Contiguous squamous proliferations in syringocystadenoma papilliferum: A retrospective study of 14 cases

Background: Syringocystadenoma papilliferum is a benign adnexal neoplasm. Contiguous squamous proliferation has been rarely described in syringocystadenoma papilliferum. Aims: This study aimed to evaluate the spectrum and pathogenesis of contiguous squamous proliferation in syringocystadenoma papilliferum. Materials and Methods: All cases of syringocystadenoma papilliferum diagnosed over the past 12 years were screened for contiguous squamous proliferation. Cases with associated nevus sebaceous were excluded from the study. Immunohistochemistry for GATA3, CK7, BRAFV600E and p16 was performed. PCR for human papilloma virus, type 16 and 18, was carried out. Results: Of a total of 30 cases, 14 cases showed associated contiguous squamous proliferation which included four cases of verrucous hyperplasia, six cases with papillomatosis, two cases with mild squamous hyperplasia and one case each of Bowen’s disease and squamous cell carcinoma. In the cases with non-neoplastic contiguous squamous proliferations, the squamous component did not express CK7 or GATA3. However, the squamous component of premalignant and malignant lesions expressed CK7 and GATA3 concordant with the adenomatous component. BRAF was positive in adenomatous component in five cases while the contiguous squamous proliferation component was negative for BRAF in all but one case. p16 was negative in both components of all cases and PCR for human papilloma virus was negative in all cases. Limitations: Due to the rarity of disease, the sample size of our study was relatively small with two cases in the 2nd group, that is, syringocystadenoma papilliferum with malignant contiguous squamous proliferation. Detailed molecular studies such as gene sequencing were not performed. Conclusion: Syringocystadenoma papilliferum with contiguous squamous proliferation is underreported, and most commonly displays verrucous hyperplasia. The premalignant and malignant contiguous squamous proliferations likely arise from syringocystadenoma papilliferum while the hyperplastic contiguous squamous proliferations likely arise from the adjacent epidermis. Relationship with high-risk human papilloma virus is unlikely. However, further molecular analysis of larger number of cases is required to establish the pathogenesis.

L'isolement personnel comme une forme de jouer avec la solitude / Personal isolation as a way of playing with solitude / Isolamento pessoal como uma maneira de brincar com a solidão / El aislamiento personal como una forma de jugar con la soledad

Ce texte propose de réfléchir sur l'isolement et la non communication en tant que des stratégies de subjectivation fondamentales à partir de la contribution de Winnicott et Ogden qui postulent l'isolement comme une condition nécessaire à la constitution psychique. Quelques extraits d'un cas d'un enfant qui a subit une situation traumatique montre encore l'importance de l'isolement et de la position autistique-contigue dans le cadre analytique.

This paper analyses the function of personal isolation and non-communication as major strategies of subjectivation, as proposed by Ogden and Winnicott who indicate that primitive isolation is a necessary condition for the psychic constitution of the infant. A fragment of a child´s clinical analysis demonstrates the importance of isolation and of the autistic-contiguous position for the analytic setting.

O texto pretende refletir sobre o isolamento e a não comunicação na condição de estratégias fundamentais de subjetivação, tendo como referência as contribuições de Ogden e Winnicott, que postulam o isolamento como condição necessária ao processo de constituição psíquica. Fragmentos de um caso clínico de uma criança exemplificam a importância do isolamento e da posição autística-contígua na situação analítica.

Este artículo pretende reflexionar sobre el aislamiento personal y la no comunicación como formas estratégicas de subjetivación, teniendo como referencia las contribuciones de Ogden y de Winnicott que señalan que el aislamiento es una condición necesaria para el proceso de constitución psíquica. Algunos extractos de un caso de un niño que ha vivido una situación traumática muestran aún más la importancia del aislamiento y de la posición autista-contigua en el marco analítico.

Dieser Artikel analysiert die Funktion der persönlichen Isolation und Nicht-Kommunikation als grundlegende strategische Formen der Subjektivierung, basierend auf Ogdens und Winnicotts Theorien, die darauf hinweisen, dass Isolation eine notwendige Voraussetzung für die psychische Verfassung des Kindes ist. Fragmente einer Analyse eines Kindes zeigen auf, wie wichtig die Isolation und die autistisch- berührende Position für den analytischen Rahmen ist.

