Solitary primary intraosseous xanthoma of the mandible in a 15-year-old boy: a case report.

BACKGROUND: A xanthoma is a rare bone condition consisting of a predominant collection of lipid-rich, foamy histiocytes. The central xanthoma of the jaws is a unique benign tumor. CASE REPORT: A 15-year-old Caucasian male has been presented to our department. He had radiological changes in the area of the left mandibular angle, with an area of diffuse osteolysis of 3.0 cm by 2.0 cm. Computed tomography reveals an area of diffuse osteolysis that starts from the distal root of the lower second molar and reaches the ascending process. A bone biopsy was performed, which revealed a benign proliferative process composed of histiocytic cells involving and infiltrating trabecular bone in a background of loose fibrous connective tissue devoid of any other significant inflammatory infiltrate. The size of the formation was 2.9 cm by 2.0 cm. Immunohistochemical staining for CD68 was strongly positive and negative for S-100 and CD1a. From routine blood tests, cholesterol, triglycerides, and blood sugar are within normal values, which excludes systemic metabolic disease. Subsequent to the surgical intervention, the patient underwent postoperative assessments at intervals of 14, 30, 60 days, and a year later, revealing the absence of any discernible complications during the aforementioned observation periods. CONCLUSION: The diagnosis of primary xanthoma of the mandible is rare and can often be confused with other histiocytic lesions. A differential diagnosis should be made with nonossifying fibroma and Langerhans cell histiocytosis, as in our case. In these cases, immunohistochemistry with CD 68, S-100, and CD1a, as well as blood parameters, are crucial for the diagnosis.

Mechanisms for surface contamination of soils and bottom sediments in the Shagan River zone within former Semipalatinsk Nuclear Test Site.

The Shagan River is the only surface watercourse within the former Semipalatinsk Test Site (STS). Research in the valley of the Shagan River was carried out to study the possible migration of artificial radionuclides with surface waters over considerable distances, with the possibility these radionuclides may have entered the Irtysh River. The investigations revealed that radioactive contamination of soil was primarily caused by the first underground nuclear test with soil outburst conducted at the "Balapan" site in Borehole 1004. The surface nuclear tests carried out at the "Experimental Field" site and global fallout made insignificant contributions to contamination. The most polluted is the area in the immediate vicinity of the "Atomic" Lake crater. Contamination at the site is spatial. The total area of contamination is limited to 10-12 km from the crater piles. The ratio of plutonium isotopes was useful to determine the source of soil contamination. There was virtual absence of artificial radionuclide migration with surface waters, and possible cross-border transfer of radionuclides with the waters of Shagan and Irtysh rivers was not confirmed.

Effect of the adjunct of carbon dioxide during cardiopulmonary bypass on cerebral oxygenation.

INTRODUCTION: Over the last few years, near-infrared spectroscopy (NIRS) has been introduced to study cerebral haemodynamics and oxygenation. This paper points out how the use of an external source of CO2 effects on the absolute value of cerebral NIRS during cardiac surgery on cardiopulmonary bypass. PATIENTS AND METHODS: Between January 2010 and September 2011, 368 patients underwent congenital heart disease correction on cardiopulmonary bypass (CPB). Nineteen patients, with a mean age of 26 days (range 6-120 days), required an external source of CO2 to correct hypocarbia during cardiopulmonary bypass. Different parameters were monitored: NIRS value, oxygen saturation, oxygen partial pressure, CO2 partial pressure, haematocrit, mean arterial pressure and pH. They were analyzed during different phases of the surgical procedure: before, during and after CO2 infusion. RESULTS: There were no deaths during the hospital stay. The NIRS value increased significantly (p<0.05) after the addition of CO2, from a starting value of 52.9 to a final value of 63.4. PaCO2 was found to increase too: from 31.3 mmHg to 40.6 mmHg. On the other hand, both values decreased when the CO2 was removed, to respective final values of 55.8 and 34.4 mmHg. Mean arterial pressure, haematocrit and PaO2 didn't modify significantly during this period. CONCLUSIONS: Nowadays, NIRS is usually used in cardiac surgery to reduce possible risks of neurological damage. The importance of the role of pCO2 in the cerebral vascular resistance and in cerebral blood flow has already been proven. This research demonstrates a relationship between pCO2 and the NIRS value. This paper could introduce an important correcting tool when an inadequate NIRS value occurs although the level of oxygenation, haematocrit and mean arterial pressure are acceptable and the arterial line is accurately positioned.

