Association between GPX1 Pro189Leu polymorphism and the occurrence of bladder cancer in Morocco.

Worldwide, Bladder cancer is the most frequent male malignancy. It is the third most common male malignancy in Morocco. The risk factors for developing bladder cancer are multiples including dietary conditions, environmental exposure and oxidative stress. GPX1 gene encoding for the human cellular antioxidant enzyme glutathione peroxidase1 is a key factor in the cell detoxification process. GPX1 Pro198Leu polymorphism is associated with a decrease of enzyme activity and may contribute to bladder cancer susceptibility. The present case-control study was planned to assess the presence of GPX1 Pro198Leu polymorphism in Moroccan population to determine whether it is associated with the risk of developing bladder cancer in Moroccan patients. A total of 32 patients with bladder cancer and 40 healthy controls were enrolled. Genotyping of the GPX1 Pro198Leu polymorphism was carried out by PCR amplification and DNA sequencing. Pro198Leu polymorphism was observed in both bladder cancer patients and healthy controls. No significant association between the polymorphism and bladder cancer occurrence was found (Pro/Leu vs. Pro/Pro: p=0.425; Leu vs. Pro: p=0.435). For the analysis of Pro198Leu polymorphism and progression of bladder cancer, no association was observed neither for stages (Pro/Leu vs. Pro/Pro: p=0.500; Leu vs. Pro: p=0.500) nor grades (Pro/Leu vs. Pro/Pro: p=0.415; Leu vs. Pro: p=0.427). Our results clearly showed no significant association between Pro198Leu polymorphism and risk of bladder cancer in our population, suggesting that the effect of this polymorphism on bladder cancer development might be a result of a combination with other genetic alterations and/or non-genetic variables such as diet and lifestyle factors.

Epigenetic alterations of adenomatous polyposis coli (APC), retinoic acid receptor beta (RARß) and survivin genes in tumor tissues and voided urine of bladder cancer patients.

The CpG promoter methylation has been reported to occur frequently in bladder cancer. Moreover, analysis of gene methylation has been shown to be feasible from voided urine and can be detected with a high degree of sensitivity. The aim of this present study is to determine how methylation patterns of APC, RARβ and Survivin genes change during bladder carcinogenesis and to evaluate whether DNA methylation could be detected in urine sediment. Using the sensitive assay of MSP, we explored the promoter methylation status for the three genes in tumor specimens and urine sediment DNA from 32 bladder cancer patients. Methylation frequencies of the tested genes in tumor specimens were 100%, 75% and 84.4% for APC, RARβ and Survivin, respectively. Hypermethylation of APC was found in all pathological grades and stages of bladder cancer. More frequent promoter hypermethylation of RARβ and Survivin was observed in high grade tumors and the hypermethylation increased from low to high stages, but there was no significant correlation between stages/grades and hypermethylation of these two gene promoters. In order to investigate clinical usefulness for noninvasive bladder cancer detection, we further analyzed the methylation status in urine samples of bladder cancer patients. Methylation of the tested genes in urine sediment DNA was detected in the majority of cases that were hypermethylated in tumor samples (93.7%) and the frequencies were 79.3% 70.8% and 96.3% for APC, RARβ and Survivin, respectively. Our results indicate that methylation of APC, RARβ and Survivin gene promoters is a common finding in patients with bladder carcinoma. The ability to detect methylation not only in bladder tissue, but also in urine sediments, suggests that methylation markers are promising tools for noninvasive detection of bladder cancer.

[Maxillary T/NK lymphoma. Case report]. / Lymphome T/NK maxillaire. À propos d'un cas.

INTRODUCTION: Primary nasal T/NK cell lymphoma is a very rare pathological clinical entity; it was defined by the WHO in 2001, thanks to immunohistochemistry. The treatment combines radiotherapy and chemotherapy. We report a case. CASE REPORT: A 20-year-old male patient was admitted for ulceration of the vestibular mucosa from tooth 20 to 26, in June 2008. The lesion had appeared four months before, with a painful ulceration close to tooth 25. The lesion evolved progressively, it eroded the alveolar bone, exposing the roots of teeth 24, 25, and 26. CT scan revealed lysis of the external maxillary sinus wall. The diagnosis of T/NK cell lymphoma was obtained by immunohistochemistry of the biopsy. The tumor was staged IeA according to the Ann Arbor classification. After four courses of CHOP chemotherapy and two years of follow-up there was no recurrence. DISCUSSION: Maxillary T/NK cell lymphoma is extremely rare. The diagnosis is based on immunohistochemistry. The treatment associates chemotherapy and radiotherapy. Recent studies suggest that radiotherapy at an early stage could improve the prognosis. But there is no consensus on therapeutic protocols.