Treatment of Multiple Thoracolumbar and Lumbar Spine Fractures: Comparison of Contiguous and Non-Contiguous Fractures in Non-Osteoporotic Patients

STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the outcomes of multiple thoracolumbar and lumbar fractures depending on whether the fractures were contiguous. SUMMARY OF THE LITERATURE REVIEW: The treatment of multiple spine fractures in patients without osteoporosis has rarely been reported. MATERIALS AND METHODS: From February 2004 to January 2016, 81 patients without osteoporosis who had acute thoracolumbar and lumbar fractures and underwent posterior fusion surgery were evaluated. Patients were divided into 2 groups (group A: contiguous, group B: non-contiguous). We investigated the causes of the injuries, the locations of the injuries within the spine, the range of fusion levels, and functional outcomes based on the patients' general characteristics. RESULTS: Group A comprised 37 patients and group B comprised 44 patients. In most patients, the fusion included 3 segments (group A: 12, group B: 14) or 4 segments (group A: 9, group B: 10). Group A scored 21.2 and group B scored 19.0 on the Korean Oswestry Disability Index. In both groups, longer fusion was associated with poorer clinical results. In the clinical evaluation of the fusion rate, there was no statistically significant difference between the 2 groups (p=0.446). CONCLUSIONS: In this study, patients with multiple vertebral fractures showed more fusion segments and poor clinical outcomes in contiguous fractures. In the patients with non-contiguous fractures, the clinical results were better when a minimal number of segments was fused. Therefore, the authors recommend conservative treatment to minimize the number of segments that are fused in non-contiguous multiple thoracolumbar and lumbar fractures when decompression is not necessary.

Novel Non-contiguous Duplications in the DMD Gene in Five Patients with Duchenne Muscular Dystrophy

BACKGROUND: Muscular dystrophy is an X-linked recessive disorder caused by mutations in the DMD gene. Muscular dystrophy is classified into 2 types; Duchenne muscular dystrophy (DMD), which has severe clinical symptoms, and Becker muscular dystrophy (BMD), which has much milder clinical symptoms. Phenotypic progression to either DMD or BMD can be predicted by analyzing mutations in DMD by using the reading frame rule. METHODS: Of 88 patients with mutations in DMD, which were detected using Multiplex Ligation-dependent Probe Amplification DMD test kit (MRC-Holland, The Netherlands), medical records of 5 patients with non-contiguous duplications were reviewed. These rare non-contiguous duplications in DMD were compared with those reported previously. RESULTS: We identified 3 novel non-contiguous duplications in DMD that included exons 2-7 and 45-51, exons 5-37 and 50-59, and exons 52-53 and 56-61. The 5 patients with these non-contiguous duplications showed the phenotypic features of DMD. Especially, duplication of exons 52-53 and 56-61 was observed in a family, i.e., 2 DMD-affected brothers and their carrier mother. CONCLUSIONS: Prediction of phenotypes associated with complex non-contiguous duplications by using the reading frame rule is difficult because the duplications affect the expression of DMD together. Because most patients with non-contiguous duplications showed the phenotypic features of DMD, the reading frame rule should be interpreted cautiously. This study provides important insights on the non-contiguous duplications in DMD for understanding genotype-phenotype correlations and for developing dystrophin for therapeutic purposes.

Refugios psíquicos en los ciernes / Psychic retreats in budding

En el artículo se revisa el concepto de refugios psíquicos, su origen y las bases teóricas que llevaron a Steiner a desarrollarlo. El autor toma la forma de refugio descrita por Steiner como "refugio ante ansiedades de las posiciones esquizoparanoide y depresiva", y plantea que es posible extender su uso también como refugio ante las ansiedades de lo que Ogden ha llamado posición autista-contigua. Se describen las ansiedades y defensas de esta posición autista-contigua, desarrollando especialmente la identificación adhesiva. Se examina el concepto de identificación adhesiva, comenzando por su autora E. Bick , para luego continuar con algunos de sus seguidores que han ampliado y enriquecido su teoría.Finalmente el autor fundamenta la existencia de refugios ante la posición autista -contigua mediante el uso de identificaciones adhesivas. Se discute sus posibles expresiones clínicas y los problemas teóricos que puede enfrentar el desarrollo de este concepto.

