs revealed a high-molecular-weight factor (>30 kDa) that showed stable activity at high temperature (56 degrees C) and acidic pH (pH 2). Keratinocyte differentiation did not alter the release of KD-CIFs into KCM. These results provide further evidence that type I collagen expression and synthesis in fibroblasts are regulated by a keratinocyte-releasable factor(s) with an apparent molecular weight between 30 and 50 kDa.