Human malaria in immunocompromised mice: an in vivo model to study defense mechanisms against Plasmodium falciparum.

We have recently described that sustained Plasmodium falciparum growth could be obtained in immunodeficient mice. We now report the potential of this new mouse model by assaying the effect of the passive transfer of antibodies (Abs) which in humans have had a well-established effect.Our results show that the total African adult hyperimmune immunoglobulin Gs (HI-IgGs) strongly reduce P. falciparum parasitemia similarly to that reported in humans, but only when mice are concomitantly reconstituted with human monocytes (HuMNs). In contrast, neither HI-IgGs nor HuMNs alone had any direct effect upon parasitemia. We assessed the in vivo effect of epitope-specific human Abs affinity-purified on peptides derived either from the ring erythrocyte surface antigen (RESA) or the merozoite surface protein 3 (MSP3). The inoculation of low concentrations of anti-synthetic peptide from MSP3, but not of anti-RESA Abs, consistently suppressed P. falciparum in the presence of HuMNs. Parasitemia decrease was stronger and faster than that observed using HI-IgGs and as fast as that induced by chloroquine. Our observations demonstrate that this mouse model is of great value to evaluate the protective effect of different Abs with distinct specificity in the same animal, a step hardly accessible and therefore never performed before in humans.

Primary retroperitoneal mucinous cystadenoma.

Primary retroperitoneal mucinous cystic tumors are extremely rare, and although their histopathogenesis is still uncertain, several theories have been proposed. Traditionally, transabdominal laparotomy and enucleation of the cyst is the treatment of choice. The anatomopathological examination of the mass is imperative in the fact to eliminate malignant lesions. We report the case of a 43-year-old woman, with primary retroperitoneal mucinous cystic tumor, revealed by an abdomino-pelvic mass. During laparotomy, a totality of the tumor was removed. The anatomopathologic study permitted the diagnosis.

[Primary leiomyosarcoma of the pancreas]. / Léiomyosarcome primitif du pancréas.

Primary leiomyosarcoma (LMS) of the pancreas is a rare mesenchymal neoplasm (0.1% of pancreatic tumors) with only 35 cases reported in the world literature. We describe a 36th case. This tumor affects adults in the fifth decade of life, especially men. Its diagnosis is difficult and is based on immunohistochemical analyses that reveal smooth muscle cell markers. We report the case of a patient with primary LMS in the head of the pancreas. He underwent a pancreaticoduodenectomy for both diagnosis and treatment after imaging was unable to provide a precise diagnosis. The discussion covers the clinical, diagnostic, immunohistochemical, and therapeutic characteristics of this neoplasm.

[Primary leiomyosarcoma of visceral mediastinum]. / Léiomyosarcome primitif du médiastin viscéral.

Primary leiomyosarcoma of the thorax is a rare malignant mesenchymatous tumour. Most of those tumours occurring in the mediastinum arise from the oesophagus and great vessels, whereas an appearance in the soft tissue of the mediastinum is extremely rare. The rare incidence of this tumour and its slow growth reflect the difficulties in differential diagnosis according to their histopathology and location. The most common treatment is surgical resection. The authors describe a case of a leiomyosarcoma arising from soft tissue of the mediastinum and present a review of the literature.

[Acquired ichthyosis revealing an Hodgkin's disease]. / Ichtyose acquise révélant une maladie de Hodgkin. Une nouvelle observation.

INTRODUCTION: Acquired ichthyosis is a rare condition that usually reveals malignant diseases. CASE REPORT: A 70-year-old man was admitted with weight loss, diffuse ichthyosis, lymphadenopathy of the inguinal lymph nodes and elevated inflammatory markers in peripheral blood. Histology of the lymph node revealed mixed-cellularity Hodgkin disease. The evolution was fatal in spite of the chemotherapy. DISCUSSION: Acquired ichthyosis is a cutaneous paraneoplastic syndrome, generally related to hematologic malignancies. A possible pathomecanism is the stimulation of epidermal growth secondary to the production of epidermal growth factor (EGF) by tumour cells. Acquired ichtyosis can rarely reveal systemic or infectious diseases. It can also be drug-induced or idiopathic.

