Squamous cell carcinoma arising in recurrent odontogenic keratocyst: case report and literature review.

BACKGROUND: Keratinizing odontogenic cysts of the mandible commonly have an aggressive clinical course, marked by multiple recurrences. Primary intraosseus carcinoma (PIOC) of the mandible is rare, and when it occurs it is often found to be arising in or closely associated with some type of cystic structure. METHODS: A patient with squamous cell carcinoma arising from an odontogenic keratocyst is studied clinically, radiographically, and pathologically. RESULTS: The patient who was documented to have an odontogenic keratocyst, 1 year later had a squamous carcinoma removed from the recurrent cyst. CONCLUSION: We report the occurrence of squamous cell carcinoma arising from a recurrent odontogenic keratocyst, which has not previously been documented in the literature. The literature on this subject is reviewed.

Treatment of a distal splenic artery aneurysm with splenic conservation. A case report.

We report the case of a successful treatment of a splenic artery aneurysm by aneurysm excision and direct splenic artery reconstruction allowing spleen conservation. This aneurysm was related to an arterial wall medianecrosis. Because of the reappraisal of the splenic immunological function, we believe as others that this surgical management can be a new alternative to splenectomy as treatment of splenic artery aneurysms.

Experimental thrombosis on a collagen coated arterioarterial shunt in rats: a pharmacological model to study antithrombotic agents inhibiting thrombin formation and platelet deposition.

A rat thrombosis model was developed to assess the efficacity of antithrombotic drugs. It had the following characteristics: controlled hemodynamic and rheological conditions corresponding to arterial flow, a collagen coated surface as a relevant thrombogenic stimulus, a method of measurement allowing dynamic monitoring of thrombus formation and the possibility to assess the thrombus structure. A shunt composed of polyethylene and silicone catheters, including in the middle of the shunt a collagen coated glass capillary, was inserted between the two primitive carotids of the rat. The duration of patency of the shunt was recorded using a thermic probe fixed on its central part. In this model, the patency of the shunt was 539 +/- 55 s. Platelet and fibrinogen-fibrin accumulation in successive one centimeter segments along the shunt were measured using 111In labeled platelets and 125I labeled fibrinogen. Platelet accumulation occurred on the collagen coated surface and at the junctions between the different components of the shunt, where flow was disturbed. The effects of four antithrombotic agents were measured: aspirin, clopidogrel, heparin and r-hirudin. Clopidogrel, heparin and hirudin significantly prolonged patency duration of the shunt, whereas aspirin was inactive. Aspirin did not reduce platelet or fibrinogen-fibrin accumulation on the collagen coated surface. Platelet accumulation on the collagen surface was significantly lower in the clopidogrel group (50 mg/kg) than in the group treated with heparin (500 U/kg), demonstrating the direct antiplatelet effect of clopidogrel. Hirudin at doses giving similar values of APTT as heparin (500 U/kg) prolonged the occlusion time to over 2 h while the heparin occlusion time was only 20 min.(ABSTRACT TRUNCATED AT 250 WORDS)

[Arterioarterial shunt coated with collagen. A model of acute arterial thrombosis for testing antithrombotic agents in rats]. / Shunt artérioartériel recouvert de collagène. Un modèle de thrombose artérielle aiguë pour tester les antithrombotiques chez le rat.

We developed a new thrombosis model in Wistar rats. It consists of a shunt of which the central part is coated with collagen, a thrombogenic protein, implanted between the two carotid arteries of the rat. The occlusion time of the shunt is measured by a thermic method. The composition of the thrombus is analyzed by double isotope labeling of platelets and fibrinogen. Four antithrombotic drugs were studied: two antiplatelet agents, aspirin and clopidogrel; two anticoagulants, heparin and recombinant hirudin. The results show that aspirin alone does not increase the occlusion time of the shunt. Clopidogrel, heparin and hirudin at doses of 50 mg/kg, 500 IU/kg and 5 mg/kg significantly increase the thrombosis time but the composition of the thrombus varies according to the nature of the drug: antiplatelet (clopidogrel) or anticoagulant (heparin, hirudin). This model enables a plurifactorial analysis of acute arterial thrombosis and should be of value to discriminate the effects of antithrombotic and thrombolytic agents.

[Monomelic thermochemotherapy for malignant melanoma of the limbs. Results of a homogeneous series of 128 patients]. / Thermochimiothérapie monomélique pour mélanome malin des membres. Résultats d'une série homogène de 128 patients.

