Mature teratoma of conus medullaris: A case report and review of literature.

In conus medullaris, mature teratomas are rare. We report a case of a 40-year-old man who presented with urinary incontinence, low back pain, and muscle weakness. Magnetic resonance imaging revealed a mass in conus medullaris (T11-L1), further confirmed as a mature teratoma by pathological examination. We identified 63 cases of conus medullaris teratoma over the past two decades by systematically analyzing the case reports. Findings demonstrated that most cases were diagnosed in the fourth decade of life, with the majority of cases (57.6%) being male. Lower back pain, radiating pain in the extremities, hypoesthesia, and urinary dysfunction are the most common clinical presentations among patients with teratoma of conus medullaris. Mature teratoma is the dominant pathologic subtype of teratomas in this region, comprising more than 95% of cases. Our case highlights the importance of considering spinal teratoma as a differential diagnosis in patients presenting with urinary incontinence and lumbar pain.

Pesticide Exposure and Head and Neck Cancers: A Case-Control Study in an Agricultural Region.

INTRODUCTION: Causes of head and neck cancers (HNCs) are multifactorial, and few studies have investigated the association between chemical exposure and HNCs. The objective of this study was to investigate associations between HNCs, agricultural occupations, and pesticide exposure. The potential for the accumulation of pesticides in the adipose tissue of patients was also investigated. MATERIALS AND METHODS: A structured questionnaire was used to collect information on demographics, occupation, and exposure to pesticides in a hospital-based case-control study. Pesticide residue in the adipose tissue of the neck in both cases and controls was also monitored via gas chromatography-mass spectroscopy. RESULTS: Thirty-one HNC cases were included in this study as well as 32 gender-, age-, and smoking-matched controls. An agricultural occupation was associated with HNC (odds ratio [OR], 3.26; 95% confidence interval [CI], 1.13-9.43) after controlling for age, sex, and smoking. Pesticide exposure was associated with total HNC cases (OR, 7.45; 95% CI, 1.78-3.07) and larynx cancer (OR, 9.33; 95% CI, 1.65-52.68). A dose-response pattern was observed for HNC cases (P=0.06) and larynx cancer (P=0.01). In tracing the pesticide residue, five chlorinated pesticides, namely dichlorodiphenyltrichloroethane (DDT), dichlorodipheny-ldichloroethane (DDD), dichlorodiphenyldichloroethylene (DDE), dieldrin, and lindane, were identified in the adipose tissue. Chlorinated pesticide detection was significantly associated with HNC (OR, 3.91; 95% CI 0.9-0.16.9). CONCLUSION: HNCs were found to be associated with pesticide exposure after controlling for confounders. A high education level was identified as a modifying factor decreasing the risk of HNCs. Further studies with larger number of subjects are recommended to assess these relationships in greater detail.

Effects of pulsed electromagnetic field on intervertebral disc cell apoptosis in rats.

Despite numerous studies on pulsed electromagnetic field (PEMF) application, its effects of PEMF on intervertebral disc (IVD) have not yet been investigated in vivo. Accordingly, the effects of PEMF upon IVD in rats were evaluated through molecular surveys. Rats were divided into six groups: Group I and II were exposed to low and high frequency of PEMF (LF and HF, respectively). Group III and IV underwent induced disc degeneration and were exposed to low and high frequency of PEMF (LF/IDD and HF/IDD, respectively). Group V underwent induced disc degeneration (IDD), and group VI was control. The values of caspase 3, Bax, Bcl-2 and ß-actin band density, as cell apoptotic markers, were obtained from band densitometry. Our results showed that the value of cleaved caspase-3 of cells and Bax/Bcl-2 ratio in IDD group increased significantly compared to the control group (p < 0.001). The value of cleaved caspase-3 and Bax/Bcl-2 ratio decreased significantly in LF/IDD and HF/IDD groups compared to IDD group (p < 0.05). No significant increase was seen in the cell apoptotic markers in the groups just exposed to PEMF compared to the control group. There was also no significant decrease in the Bax/Bcl-2 ratio in HF/IDD and LF/IDD groups compared to the control group. These data suggest that PEMF attenuates degenerative processes in rat's intervertebral discs and has no effect on normal discs. Regulations of the expression of apoptotic proteins may be one of the mechanisms by which PEMF is effective in reduce disc degeneration.

Effect of atorvastatin on angiogenesis in degenerated intervertebral disc in rat.

STUDY DESIGN: An experimental study to measure the depth of penetration of new vessels in degenerated intervertebral disc in rat. OBJECTIVE: To evaluate the effects of atorvastatin on angiogenesis in experimental disc degeneration in rat. SUMMARY OF BACKGROUND DATA: Back pain is strongly associated with degenerated intervertebral disc and management of this condition is still empirical. Decrease of nucleus nutrition due to loss of vascularity with aging may aggravate the process of disc degeneration. So, angiogenesis may be useful in the healing process of degenerated disc. In this study, we wanted to evaluate the effect of atorvastatin, whose stimulating effect on angiogenesis on other tissues was shown in several studies, on degenerated intervertebral disc in rat. METHODS: Atorvastatin was administered intraperitoneally for 6 weeks in doses of 1, 4, and 8 mg/kg in rats after experimental disc degeneration. The rats intervertebral disc sections were stained immunohistochemically for von Willebrand Factor to evaluate the depth of vessels penetration and degree of vascularity. RESULTS: In the nonoperated control group, the intervertebral discs were avascular. But experimental disc degeneration promoted angiogenesis. In this group, the mean of penetration was 49.25 µ (standard deviation = 19.905). Atorvastatin stimulated angiogenesis after experimental disc degeneration in the rats and the angiogenesis was more significant in the high and medium dose groups than operated control group. High-dose atorvastatin could not inhibit angiogenesis in experimental degenerated disc. There was no any significant difference in degree of vascularity among the groups. CONCLUSION: Atorvastatin stimulates angiogenesis in experimental disc degeneration in rats. But, it does not show a biphasic effect.

Self-mutilation of the nose in a schizophrenic patient with Cotard syndrome.

Cotard syndrome is a rare condition, which its main symptom is nihilistic delusion. Self-mutilation of the nose is also a rare condition, which has not been seen in schizophrenic patients with Cotard syndrome. A single case is presented here. A 32-year-old woman who was diagnosed as having schizophrenia and believed that she was dead, cut the tip of her nose. She had no guilt feeling and described her act as a cosmetic surgery. We try to explain how various symptoms that seem to be very far from each other could exist side by side. Misinterpretation of her face is suggested to be the starting point in her complex symptoms.