[Desmoplastic ameloblastoma in a 7 year old child]. / Améoblastome desmoplastique chez un enfant de 7 ans.

Desmoplastic ameloblastoma is a benign, locally aggressive neoplasm of proliferating odontogenic epithelial origin. It is seen among old patients from 17 to 72 years with an average age 42 years and without predilection of sex. We report the case of a 7 year old child, having presented since the 5 years age, a gingival tumefaction on the left higher incisivo-canin group which increased volume gradually. The stomatologic examination showed a gingival tumefaction covered with a healthy mucous membrane, ovoid form and measuring 3 cm on its horizontal axis. The tomodensitometry of the jawbone showed in front of the 21st and the 22nd tooth, the presence of an osseous lesion associating of the hearths of osteolysis and osteocondensation with rupture of cortical and invasion of the soft tissue. A curetting of the lesion was carried out and the anatomopathologic examination retained the diagnosis of desmoplastic ameloblastoma. The characteristic of our observation is the youth of the patient. In addition, the desmoplastic ameloblastoma is relatively rare, is characterized by an anatomical distribution, a radiological appearance and a morphological aspect differents from the traditional ameloblastoma. A radical surgical treatment is suggested for this tumour to avoid recurrency.

[Surgical treatment of secondary hyperparathyroidism in chronic renal failure. Report of 57 cases]. / Traitement chirurgical de l'hyperparathyroidie secondaire des insuffisants renaux: a propos de 57 cas.

AIM: The aim of this study was to report the experience of the department of general surgery (Aile III) Ibn Rochd Hospital in surgical management of hyperparathyroidism in patients with end-stage renal disease (ESRD). METHODS: Fifty seven patients (24 M, 33F) with hyperparathyroidism underwent surgical parathyroidectomy from 1998 to 2004. Surgical indication was established according to clinical or biological assessment. Fifty nine operations were performed (57 first-hand cervicotomies and resumptions in too cases). RESULTS: Histological examination of parathyroid gland specimens disclosed adenoma in 33 patients and hyperplasia in 14 patients. The follow-up was normal in 52 patients, marqued by cervical hematoma in 2 cases and death was deplored in 4 patients. The post-operative calcium level was in the normal range in 43 cases, low comparatively to the baseline in 12 cases and high in 2 cases. The PTH levelwas normal in 55 patients and high in two patients. Long-term outcome was evaluated in 36 patients mean follow-up (18 months). A good evolution was noted in all patient referring to clinical, biological and radiological investigations. CONCLUSION: That, in our context, surgical parathyroidectomy still an appropriate approach for the treatment of hyperparathyroidism in patients with end-stage renal disease.

[Angiolymphoid hyperplasia with eosinophilia]. / Hyperplasie angiolymphoïde à éosinophiles.

INTRODUCTION: Angiolymphoid hyperplasia with eosinophilia is a rare affection. CASE REPORT: A 36 years-old woman presented an angiolymphoid hyperplasia with eosinophilia manifesting by erythematous nodular lesions on the face and the forearms, severe neuropathy, visual loss and eosinophilia. Corticosteroids, immunosuppressive drugs and interferon-alpha were unsuccessful. DISCUSSION: Angiolymphoid hyperplasia with eosinophilia is a dermatological disease with possible systemic features. Differential diagnosis with Kimura disease is based on clinical presentation and histological findings. Etiopathology remains unknown and the treatment is not codified.

[Cutaneous blastomycosis revealing intravascular B-cell lymphoma: a case in Morocco]. / Blastomycose cutanée révélant un lymphome B intravasculaire: une observation marocaine.

Blastomycosis is a systemic fungal infection caused by a thermally dimorphic fungus, Blastomyces dermatitidis. The incidence in immunocompromised patients has increased in the last two decades. A 55-year-old man consulted for inflammatory nodules on the forearm. Biopsy of one nodules showed a pseudoepitheliomatous hyperplastic epidermis overlaying a dense agranulomatous inflammatory infiltrate containing free-formed ovoid bodies enclosing giant macrophageous cells. These findings were consistent with blastomycosis. After a month of treatment cutaneous lesions regressed partially but the patient's general status continued to deteriorate with the appearance of an edematous-ascitic syndrome and icterus. Laboratory blood testing demonstrated cholestasia and abdominal ultrasound showed hepatosplenomegaly. Needle liver biopsy revealed giant B-cell lymphomatous infiltration of the hepatic ducts. The patient's condition worsened rapidly and he died five months after diagnosis despite four rounds of chemotherapy. Blastomycosis is rare in Morocco. Primary infection is usually a pneumonic process. Isolated cutaneous infection is possible but uncommon. To our knowledge the association of blastomycosis and intravascular lymphoma has not been previously reported. In immunocompromised patients, clinical findings can be alarming and the outcome can be rapidly fatal.

