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Unusual Occurrence (unusual + occurrence)
Selected AbstractsEpithelioid sarcoma with angiomatoid features: report of an unusual case arising in an elderly patient within a burn scarJOURNAL OF CUTANEOUS PATHOLOGY, Issue 3 2008Steven Kaddu Epithelioid sarcoma (ES) is a rare, aggressive soft tissue tumor with a characteristic predilection for adolescents and young adults, and a tendency to occur on distal extremities. We report a case of ES arising in an 80-year-old woman within a burn scar that histopathologically showed unusual ,angiomatoid' features. The patient presented initially with a solitary nodule on her right wrist arising at the site of a burn scar. Histopathologically, the tumor was composed of a proliferation of relatively bland, epithelioid and spindle cells focally arranged in a nodular pattern around areas of ,geographic' necrosis. In addition, there were prominent foci of hemorrhage and blood-filled spaces as well as tumor cells with intracytoplasmic vacuoles, features suggestive of an angiomatous process. Immunohistochemistry showed positivity of tumor cells for cytokeratins and epithelial membrane antigen (EMA) whereas all vascular markers tested were negative. The overall histopathologic features were consistent with a diagnosis of ES. Follow up showed multiple recurrences arising proximally along the right upper extremity. Our case underlines the clinical and histopathological heterogeneity of ES, emphasizing the unusual occurrence of ES with ,angiomatoid' features in the elderly. In this uncommon setting, this tumor should be especially distinguished from epithelioid hemangioendothelioma and epithelioid angiosarcoma. The significance of development of ES on a healed burn scar is uncertain, but may suggest a possible causal relationship. [source] An unusual occurrence of giant cell hepatitisLIVER TRANSPLANTATION, Issue 12 2009Vandana Singh [source] Early recurrence of primary disease after pediatric renal transplantation: Two case reports and a review of the literaturePEDIATRIC TRANSPLANTATION, Issue 2 2007Supriya Jain Abstract:, Recurrence of primary diseases such as FSGS or HUS is known to cause early graft dysfunction after pediatric renal transplantation. We report the unusual occurrence of early graft dysfunction following kidney transplant in two pediatric cases. Both subjects had biopsy proven recurrence of CGN in less than a week after transplantation. We were able to sustain the renal function in one of them following aggressive treatment. Hence, early recurrence of CGN should be considered in the differential diagnosis of early graft dysfunction. [source] Childhood hyperuricemia and acute renal failure resulting from a missense mutation in the HPRT geneAMERICAN JOURNAL OF MEDICAL GENETICS, Issue 3 2002Tarak Srivastava Abstract A 6-year-old boy was determined to have partial hypoxanthine phosphoribosyl transferase (HPRT) enzyme deficiency without the phenotypic features of Lesch-Nyhan syndrome. He presented with recurrent acute renal failure (ARF) from hyperuricemia. Treatment with allopurinol prevented further attacks of renal failure. T lymphocyte cultures were used to sequence the HPRT cDNA and a novel single nucleotide substitution at codon 65 in exon 3 was found (193C,>,T, 65leu,>,phe). This mutation was confirmed by genomic DNA sequencing and was also detected in his heterozygous, asymptomatic mother and sister. Unlike the cells from patients with classic Lesch-Nyhan syndrome, the in vitro cultures of our patient's T-lymphocytes did not proliferate in the presence of purine analogue 6-thioguanine (TG). This report highlights the unusual occurrence of recurrent ARF in a child with partial HPRT enzyme deficiency. The absence of TG resistance in vitro with this mutation shows that even small alterations in enzyme activity in vivo can result in disease symptoms, in this instance, hyperuricemia sufficient to cause ARF. Atypical HPRT mutations should also be considered in cases of unusual renal failure, because correct diagnosis can allow appropriate treatment, as well as informed genetic counseling. © 2002 Wiley-Liss, Inc. [source] Transient global amnesia following a transoceanic flightPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2006JAVAID RASHID md Abstract, Transient global amnesia (TGA) is the abrupt onset of temporary anterograde amnesia without any focal neurological features. It is a benign condition and is completely reversible in most cases. However, the sudden occurrence of memory impairment can be especially alarming to an individual who has recently arrived in an unfamiliar setting. The cause of TGA remains unknown. Reported here is the unusual occurrence of TGA in a man following the completion of an international airplane flight. Possible