The paper reviews the concept of psychic retreat, its origin and the theoretical basis Steiner took to develop it. The author takes the form of retreat described by Steiner as "refuge from anxieties paranoid-schizoid and depressive positions," and suggests that it is also possible to extend its use as a retreat from the anxieties of what Ogden has called autistic-contiguous position. It describes the anxieties and defenses of the autistic-contiguous position, especially developing adhesive identification. He reviews the concept of adhesive identification, starting with its author E. Bick, then continue with some of his followers have expanded and enriched her theory.Finally, the author explains the existence of retreats to the autistic-contiguous position using adhesive identifications. Discussing the possible clinical expressions and theoretical problems that the development of this concept may face.

An Efficient Approach to Mining Maximal Contiguous Frequent Patterns from Large DNA Sequence Databases

Mining interesting patterns from DNA sequences is one of the most challenging tasks in bioinformatics and computational biology. Maximal contiguous frequent patterns are preferable for expressing the function and structure of DNA sequences and hence can capture the common data characteristics among related sequences. Biologists are interested in finding frequent orderly arrangements of motifs that are responsible for similar expression of a group of genes. In order to reduce mining time and complexity, however, most existing sequence mining algorithms either focus on finding short DNA sequences or require explicit specification of sequence lengths in advance. The challenge is to find longer sequences without specifying sequence lengths in advance. In this paper, we propose an efficient approach to mining maximal contiguous frequent patterns from large DNA sequence datasets. The experimental results show that our proposed approach is memory-efficient and mines maximal contiguous frequent patterns within a reasonable time.

Multiple Non-contiguous Spine Fractures with Concomitant Injuries: A Case Report

Multiple non-contiguous spinal fracture is a special type of multi-level spinal injury, which is rare but most frequently occur in motor vehicle accident or a falling from a height. We report five patients of multiple non-contiguous spinal fractures. All patients underwent segmental pedicle screws fixation without fusion for preserving facet joints and minimizing blood loss and operation time. We performed necessary operation for any concomitant injuries at the same day.

Chromosome 19p13. 3 deletion in a child with Peutz-Jeghers syndrome, congenital heart defect, high myopia, learning difficulties and dysmorphic features: clinical and molecular characterization of a new contiguous gene syndrome

The Peutz-Jeghers syndrome (PJS) is an autosomal-dominant hamartomatous polyposis syndrome characterized by mucocutaneous pigmentation, gastrointestinal polyps and the increased risk of multiple cancers. The causative point mutation in the STK11 gene of most patients accounts for about 30 percent of the cases of partial and complete gene deletion. This is a report on a girl with PJS features, learning difficulties, dysmorphic features and cardiac malformation, bearing a de novo 1.1 Mb deletion at 19p13.3. This deletion encompasses at least 47 genes, including STK11. This is the first report on 19p13.3 deletion associated with a PJS phenotype, as well as other atypical manifestations, thereby implying a new contiguous gene syndrome.

Flow Cytometric Analysis of DNA Content in Parotid Tumor and Its Contiguous Acini / 华中科技大学学报（医学）（英德文版）

To investigate the relationship between proliferative capacity of salivary gland cells in contiguous acini of parotid tumors and recurrent neoplasma, DNA contents of 30 fresh specimens of parotid were studied by using cytometry in tumors, normal and shallow or deep lobe acini of the masses. The results showed that the DI was 1.369, S % 16.95, PI 26.18 in malignant tumors;DI was 1.171, S % 12.41, PI 15.54 in recurrent pleomorphic adenoma; DI was 1.141, S % 12.74, PI 13.07 in pleomorphic adenoma, DI was 0.999, S % 5.10, PI 8.00 in normal acini. Analysis of variance showed there was a significant difference (P＜0.01). The average DNA contents of shallow on deep lobe of contiguous tumors was 1.08 in DI, 10. 65 in S %, 13.49 in PI in malignant tumor, 1.06 in DI, 8.96 in S % and 9.85 in PI in pleomorphic adenoma, which were all higher than in normal acini (P＞0.05). It was concluded that the levels of DI and S % of parotid tumor and its contiguous acini are related to degree of malignancy or recurrent condition of the tumors, suggesting contiguous acini of parotid tumors had the strong capacity of proliferation,which might play an important role in recurrent or malignant change of the parotid tumors.