Thermochemotherapy through regional CEC has been applied to malignant melanomas of the limbs for a long time as it was described by Creech and Krementz more than twenty years ago. Strangely enough, its application has remained confidential in France. In order to assess this method, we have been applying it to 128 consecutive patients from January 1, 1982 to January 1, 1990. After the exclusion of 9 patients (7 technical failures, 1 wrong diagnosis, 1 improper inclusion), the remaining series is of 119 patients for 125 infusions. The average distance in time is 3.4 years. The series includes 31 men and 88 women with an average age of 51.2 + 14.2 years (23-75) with malignant melanoma of the upper limb (25 cases) or lower limb (94 cases). The histological type of the tumor was nodular in 47 cases (39.5%), SSM in 40 cases (33.6%), acrolentiginous in 26 cases (22%) and undetermined in 6 cases (5%). All lesions were high-risk malignant melanomas for which Clark's index was higher than III and Breslow's index higher than 1.5 mm in 103 cases (16 cases in which Breslow's index ranged from 1 to 1.5 mm were included at the beginning of the series). Chemotherapy utilized Mephalan with a dose of 0.8 to 1.5 mg/kg of body weight, delivered through monomelic CEC and under hyperthermia at 41 degrees C during 45 to 50 minutes, via a cannulation of the axillary artery and vein in the upper limb and of the common femoral artery and vein in the lower limb.(ABSTRACT TRUNCATED AT 250 WORDS)

Anterior urethral polyps.

The second reported case of an anterior urethral polyp is presented. The etiology, pathology and treatment of urethral polyps are discussed.

Sclerosing vascular variant of plasma cell granuloma.

A single mass in the right lung was found in a 33 year old asymptomatic male by routine chest x-ray examination. In the surgically removed right middle lobe was a well circumscribed but nonencapsulated round tumor (diameter, about 4 cm.) compressing and gradually becoming incorporated into the adjacent pulmonary parenchyma. Histologically the bulk of the tumor consisted of numerous hyalinized blood vessels in a loose mesenchymal background, the latter containing spindle shaped connective tissue cells and an acid mucopolysaccharide stroma. At the margins in the fibrous septa, which divided the tumor into nodules, there was intense lymphoplasmacytic infiltrates forming lymphoid follicles. No epithelial elements were observed around the hyalinized blood vessels. Electron microscopic findings suggest mesenchymal cells, giving rise to endothelial cells of numerous blood vessels and spindle cell connective tissue cells associated with unique lymphoplasmacytic aggregates. The unusual tumor best fits the characteristics of the sclerosing plasma cell granuloma, composed predominantly of sclerosing vascular vessels.

Pancreatic polypeptide cell hyperplasia with and without watery diarrhea syndrome.

Two cases of pancreatic polypeptide cell hyperplasia were obtained by operation. The first case exhibited adenocarcinoma of the stomach with metastases to the neck lymph nodes and pancreatic polypeptide hypersecretion. Pancreatic polypeptide cell hyperplasia was confirmed by the immunoperoxidase method and by the elevated level of pancreatic polypeptide in the pancreatic extracts and in the circulating blood. There was no watery diarrhea syndrome. The second case presented with persistent watery diarrhea of two and one-half year duration, and the resected pancreas contained extremely large atypical islets, exclusively composed of pancreatic polypeptide cells. It is speculated that in some cases pancreatic polypeptide oversecretion may be causative for pseudo-Verner-Morrison syndrome in the absence of ulcer of carcinoma in the upper gastrointestinal tract.

Rheumatoid nodulosis: another cuase of juxtarticular nodules.

A case of rheumatoid nodulosis and the difficulties encountered in its diagnosis are presented. A positive rheumatoid factor, biopsy proved involvement of the synovium and bone at the second metacarpophalangeal joint, and regression of nodules and mild arthritic symptoms with gold therapy, supported the diagnosis of a rheumatoid disease variant. The relationship of the disease to rheumatoid arthritis, gout, and xanthomatosis is discussed.

Colonic perforation in Crohn's disease.

Three cases of acute, free perforation of the colon in Crohn's disease are described and their clinical and pathological features are detailed. Colonic perforation in Crohn's disease bears no definite relationship to obstruction or adrenocorticosteroid therapy. It may occur with or without toxic megacolon, and pathological study has not thus far suggested a common pathogenetic mechanism. Although free perforation has been considered to be extremely rare in Crohn's colitis, it is likely that this complication is more common than previously believed.

[Secreting paragangliomas of the organ of Zuckerkandl. A report on two cases (author's transl)]. / Paragangliomes sécrétants de l'organe de Zuckerkandl. Apropose de deux cas

The authors describe two cases of secreting paragangliomas of the organ of Zuckerkandl, beinging the number of known cases to 78. They underline the interest of arteriographic and phlebographic explorations which define more accurately the origin and spread of these tumours.

Performance analysis of an ex vivo geometric total knee prosthesis.

Studies were made of a well functioning geometric total knee prosthesis, removed at autopsy from a sixty-one-year-old man, which had been used for eight months. The components were firmly embedded in bone with no evidence of loosening. There was significant deformation of the polyethylene tibial component, but no significant wear on the metallic component. Thin layers of fibrous tissue were found in some areas of the bone-cement interfaces.