[Isolated pseudo-tumoral tuberculosis of the spleen. A case report]. / La tuberculose splénique pseudotumorale isolée. (A propos d'un cas).

INTRODUCTION: The tuberculosis isolated tumoral spleen is rare, even in the countries to strong tubercular endemic. EXEGESIS: From an observation, concerning an important, tumoral and isolated splenomegaly in 48-year-old-man. The authors put the accent on his tumorous variety by the clinic, the imagery and on macroscopic appearance of the operative piece. Are discussed the isolated character, the way of dissemination, the site of initial infestation and the deceitful character of haematological manifestations. A splenectomy to diagnostic and therapeutic goal have been realised, associated to the chemotherapy. CONCLUSION: This is an expression of the profound organ's tuberculosis rich on endothelial reticular system. It's mean a singular topography of the bacillary lesion and a great distribution of the tubercular affect.

Evolution during growth of the mechanical properties of the cortical bone in equine cannon-bones.

Two specimens (70.0 x 4.5 x 1.8 mm) (proximal and distal) of cortical bone were taken from each of the cranial, caudal, lateral and medial quadrants at mid-diaphysis of the third metacarpus and metatarsus of French saddle horses (12 males and seven females) aged from 1 day to 4 years. The mechanical properties (bending strength, Young's modulus, yield stress and ultimate specific deflection) were determined by a 4-point bending test, loading at a rate of 166 x 10(-6) ms-1. During growth, the mechanical properties of the cortical bone were not significantly different (p > 0.05) between metacarpus and metatarsus, but they were slightly higher in the proximal than in the distal diaphysis. The variations in these properties were significant (p < 0.0001) between quadrants. From birth to adult age, the lateral and medial quadrants had greater average bending strength (Sb = 226 +/- 27 MPa), average Young's modulus (E = 16 +/- 2 GPa) and average yield stress (Sy = 110 +/- 23 MPa) than the cranial quadrant (Sb = 209 +/- 23 MPa, E = 15 +/- 2 GPa, Sy = 99 +/- 18 MPa) while the caudal quadrant gave the lowest values (Sb = 195 +/- 30 MPa, E = 14 +/- 2 GPa, Sy = 92 +/- 21 MPa). During the growing period, the bending strength, the Young's modulus and the yield stress were positively correlated with age (p < 0.01) and the total body weight (p < 0.001) of the horses. Conversely, the ultimate specific deflection decreased slightly during the same period. The mechanical properties of the cortex were also related (p < 0.005) to the mineral content (ash or calcium). The Young's modulus was particularly correlated to calcium content (p < 0.0001). It is also linearly related to the bending strength (r = 0.8), and its in vivo determination by the ultrasound method should provide an easy and non-invasive investigation means of the mechanical properties of the cortical bone in equine cannon-bones.

[Leiomyosarcoma of the vagina: a rare case]. / Le léiomyosarcome du vagin: une observation rare.

Vaginal leiomyosarcoma is unfrequent. We report on a case in a 50-year-old multipara patient who had presented a posterior vaginal swelling since 6 months. The tumor was discovered at the occasion of pains and non hemorragic discharge. The histological pattern of the tumor was well-differentiated spindle cell sarcoma with pleiomorphic areas. The immunohistochemistry confirmed the smooth myogenic differentiation. The treatment consisted of posterior pelvic exenteration extended to the vagina. The patient is alive and free of disease at 20 months of fellow-up.

CT features of a voluminous gastric trichobezoar.

We report on the case of a 15-year-old girl with a voluminous gastric trichobezoar imaged by CT. The absence of any attachment of the mass to the gastric wall and the presence of air within the mass are very suggestive for diagnosis.

[Role of external biliary drainage in common bile duct lithiasis. Apropos of 172 case reports]. / Place du drainage biliaire externe dans la lithiase cholédocienne. A propos de 172 observations.

A series of 172 lithiasis of the common bile duct has been analysed. Priority has always been given to the external drainage by a T tube. It seems to be the simplest method, with the lowest morbidity. 6 patients, as 3.48% are deceased precociously after the intervention in keeping with the gravity of the lesions and the general state.