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Selected AbstractsLocalized lymphedema (elephantiasis): a case series and review of the literatureJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2009Song Lu Background:, Lymphedema typically affects a whole limb. Rarely, lymphedema can present as a circumscribed plaque or an isolated skin tumor. Objective:, To describe the clinical and pathologic characteristics and etiologic factors of localized lymphedema. Methods:, Case,control study of skin biopsy and excision specimens histologically diagnosed with lymphedema and presenting as a localized skin tumor identified during a 4-year period. Results:, We identified 24 cases of localized lymphedema presenting as solitary large polyps (11), solid or papillomatous plaques (7), pendulous swellings (4), or tumors mimicking sarcoma (2). Patients were 18 females and 6 males with a mean age of 41 years (range 16,74). Anogenital involvement was most frequent (75%) , mostly vulva (58%), followed by eyelid (13%), thigh (8%) and breast (4%). Causative factors included injury due to trauma, surgery or childbirth (54%), chronic inflammatory disease (rosacea, Crohn's disease) (8%), and bacterial cellulitis (12%). Eighty-five percent of these patients were either overweight (50%) or obese (35%). Compared with a series of 80 patients with diffuse lymphedema, localized lymphedema patients were significantly younger (41 vs. 62 years old, p = 0.0001), had no history of cancer treatment (0% vs. 18%, p = 0.03), and had an injury to the affected site (54% vs. 6%, p = 0.0001). Histologically, all cases exhibited dermal edema, fibroplasia, dilated lymphatic vessels, uniformly distributed stromal cells and varying degrees of papillated epidermal hyperplasia, inflammatory infiltrates and hyperkeratosis. Tumor size significantly and positively correlated with history of cellulitis, obesity, dense inflammatory infiltrates containing abundant plasma cells, and lymphoid follicles (p < 0.05). A history of cellulitis, morbid obesity, lymphoid follicles and follicular cysts predicted recurrent or progressive swelling despite excision (p < 0.05). Conclusions:, Localized lymphedema should be considered in the etiology of skin tumors when assessing a polyp, plaque, swelling or mass showing dermal edema, fibrosis and dilated lymphatics on biopsy. A combination of lymph stasis promoting factors (trauma, obesity, infection and/or inflammatory disorders) produces localized elephantiasis. [source] Oral and pharyngeal cancer mortality rates in Mexico, 1979,2003JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 1 2008Gabriela Anaya-Saavedra Background:, In Mexico, information on oral and pharyngeal cancer (OPC) is scarce. The purpose of this study was to explore the trends in OPC mortality rates in Mexico from 1979 through 2003 and to describe the distribution of OPC deaths for selected socio-demographic variables for the period of 2001,2003. Material and methods:, Annual crude and age-adjusted mortality rates were obtained by gender and site of lesion, using the 2003 WHO World standard million population. The Poisson regression model was used to detect a trend in the mortality rates, testing the hypothesis ,1 = 0. Also, the annual percentage change (APC) was computed over the age-adjusted rates. Results:, The total number of OPC deaths during the period 1979,2003 was 15 576. The age-adjusted mortality rate was 1.13/100 000 in 1979 and 1.08/100 000 in 2003. Oral cancer was more frequently found than salivary gland and pharyngeal cancer (41.5% vs. 13.4% and 17.1%). The tongue (19%) was the most frequent oral affected site. The Poisson regression analysis indicated a stationary trend in cancer mortality rate; also, the APC regression model showed no increase or decrease in OPC from 1979 to 2003. Conclusions:, Oral and pharyngeal cancer mortality rates in Mexico were low compared to most countries, and remained stable in the past two decades. [source] Hiradenitis suppurativa presenting as a polypoidal lesion at the anal vergeCOLORECTAL DISEASE, Issue 1 2009S. A. Seneviratne Abstract Hidradenitis suppurativa is a chronic disease characterized by painful recurrent abscesses, fistulas and scarring lesions in axilla, groin, perineum and rarely mass lesions at the affected site. Here we present a case of hidradenitis suppurativa that presented as a polypoidal growth at the anal verge. [source] Oral piercing and oral trauma in a New Zealand sampleDENTAL TRAUMATOLOGY, Issue 5 2005J. A. Kieser Abstract,,, This study investigated the periodontal and dental trauma resultant from tongue and lip piercings in a convenience sample of 43 adult dental patients. Patients underwent an intra-oral examination followed by the administration of a questionnaire. Each patient was examined for lingual or buccal recession of the upper and lower incisors as well as the extent of abnormal toothwear or trauma on these teeth. Following bivariate analyses, regression analyses were conducted to test the study hypotheses and derive adjusted estimates for the dependent