Flow Cytometric Analysis of DNA Content in Parotid Tumor and Its Contiguous Acini / 华中科技大学学报（医学）（英德文版）

To investigate the relationship between proliferative capacity of salivary gland cells in contiguous acini of parotid tumors and recurrent neoplasma, DNA contents of 30 fresh specimens of parotid were studied by using cytometry in tumors, normal and shallow or deep lobe acini of the masses. The results showed that the DI was 1.369, S % 16.95, PI 26.18 in malignant tumors;DI was 1.171, S % 12.41, PI 15.54 in recurrent pleomorphic adenoma; DI was 1.141, S % 12.74, PI 13.07 in pleomorphic adenoma, DI was 0.999, S % 5.10, PI 8.00 in normal acini. Analysis of variance showed there was a significant difference (P＜0.01). The average DNA contents of shallow on deep lobe of contiguous tumors was 1.08 in DI, 10. 65 in S %, 13.49 in PI in malignant tumor, 1.06 in DI, 8.96 in S % and 9.85 in PI in pleomorphic adenoma, which were all higher than in normal acini (P＞0.05). It was concluded that the levels of DI and S % of parotid tumor and its contiguous acini are related to degree of malignancy or recurrent condition of the tumors, suggesting contiguous acini of parotid tumors had the strong capacity of proliferation,which might play an important role in recurrent or malignant change of the parotid tumors.

Evaluation of Bone Change by Digital Subtraction Radiography After Implantation of Tooth ash-plaster Mixture / 대한구강악안면방사선학회지

PURPOSE: To assess the methods for the clinical evaluation of the longitudinal bone changes after implantation of tooth ash-plaster mixture into the defect area of human jaws. MATERIALS AND METHODS: Tooth ash-plaster mixtures were implanted into the defects of 8 human jaws. 48 intraoral radiograms taken with copper step wedge as reference at soon, 1st, 2nd, 4th, and 6th week after implantation of mixture were used. X-ray taking was standardized by using Rinn XCP device customized directly to the individual dentition with resin bite block. The images inputted by Quick scanner were digitized and analyzed by NIH image program. Cu-equivalent values were measured at the implanted sites from the periodic digital images. Analysis was performed by the bidirectional subtraction with color enhancement and the surface plot of resliced contiguous image. The obtained results by the two methods were compared with Cu-equivalent value changes. RESULTS: The average determination coefficient of Cu-equivalent equations was 0.9988 and the coefficient of variation of measured Cu values ranged from 0.08 ~ 0.10. The coefficient of variation of Cu-equivalent values measured at the areas of the mixture and the bone by the conversion equation ranged from 0.06 ~0.09. The analyzed results by the bidirectional subtraction with color enhancement were coincident with the changes of Cu-equivalent values. The surface plot of the resliced contiguous image showed the three dimensional view of the longitudinal bone changes on one image and also coincident with Cu-equivalent value changes after implantation. CONCLUSION: The bidirectional subtraction with color enhancement and the surface plot of the resliced contiguous image was very effective and reasonable to analyze clinically and qualitatively the longitudinal bone change. These methods are expected to be applicable to the non-destructive test in other fields.

Non / 대한정형외과학회잡지

Incidence of non-contiguous multiple spine fracture was increased from 3.2%~4.5% at 1960th and 70th to 5.7% ~23.8% at 80th and 90th. But there is no reports in Korea which has high incidence of traffic and industrial accidents. In 345 consecutive patients with acute spine fracture, we found that 43 patients (12.5%) had multiple non-contiguous spine fractures. At the 43 patients studies 37 (87.4%) sustained fractures at 2 levels while 6 had more than 3 levels of injury, 26 were injured by fall from heights, 27 (62.8%) had 2.33 associated injuries on an average, and 12 (27.9%) had a neurologic deficit. There are five patterns account for 26 (50%) of the total number of patients. In 19 patients (44.2%), there was a mean 29.3 days delay (from 3 to 233 days) in diagnosis of the minor lesions. In 19 delay diagnosed minor lesions, it confirmed by bone scan in 12 patinets(63.6%). Two patients died within 24 hours after accident, and 41 patients (41 major and 50 minor fractures) were treated in our hospital. Among them, 21 (51.2%) needed modification of treatment by the presence of non-con- tiguous multiple spine fractures. According to above findings, the physician must be aware of the possible noncontiguous multiple spine fractures when examine and treat the patients with spine fracture.