Non-invasive cerebral oximetry monitoring during cardiopulmonary bypass in congenital cardiac surgery: a starting point.

INTRODUCTION: Non-invasive cerebral monitoring with the INVOS cerebral oximeter is an accepted good indicator of cerebral metabolism. In recent years, it has been used in the monitoring of patients who underwent cardiac surgery. Herein, we describe the INVOS trend during cardiopulmonary bypass (CPB) in a cohort of patients operated in our institution for congenital heart disease. PATIENTS AND METHODS: Between December 2009 and March 2010, 40 patients (mean age 8.4 years; range 11 days-60 years) underwent cardiac surgical procedures using CPB. Values of INVOS cerebral parameter, pH, oxygen saturation, and CO(2) level were collected pre CPB, during cooling, re-warming and weaning, and post CPB. INVOS parameters were evaluated according to CPB priming, age and preoperative oxygen saturation. RESULTS: Patients were divided according to CPB priming (haematic vs clear), age (≤1 vs >1 year of age) and oxygen saturation (≤92% vs >92%). During the operations, the trend demonstrated a reduction in INVOS value at the institution of CPB and a further reduction during the cooling phase in all groups.This has been correlated to the loss of pulsatile flow. However, the value recovered during re-warming, weaning and CPB discontinuation. Cyanotic patients presented a lower cerebral oximetry compared to acyanotic patients during the whole CPB period. Between age and priming groups, we noticed a statistical difference in cerebral oximetry, with a lower value in the younger patients and in the haematic priming group. This might be interrelated because all patients younger than 1 year old always received haematic CPB priming. CONCLUSIONS: We demonstrated that cerebral oximetry decreases with the loss of pulsatile flow regardless of the mean arterial pressure and, furthermore, is not directly related to the haematocrit value in patients with reduced pulmonary blood flow.

[A case of pulmonary blastoma--a case report and review of the literature].

Pulmonary blastoma is a rare malignant tumor of the lungs, with a frequency of 0.25-0.5% of all primary malignant lung tumors. We present a case of 42-year old man with biphasic pulmonary blastoma The authors discussed the clinical features, laboratory findings, radiologic and CT features, the operative treatment and the pathologic diagnosis.

[Extranodal lymphomas of the gastrointestinal tract. Retrospective study of a six year period].

INTRODUCTION: We present a six year study (from 1998-2003 year) concerning Non-Hodgkin's lymphomas originating from the gastrointestinal tract according to the classification of WHO (1997). RESULTS: For the mentioned period in the University Hospital "Sveti Georgi" are diagnosed 22 cases of extranodal Non-Hodgkin's lymphomas of the gastrointestinal tract; 9 (40.9%) of them originated from lymph nodes of Valdier, 1 (4.5%)--from parotid gland, 6 (27.3%)--from stomach, 4 (18.2%) from large intestine and 2 (9.1%) cases from the small intestine. The ratio men/women is equal, and the age is between 20 to 84 years. All the lymphomas were B-cells type; in 6 cases they are MALT lymphomas, and in the rest of the cases--diffuse large cell B-cell type Non-Hodgkin's lymphomas. CONCLUSION: In our investigation all Non-Hodgkin's lymphomas of the gastrointestinal tract are of B-cell type. Obviously their diagnosis is being late; probably because diffuse large cell B-cell type Non-Hodgkin's lymphomas are the predominant type.

[Acute appendicitis and pregnancy].