variables. Of the 43 individuals who participated (93.0% females; mean age 21 years; age range 14,34 years) 76.7% had a tongue piercing, 34.9% had a lip piercing, and 11.6% had both. Only four had had their piercing procedure provided by a doctor or dentist. Postpiercing complications were reported by 34.9%. Most of those with a labial piercing (80.0%) had 1+ labial site with gingival recession (GR), and almost one-third of those with a tongue piercing had at least one lingual site with GR. Age was a significant predictor of the prevalence of lingual recession, with the odds of having lingual recession increasing by 1.17 (95% CI 1.01, 1.35) for every year older than 14. Age was the only significant predictor of the number of lingual sites with recession, but was not a predictor of the prevalence of labial recession or the number of affected sites. There were no significant associations between piercings and abnormal toothwear or trauma. These findings suggest that oral piercings are associated with localized gingival recession, and that the providers of such procedures should ensure that, as part of the informed consent process, prospective patients are informed of the likelihood that their periodontal health may be compromised. [source] Immunoreactivity of corticotropin-releasing hormone, adrenocorticotropic hormone and , -melanocyte-stimulating hormone in alopecia areataEXPERIMENTAL DERMATOLOGY, Issue 7 2006Hei Sung Kim Abstract:, Psychological factors are believed to play a role in the pathogenesis of alopecia areata (AA), a frequently encountered hair disorder. In our study, statistically significant elevation of psychological stress was felt by AA patients prior hair loss compared with control, which was strongly believed contributory to hair loss (t -test, P < 0.01). The corticotropin-releasing hormone (CRH) and proopiomelanocortin (POMC) mRNA have been identified in the basal layer of the epidermis and pilosebaceous units of the normal scalp. And with the recent discovery of melanocytes and dermal fibroblasts capable of corticosterone production, the presence of a local stress response system resembling the hypothalamic,pituitary,adrenal (HPA) axis has been suggested. The local stress response system is involved in regulation of the normal hair cycle, but its precise role in AA is unknown. The influence of a local HPA axis or rather, CRH,POMC axis in AA was investigated by analysing immunohistochemically the expression levels of CRH and POMC peptides, including the adrenocorticotropic hormone (ACTH) and , -melanocyte-stimulating hormone (, -MSH), in a number of AA lesions and normal scalp (as control). The epidermis and pilosebaceous units of normal scalp stained weakly with CRH, ACTH and , -MSH, whereas those from the affected sites of the AA group showed intense expression of the peptides (chi-square test, P < 0.01). The meaning of this enhanced expression and their role in the pathogenesis of AA should be further evaluated in future. [source] An examination of skulls from two British sites for possible evidence of scurvyINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 4 2003M. Melikian Abstract Skulls and mandibles from the Romano-British site of Poundbury, Dorset and a medieval site at Abingdon in Oxfordshire were examined for porosity which has been considered to be indicative of the presence of scurvy. In addition, a number of skulls from various locations in Peru were examined. Virtually all the skulls had porosity at at least one site and in all cases the palate was most frequently affected. The rank order of affected sites showed some differences between the three samples but the most striking change was the frequency with which the cranial vault and maxilla were affected in the Peruvian skulls compared with the British. The differences were not statistically significant, however. None of the appearances was consistent with those of known cases of infantile scurvy and we doubt whether scurvy can be diagnosed on the basis of porosity in the skull and mandible unless it conforms to recognized clinical patterns. Copyright © 2003 John Wiley & Sons, Ltd. [source] HHV-6, HHV-7, HHV-8 in gingival biopsies from chronic adult periodontitis patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2003A case, control study Abstract Background: Recent reports have suggested that various herpesviruses may be involved in the occurrence and progression of different forms of periodontal disease. Objective: The objective of the present study was to investigate the presence of the novel herpesviruses HHV-6, HHV-7 and HHV-8 in gingival biopsies from patients affected by chronic adult periodontitis. As control, gingival biopsies from periodontally healthy subjects were analysed. Materials and methods: Gingival biopsies were harvested from 23 volunteers: 13 patients affected by chronic adult periodontitis (CAP) and 10 periodontally healthy subjects. Each CAP patient contributed two biopsies involving the epithelium and connective tissue facing the sulcus/periodontal pockets: one biopsy from a site having