etiologies of the episode are considered. [source] Management and Outcome of Patients With Mucoepidermoid Carcinoma of Major Salivary Gland Origin: A Single Institution's 30-Year Experience,THE LARYNGOSCOPE, Issue 2 2008Katri Aro MD Abstract Background: Mucoepidermoid carcinoma (MEC) is one of the most frequent epithelial malignancies of the salivary glands. Prediction of clinical outcome of MEC is challenging. Material and Methods: We retrospectively reviewed 52 cases of MEC of major salivary gland origin diagnosed at the Department of Otolaryngology,Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland, during a 30-year period of 1976 to 2005. Criteria used for diagnosis were those of World Health Organization classifications valid at each time point, and criteria for grading were those recommended by Armed Forces Institute of Pathology fascicle (1996). Since 1993, the degree of cell proliferation was used at our institution as an adjunct tool when grading MEC. The majority of cases occurred in the parotid gland (n = 47, 90%) followed by the submandibular gland (n = 5, 10%). Results: We had 39% high-grade (HG), 14% intermediate-grade (IMG), and 44% low-grade (LG) MECs. T categories were T1, n = 18; T2, n = 16; T3, n = 9; T4, n = 9. Forty-nine (94%) patients were treated with curative intent. These patients underwent surgery, and 24 (49%) patients received postoperative radiotherapy. Follow-up time varied from 6 months to 9 years. Forty-five percent of HG-MEC patients and 67% of IMG-MEC patients developed locoregional failures or distant metastases during a 3-year follow-up as opposed to none of the LG-MEC patients. Of MEC patients with N0 neck, two HG-MEC patients and one IMG-MEC (8%) patient developed regional recurrence during follow-up. Conclusions: Patient outcome in the different grades of MEC suggests a need for overview of the treatment protocol, especially with regard to LG-MEC and IMG-MEC. The apparently unusual occurrence of locoregional failures and metastases in LG-MEC suggests a restrictive approach in surgical management. However, the frequent occurrence of such failures in IMG-MEC warrants an aggressive approach with these tumors. [source] Tuberculosis of the appendix: An unusual occurrence with review of literature*ANZ JOURNAL OF SURGERY, Issue 9 2009Nidhi Goyal MBBS, Resident No abstract is available for this article. [source] An anomalous journal impact factorASTRONOMISCHE NACHRICHTEN, Issue 7 2006H. A. Abt The impact factor (average number of citations per paper) for the Astrophysical Journal Supplement Series jumped between 2003 and 2004 from 6.247 to 15.231, giving it the world's second highest impact factor for an astronomical journal in 2004. Was this change due to a computing error or to an unusual occurrence? It is shown that it was due to the extremely high citation rates (average of 160 citations per year) for 13 papers in the special issue devoted to the WilkinsonMicrowave Anisotropy Probe. (© 2006 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Hepatic myelolipoma incarcerated in a peritoneopericardial diaphragmatic hernia in a catAUSTRALIAN VETERINARY JOURNAL, Issue 6 2010RM Wouda Hepatic myelolipoma incarcerated in a peritoneopericardial diaphragmatic hernia was diagnosed in an 11-year-old, desexed female Persian cat. The cat was initially referred for investigation of tachypnoea and dyspnoea. Peritoneopericardial diaphragmatic hernia is a common incidental finding in cats and is usually asymptomatic. Myelolipoma is an extremely rare benign tumour, composed of extramedullary haematopoietic cells and adipose tissue. Myelolipomas are hypothesised to result from metaplastic alteration, rather than a neoplastic process, although this theory cannot be substantiated. The present case is only the fourth report of such an unusual occurrence in cats and displays significant differences to previous reports. Hepatic entrapment and burgeoning of the mass within the pericardial sac resulted in cardiac tamponade and overt signs of right-sided cardiac failure. Surgical intervention was successful and despite concerns regarding the cat's clinical presentation and the gross appearance of the lesion(s), a good long-term outcome is anticipated. [source] Clusters of sirenomelia in South AmericaBIRTH DEFECTS RESEARCH, Issue 2 2009Ięda M. Orioli Abstract BACKGROUND One hospital in the city of Cali, Colombia, of the ECLAMC (Latin-American Collaborative Study of Congenital Malformations) network, reported the unusual occurrence of four cases of sirenomelia within a 55-day period. METHODS An ECLAMC routine for cluster evaluation (RUMOR) was followed that included: calculations of observed/expected ratios, site visits, comparison with comprehensively collected local, South American, and worldwide data, cluster analysis, and search