Acute appendicitis remains the most common nonobstetric surgical diagnosis during pregnancy, requiring surgery. It is estimated that its frequency is 1 case per 1500 pregnancies. The delay in the diagnosis correlates with an increase in ruptured appendix and a dramatic elevation in fetal and maternal morbidity and mortality. In the study the authors discuss the clinical presentation, laboratory findings, operative treatment, pathologic diagnosis and the outcome of the disease of 17 cases with acute appendicitis in pregnancy, operated in the Clinic of Thoraco Abdominal Surgery for a ten years period of time. The early surgical treatment plays an important role for the succsessful outcome of the disease and reduces the complications for the mother and the fetus.

[Carcinoid tumors of the gastrointestinal tract--frequency, organ localization, clinical course, treatment (a presentation of 10 cases)].

Carcinoid tumors originate from the argentofile cells found at the bottom of the crypt of Lieberkuhn. In spite of their slow growth and comparatively better prognosis, the carcinoid are malignant tumors, which effective treatment is their surgical resection. We present 10 patients with carcinoid of the gastrointestinal tract (GIT)--3 from small intestine, 3 from large intestine, 2 from appendix, I from rectum and 1 from stomach, operated at our clinic for a 6 year period of time.

A case of melanoma metastatic to the gallbladder and the common bile duct with clinical presentation of obstructive jaundice and bilirubinemia.

Cutaneous melanoma is known to have the capacity to metastasize to virtually any organ. Because melanoma metastases to the gallbladder and the extrahepatic bile ducts are usually clinically asymptomatic, there are only few reports on this topic in living patients. We describe a case of melanoma metastatic to the gallbladder and the common bile duct presenting with obstructive jaundice and bilirubinemia.

[Hepatoid adenocarcinoma of the lung: a case report]. / Sluchai na khepatoiden adenokartsinom na beliia drob.

A case of a 71-year-old man with dyspnea attacks, weight loss and astheno-adynamia syndrome is presented. A 7.7 x 6.4 cm well-delineated tumor is found intraoperatively in the superior lobe of the left lung towards the posterior mediastinum. The tumor cells resemble hepatocytes histologically and show expression for alpha-fetoprotein. Diagnosis primary hepatoid lung adenocarcinoma is made. Pericellular basal membrane-like material is found on electron microscopy. A clinico-morphological discussion regarding the biological behavior and prognosis of this rare tumor is presented.

[The effect of subgingival irrigation with acetylsalicylate on the polymorphonuclear leukocyte count in periodontal pockets of medium depth]. / Effetto di irrigazioni subgengivali con acetilsalicilato sul numero di leucociti polimorfonucleati in tasche parodontali di media profondità.

Considering the role played by arachidonic acid metabolites in the pathogenesis of periodontal disease and the possible beneficial effects exerted by non steroidal anti inflammatory drugs on periodontal damage, the aim of the present study was to assess the capability of a 1% acetylsalicylate solution, delivered by subgingival irrigation, in reducing the number of polymorphonuclear leukocytes (PMN) in periodontal pockets of patients affected by periodontitis. Ten patients systemically healthy, in the age between 36 and 64, participated in the study. After supragingival scaling in each patient test and two control sites were chosen among those exhibiting a pocket depth between 5 and 7 mm. The number of periodontal pocket PMN was evaluated after subgingival washing by the technique of Skapski & Lenher and Gingival Bleeding Index (GBI) score was recorded in each experimental site. Test sites then received subgingival subgingival washing by 0.5 ml of a 1% acetylsalicylate solution three times a week whereas control sites were irrigated by physiologic solution. After treatment the number of PMN and GBI scores from each test and control site was re-evaluated. Results showed that test sites exhibited a decrease in the number of pocket-PMN respect to control sites although not statistically significant (p > 0.5). At contrary GBI score did not modify through the study. In conclusion subgingival irrigation by acetylsalicylate demonstrated to be able to reduce subclinical inflammation in periodontal pockets evaluated by the number of PMN in gingival fluid.

[The presence of Actinobacillus actinomycetemcomitans in subgingival bacterial plaque in relation to the amount of supragingival plaque]. / Presenza di Actinobacillus actinomycetemcomitans nella placca batterica sottogengivale in relazione alla quantità di placca batterica sopragengivale.