a probing pocket depth (PPD) 5 mm and presenting with bleeding upon probing (affected site) at the time of biopsy collection, and the other biopsy from a site with PPD3 mm and without bleeding on probing (nonaffected site). After DNA extraction, nested PCR was used in herpesvirus identification. Results: HHV-6 DNA sequences were detected in one non-affected site (8%) and no affected sites (0%) of CAP patients. One biopsy (10%) in healthy subjects revealed HHV-6 positivity. Tissue specimens in 10/13 CAP patients (77%) and 7/10 healthy subjects (70%) contained HHV-7 DNA. HHV-7 prevalence in affected and nonaffected sites of CAP patients was 77% and 54%, respectively. HHV-8 was detected in 7.7% of CAP patients and 0% of healthy subjects. Conclusions: Gingival tissue may act as a reservoir for HHV-7. A high prevalence of HHV-7 was detected in both periodontally diseased and healthy individuals. The prevalence of HHV-6 and -8 was similarly low in both groups. Our data do not support an association of investigated herpesvirus species with destructive periodontal disease. Zusammenfassung Hintergrund: Kürzliche Studien haben angedeutet, dass verschiedene Herpesviren bei der Entstehung und Progression verschiedener Formen der parodontalen Erkrankungen involviert sein könnten. Ziel: Das Ziel der vorliegenden Studie war die Untersuchung einer Präsenz von neuen Herpesviren HHV-6, HHV-7 und HHV-8 in gingivalen Biopsien von Patienten mit chronischer Erwachsenen-Parodontitis. Als Kontrollen dienten gingivale Biopsien von parodontal gesunden Personen. Material und Methoden: Gingivale Biopsien wurden von 23 Freiwilligen, 13 Patienten mit chronischer Erwachsenen-Parodontitis (CAP) und 10 parodontal gesunden Personen gesammelt. Von jedem CAP Patient wurden zwei Biopsien mit Epithel und Bindegewebe von der parodontalen Tasche genommen: eine Biopsie von einer Fläche mit einer Sondierungstiefe (PPD) , 5 mm und positiver Provokationsblutung (geschädigte Fläche) zur Zeit der Biopsieentnahme, die andere Biopsie von einer Fläche mit einer PPD , 3 mm und ohne Provokationsblutung (nicht geschädigte Fläche). Nach der DNA-Extraktion wurde die PCR zur Virusidentifikation benutzt. Ergebnisse: HHV-6 DNA-Sequenzen wurden in einer nicht geschädigten Fläche gefunden (8 %) und bei keiner geschädigten Fläche (0 %) von CAP-Patienten. Eine Biopsie (10 %) bei gesunden Personen war HHV-6 positiv. Gewebeproben von 10/13 CAP Patienten (77 %) und von 7/10 gesunden Personen (70 %) enthielten HHV-7 DNA. Die HHV-7 Prävalenz in geschädigten und nicht geschädigten Flächen von CAP Patienten war 77 % und 54 %. HHV-8 wurde in 7,7 % der CAP Patienten und bei 0 % der gesunden Personen gefunden. Zusammenfassung: Gingivales Gewebe kann als Reservoir für HHV-7 dienen. Eine hohe Prävalenz von HHV-7 wurde sowohl bei parodontal erkrankten als auch bei gesunden Personen gefunden. Das Vorkommen von HHV-6 und HHV-8 war in beiden Gruppen ähnlich. Unsere Daten unterstützen eine Beziehung der untersuchten Herpesviren mit destruierenden parodontalen Erkrankungen nicht. Résumé Des rapports récents ont suggéré que différents virus de l'herpès pouvaient être associés à l'apparition et la progression de différentes formes de la maladie parodontale. Le but de l'étude présente a été d'analyser la présence des virus herpétiques HHV-6, HHV-7 et HHV-8 dans des biopsies gingivales provenant de patients atteints de parodontite chronique de l'adulte. Comme contrôle, des biopsies gingivales de patients sains du point de vue parodontal ont été analysées. Des biopsies gingivales ont été prélevées de 23 volontaires, 13 souffrant de parodontite chronique (CAP) et 10 sains. Chaque patient CAP procuraient deux biopsies comprenant l'épithélium et le tissu conjonctif en face des poches parodontales/sillons : une biopsie provenant d'un site avec une profondeur de poche au sondage (PPD) 5mm et présentant un saignement au sondage (site touché) au moment du prélèvement de la biopsie, l'autre biopsie provenait d'un site avec PPD 3 mm sans saignement au sondage (site sain). Après extraction de l'ADN le PCR a été utilisé pour l'identification des virus herpétiques. Des séquences ADN HHV-6 ont été détectées dans un site sain (8%) mais dans aucun site touché (0%) chez les patients CAP. Une biopsie (10%) chez les sujets sains était HHV-6 positive. Les spécimens tissulaires de dix des treize patients CAP (77%) et sept des dix patients sains (70%) avaient de l'ADNHHV-7. La fréquence globale de HHV-7 dans les sites sains et touchés des patients CAP étaient respectivement de 77 et 54 %. HHV-8 était détecté chez 7,7 % des patients CAP et 0% des patients sains. Le tissu gingival peut servir de réservoir au HHV-7. Une importante fréquence globale de HHV-7 était détectée tant chez les individus sains que chez ceux avec parodontite. La fréquence globale de HHV-6 et HHV-8 était pareillement faible dans les deux groupes. Ces données ne défendent pas la thèse d'une association des virus herpétiques étudiés à la maladie parodontale destructrice. [source] Clinicopathological features and immunohistochemical expression