Syringomatous adenoma of the nipple occurring within a supernumerary breast: a case report

Originally described by Rosen in 1983, syringomatous nipple adenoma (SAN) is a tumor of disputed histogenesis, which can be problematic both diagnostically and therapeutically. ¹ It is a benign primary tumor of breast epithelium with histology similar to that of the syringoma. In the current case, we describe a 40-year-old female with this lesion occurring within a supernumerary breast. This case represents, to our knowledge, the first such reported case, and represents a significant finding as its presence could lend some confusion as to whether or not this represents a benign primary process of breast or a potentially infiltrative tumor of the skin.     

Flerobuterol: a potential antidepressant drug related to β-adrenergic agonists. Experimental profile in mice

The potential antidepressant effect of flerobuterol (dl-(fluoro-2 phenyl)-1 t-butylamino-2 ethanol), a new drug related to beta-adrenoceptor agonists, was evaluated and compared with imipramine and salbutamol using classical psychopharmacological tests in mice. Like imipramine and salbutamol, flerobuterol (0.5-32 mg kg-1, ip) fully prevented apomorphine (16 mg kg-1, sc)- and partly reversed reserpine- and oxotremorine-induced hypothermia. At higher doses (16-32 mg kg-1), flerobuterol enhanced the toxic effects of yohimbine. Unlike imipramine, flerobuterol and salbutamol did not reduce immobility duration in the behavioural despair test. Salbutamol and flerobuterol decreased locomotor activity. Flerobuterol did not induce mydriasis, did not prevent oxotremorine-induced tremors or salivary and lacrimal gland secretion and did not reduce reserpine-induced palpebral ptosis. Propranolol (8 mg kg-1, ip) but not alpha-methyl-paratyrosine (75 mg kg-1, ip) prevented the flerobuterol-induced antagonism of apomorphine-induced hypothermia. Our results suggest that flerobuterol demonstrates potential antidepressant activity, which could be related to beta-adrenoceptor activation in mice.     

Suppurative corneal ulceration in Bangladesh

Suppurative keratitis is an important preventable cause of blindness, particularly in the developing world. This study analyses 142 cases of suppurative keratitis referred to Chittagong Eye Infirmary, Bangladesh. Some 53.5% of cases were bacterial and 35.9% were fungal. The five most common pathogens were: Pseudomonas sp. 24%, Streptococcus pneumoniae 17%, Aspergillus sp. 13%, Fusarium sp. 7% and Curvularia sp. 6%. Gram stain and culture results were consistent in 62.6% of cases. Previous antibiotic treatment was a significant factor for failure of culture isolation and less so for Gram stain failure. On Gram stain, 55.9% of pseudomonal cases were missed, but only 2% of fungal cases were missed. Over all, Gram stain had a sensitivity of 62% and positive predictive value of 84% for bacterial cases, and 98% and 94% for fungal cases, respectively. Fungal ulcers were typically filamentous, but an antecedent history of trauma was not common. The most frequent injury was due to rice grains, but the inoculum appeared to be introduced during eye washing with contaminated water. Pseudomonal ulcers occurred most frequently in the monsoon season, and Fusarium cases were seen only in the hot, dry season.     

MHC IN SYSTEMIC LUPUS ERYTHEMATOSUS: A STUDY ON A KUWAITI POPULATION

HLA alleles were studied in Kuwaiti patients with Systemic lupus erythematosus (SLE). Although significant association of B5, B8, and DR3 has been reported in the literature, the most common phenotype for our patients is A3, DR2 as susceptible alleles and DQ1 as a protective gene.     

科室主任管理职能与基本素质探讨

人力资源在管理中发挥着重要作用，其中，科室主任作为医院人力资源的重要组成部分，在医院惯性运行和可持续发展中扮演着重要角色。因此，科室主任因其技术和管理双重职责所具备的管理职能、基本素质和领导艺术在日常工作中显得尤为关键。     

Partially hepatectomized rats: a model for the study of the effect of toxins on the plasma protein profiles of nascent hepatocytes.