Actinobacillus actinomycetemcomitans (Aa) is currently considered the principal bacterium involved in juvenile forms of periodontitis. Considering that supragingival and subgingival plaque are closely correlated, the aim of the present research has been to assess if a correlation can be recognized between the amount of supragingival plaque and the presence of Aa in subgingival plaque in young subjects. Thirty-three individuals participated in the study. In each subject's dentition two periodontal sites were chosen: one (test site) was randomly selected among those sites which displayed a Plaque Index (P1I) = 0; another site was similarly chosen among those which presented the highest P1I score (2 or 3). In each test and control site Gingival Bleeding Index (GBI) was recorded and a microbiological sampling of subgingival plaque was performed. After anaerobic culture of plaque samples, the occurrence of Aa in each test and control site and the proportional representation of the bacterium in total cultivable anaerobic flora were assessed. Results showed a statistically significant difference in the occurrence of Aa between test and control sites in the same oral cavity and a correlation between GBI positivity and Aa presence. In conclusion, according to other authors, Aa seems to be more frequently founded in subgingival plaque coming from periodontal sites where supragingival plaque in more abundant.

Evaluation of chlamydiazyme enzyme immunoassay for detection of Chlamydia trachomatis in urine specimens from men.

Paired first-voided urine and urethral swab specimens were collected from 540 men attending sexually transmitted disease clinics in three geographic locations. Urine specimens were tested for the presence of Chlamydia trachomatis by commercial enzyme immunoassay (Chlamydiazyme), and the results were compared with those of urethral swab cultures. Overall prevalence of urethral C. trachomatis by culture was 14%, and the Chlamydiazyme assay had an overall sensitivity of 83%, a specificity of 96%, a positive predictive value of 76%, and a negative predictive value of 97%. Sensitivity was greater (94%) in those culture-positive samples with a high antigen load (> or = 20 inclusion-forming units per coverslip) than those with a lower antigen load (68%). Assay of urine specimens from men attending sexually transmitted disease clinics by Chlamydiazyme appears to be a reliable, noninvasive method of detection of C. trachomatis infection, and further evaluation of its performance in asymptomatic and low-prevalence populations is indicated.

Kinetic analyses demonstrate that the equilibrium assumption does not apply to [125I]endothelin-1 binding data.

The kinetics of [125I]Endothelin-1 ([125I]ET-1) binding were studied using membranes from rat heart, rat lung, rat brain, and porcine vascular smooth muscle at 37 degrees C in 0.05M Tris-HCl buffer (pH = 7.4). The dissociation half-life (t1/2, diss.) for bound [125I]ET-1 was in excess of 30 hours for each tissue studied. Equilibrium-time requirements for proper Scatchard analysis of [125I]ET-1 were also far in excess of 30 hours for each tissue. These data suggest that determination of dissociation constants, Kd, and receptor concentrations, Bmax, by conventional Scatchard analysis is not feasible with [125I]ET-1. Kinetic analyses may provide a more accurate means for determining [125I-ET-1] binding characteristics including Kd and Bmax.

[The assessment of cell-mediated immunity in allergy patients]. / Otsenka na kletuchno obusloveniia imunitet pri alergichno bolni.

The cell-mediated immunity was assessed in patients with atopic bronchial asthma, non-atopic bronchial asthma and allergic rhinitis by intracutaneous tests with bacterial allergens. "Set for cell immunity determination" and phytohemagglutinin. The cell-mediated immunity was statistically significantly more often disturbed in the allergic patients than in the healthy controls. The differences between the separate nosologic entities were insignificant. Best correlations were found between the tests with phytohemagglutinin and the standard set and between phytohemagglutinin and tuberculin from the standard set.

[Interaction between the ABO and Rh-Hr blood group systems in pairs of monozygotic (MZ) and dizygotic (DZ) twins]. / Interazione tra i sistemi ABO e Rh-Hr nelle nascite gemellari MZ e DZ.

Previous studies have revealed significant deviations of twin pairs' blood group distributions. A comparison between monozygotic (MZ) and dizygotic (DZ) pairs in a sample of 688 twin pairs as to interaction between ABO and Rh indicates that the main contribution to total deviation comes from the MZ pairs, thus confirming a different behaviour of the two twin types in this respect.