of p53, Ki-67, Mcm-2 and Mcm-5 in proliferative verrucous leukoplakiaJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 6 2010Adriele Ferreira Gouvêa J Oral Pathol Med (2010) 39: 447,452 Background:, Proliferative verrucous leukoplakia (PVL) is a distinct and aggressive type of oral leukoplakia which affects elderly women without risk behavior and presents high rates of malignant transformation. The objective of the present study was to evaluate the clinicopathological characteristics and the distribution of cell proliferation markers, aiming to elucidate the distinct biological behavior of the PVL. Methods:, Clinical and microscopical features of 12 patients with PVL were reviewed. Immunohistochemical analysis for p53, Ki-67, Mcm-2 and Mcm-5 were performed and the data were correlated. Results:, All patients were women, above 50 years of age, 91.7% were non-smoker and 100% were non-habitual drinker. Alveolar ridge (66.6%), tongue (50%) and buccal mucosa (41.6%) were the most affected sites. Four patients developed squamous cell carcinoma (SCC). The immunohistochemical findings showed higher positivity for p53, Ki-67, Mcm-2 and Mcm-5 in SCCs. However, some patients with mild or moderate dysplasia, specially the patients who developed SCC, presented high expression of Mcm-2 and Mcm-5. Conclusions:, High immunoexpression of Mcm-2 and Mcm-5 in mild and moderate dysplasia could be helpful to predict the malignant transformation of PVL. [source] Land under pressure: soil conservation concerns and opportunities for EthiopiaLAND DEGRADATION AND DEVELOPMENT, Issue 1 2003B. G. J. S. Sonneveld Abstract This paper evaluates the future impact of soil degradation on national food security and land occupation in Ethiopia. It applies a spatial optimization model that maximizes national agricultural revenues under alternative scenarios of soil conservation, land accessibility and technology. The constraints in the model determine whether people remain on their original site, migrate within their ethnically defined areas or are allowed a transregional migration. Key to this model is the combination of a water erosion model with a spatial yield function that gives an estimate of the agricultural yield in its geographical dependence of natural resources and population distribution. A comparison of simulated land productivity values with historical patterns shows that results are interpretable and yield more accurate outcomes than postulating straightforward reductions in yield or land area for each geographic entity. The results of the optimization model show that in absence of soil erosion control, the future agricultural production stagnates and results in distressing food shortages, while rural incomes drop dramatically below the poverty line. Soil conservation and migration support a slow growth, but do not suffice to meet the expected food demand. In a transregional migration scenario, the highly degraded areas are exchanged for less affected sites, whereas cultivation on already substantially degraded soils largely continues when resettlement is confined to the original ethnic,administrative entity. A shift to modern technology offers better prospects and moderates the migration, but soil conservation remains indispensable, especially in the long term. Finally, an accelerated growth of non-agricultural sectors further alleviates poverty in the countryside, contributing to higher income levels of the total population and, simultaneously, relieving the pressure on the land through rural,urban migration. Copyright © 2002 John Wiley & Sons, Ltd. [source] Healthcare service use in adolescents with non-specific musculoskeletal painACTA PAEDIATRICA, Issue 8 2010Stefano Masiero Abstract Aim:, To estimate occurrence of non-specific musculoskeletal pain in a wide population sample of Italian adolescents, and to investigate their use of healthcare services (seeking of medical attention, referral for diagnostic tests and treatment use). Methods:, We investigated 7542 high-school adolescents (aged between 12 and 16 years) by a structured questionnaire and consisting of personal data, presence of pain, health provider consulted, referral for diagnostic tests and compliance with the prescribed treatments. Results:, In 3399 (45.1%) reported musculoskeletal pain (the most affected sites being the spine and knees), 2525 (74.2%) of whom had sought medical attention. Of the 2525 subjects who had sought healthcare, 1061 (42.0%) had consulted more than one health provider, 2410 (95.4%) had been referred for diagnostic tests, and some form of treatment had been recommended for 2445 (96.8%), but only 1694 (69.2%) had complied with prescribed therapies. The most important factors linked to health seeking behaviour were pain intensity, pain lasting longer than 3 months, injury, interruption to or absence of physical activity and localization in the spine and knee. Conclusion:, Non-specific musculoskeletal pain is a frequent event in Italian adolescents and that a large number of these subjects consult a healthcare service. [source] |