for risk factors. RESULTS All four Cali sirenomelia cases were born to mothers living in a 2 km2 area, in neighboring communes, within the municipality of Cali. Considering the total births of the city of Cali as the denominator, and based on ECLAMC baseline birth prevalence rates (per 100,000) for sirenomelia (2.25, 95% CI: 2.66, 3.80), the cluster for this congenital abnormality was unlikely to have occurred by chance (observed/expected ratio = 5.77; 95% CI: 1.57,14.78; p = .002). No consistent common factor was identified, but vicinity to an open landfill as the cause could not be rejected. Another ECLAMC hospital in San Justo, Buenos Aires, Argentina, reported three further cases but these did not seem to constitute a nonrandom cluster. CONCLUSIONS The methodology used to evaluate the two possible clusters of sirenomelia determined that the Cali sirenomelia cluster was unlikely to have occurred by chance whereas the sirenomelia cluster from San Justo seemed to be random. Birth Defects Research (Part A) 2009. © 2008 Wiley-Liss, Inc. [source] An approach for post-market monitoring of potential environmental effects of Bt -maize expressing Cry1Ab on natural enemiesJOURNAL OF APPLIED ENTOMOLOGY, Issue 4 2009O. Sanvido Abstract Post-market monitoring (PMM) consistent with Swiss and European Union legislation should ensure the detection and prevention of adverse effects on the environment possibly deriving from commercial cultivation of genetically modified (GM) crops. Insect-resistant GM crops (such as Bt -maize) raise particular questions regarding disturbances of biological control functions provided by beneficial insects such as predators and parasitoids (so-called natural enemies). Consensus among regulators, scientists and the agricultural biotech industry on appropriate PMM plans allowing the detection and possibly prevention of such adverse effects is still lacking. The aims of this study were to identify the necessity for PMM of Bt -maize expressing Cry1Ab on natural enemies and to develop an appropriate PMM plan. The approach chosen consisted in determining what type of monitoring is most appropriate to address potential effects of Bt -maize on natural enemies during commercial cultivation. This included identifying whether there remain substantial scientific uncertainties that would support case-specific monitoring. Existing pre-market risk assessment data indicate that Bt -maize (Cry1Ab) comprises a negligible risk for disturbances in biological control functions of natural enemies. As a consequence, a faunistic monitoring of specific groups of natural enemies is not considered an appropriate approach to detect failures in biological control functions. Alternatively, an approach is proposed that consists in indirectly analysing biological control functions by surveying outbreaks of maize herbivores. Unusual herbivore outbreaks could indicate failures in biological control functions of natural enemies. Data could be collected via questionnaires addressed to farmers growing Bt -maize. Significant correlations between unusual occurrences of specific maize herbivores and the cultivation of Bt -maize would subsequently need specific studies to determine possible causalities in more detail. The here proposed approach has the advantage of covering different natural enemy groups. It represents a cost-effective strategy to obtain scientifically sound data as a basis for regulatory decision-making. [source] Utility of Infectious Disease Coding Sheets for Surveillance in a State Medical Examiner's Office,JOURNAL OF FORENSIC SCIENCES, Issue 4 2008Ph.D., Sarah L. Lathrop D.V.M. Abstract:, Medical examiners are often first to recognize unusual occurrences of fatal infectious diseases. Recognition of these deaths allows public health officials to institute appropriate public health measures. Therefore, we developed a simple method of identifying and tracking infectious disease deaths in a statewide medical examiner's office. One-page infectious disease forms were completed for 1566/1949 autopsies (80%) performed at the New Mexico Office of the Medical Investigator in 2004. In 241 cases one infectious disease was identified at autopsy and 58 cases had two infectious diseases. Fourteen of the infectious-diseases caused deaths involved diseases that are notifiable conditions in New Mexico. Pneumonia was the most commonly reported infectious process (47 deaths) followed by sepsis (25 deaths). Tracking infectious disease deaths highlighted the importance of recognizing these deaths, although hand-written entries were unstandardized. Preferably, a tracking system would be built into electronic databases at medical examiner and coroner's offices, expediting the identification of these diseases and contact of public health agencies. [source] | |||||||||||||