A useful framework is proposed for unifying the synthesis of plasma proteins and their degradation by, or release from, liver cells of intact and partially hepatectomized rats, in which synthesis and release of acute-phase plasma proteins occur in synchrony with the internalization and catabolism of plasma and extracellular proteins. The catabolism of proteins and other hepato-intracellular glycoproteins during sepsis or trauma is essential to provide constituent amino acids and carbohydrates for the synthesis of acute-phase plasma proteins. Increases in the plasma levels of acute-phase response proteins in sham-operated rats reached a maximum between 1 and 2 d after mock surgery, and had returned virtually to control levels within 6 d. By contrast, acute-phase proteins in the plasma of partially hepatectomized rats were decreased by 10-20% of their initial values after 24 h. A maximum acute-phase response on d 7 after the operation was characterized by an increase of 181, 445, and 19% for alpha-1-acid glycoprotein, hepatoglobin, and hemopexin, whereas other acute-phase proteins remained below control levels, for example, by 11, 25, and 38% for albumin, transferrin, and prealbumin, respectively. This delayed response suggests that the nascent liver cells had inherited the capacity of the parent cells to respond to inflammatory signal and had synthesized acute-phase plasma proteins. Accordingly, a time frame for the application of toxin to nascent hepatocytes is suggested. An increased activity (300 +/- 50%) for both bound and free neuraminidase in remnant liver tissue 19 h post partial hepatectomy suggested that hepatic regenerating factor(s) were produced in liver tissue via the hepatic bound and/or free neuraminidase-mediated desialylation of humoral substrates. By contrast, circulating levels of lysosomal enzymes alpha-fucosidase and beta-N-acetyl-D-glucosaminidase were increased marginally after 24 h but had returned nearly to control levels after 7 d, suggesting that lysosomal acid hydrolases do not play a major role in regenerative DNA synthesis, mitosis, or in the synthesis of acute-phase plasma proteins.     

Options in ossiculoplasty.

To achieve good results in ossicular reconstruction residual and recurrent disease must be eliminated. The surgeon must assess the anatomic, physiologic and pathologic situation and consider the available options. Staging is mandatory in many cases. Indication, surgical technique, hearing results and causes of failure are presented in a retrospective study of 138 consecutive operations.     

Primer sensitivity: can it influence the results in Enterococcus faecalis prevalence studies?

BACKGROUND/OBJECTIVE: Recent polymerase chain reaction (PCR)-based studies have shown significant variability in the prevalence of Enterococcus faecalis cases with nonhealing endodontic infections. This variability may be, at least in part, due to the differences in sensitivities of the primers used. The purpose of this study was to compare the sensitivity of 3 sets of PCR primers which have been reported in the endodontic literature. METHODS: The 3 primers sets used were: group 1) tuf gene-based primers with genus-level specificity; and groups 2 and 3) 16S rDNA-based primers that were E. faecalis specific. Three strains of E. faecalis at concentrations of 10(2)-10(8) cells/mL were included in this study. RESULTS: The PCR amplification of E. faecalis strains with the 3 primer pairs showed that group 1 primers consistently had the highest sensitivity, followed by group 2 and group 3 (P<.0001). CONCLUSION: A tuf-based PCR identification assay followed by direct sequencing would yield accurate and consistent prevalence rates of E. faecalis in endodontic infections.     

A short period of maxillomandibular fixation for treatment of fractures of the mandibular tooth-bearing area.

PURPOSE: This study was aimed to determine whether a short period of maxillomandibular fixation (MMF) followed by an arch bar splint wired to the lower jaw is a suitable alternative to conventional MMF for treatment of fractures of the mandibular tooth-bearing area. PATIENTS AND METHODS: Thirty patients with mandibular fractures associated with no other facial fractures were selected. They were randomly assigned into 2 groups for treatment with conventional MMF (group A) and MMF for a short period of 2 weeks followed by an arch bar splint wired to the lower jaw (group B). Complications were recorded and post-treatment maximum interincisal mouth opening was measured at 1 week and 3 and 6 months. Age and gender-matched control groups were randomly selected. Groups were then compared for significant differences. A value of P < .05 was considered significant. RESULTS: The 2 patient groups were not significantly different in relation to site and cause of fracture (P =.995 and P = .682, respectively), the mean time from injury to MMF (P = .234), and the mean time required for fracture healing (P = .315). Delayed union and nonunion were not encountered, and there were no significant differences in relation to postoperative infection ( P = 1) and malocclusion (P = .598). When compared with group A patients, group B patients had an early significantly greater degree in mouth opening (P = .001); at no time was there a significant difference in the degree of mouth opening between group B patients and the control group (1 week, P = .079; 3 months, P = .166; 6 months, P = .378). CONCLUSION: In selected cases, a short period of MMF followed by an arch bar splint wired to the lower jaw is a suitable alternative to conventional MMF for treatment of fractures of the mandibular tooth-bearing area. The method is effective and significantly reduces the potential adverse effects of long-term MMF.