Mineralogical, thermal and rheological characterization of some Tunisian green commercial clays and possible application as peloids with thermal and sea waters.

Many of therapeutic treatments in spas are concentrated on mud therapy. Clays are included in the formulation of thermal mud as vehicles of the mineral medicinal water. To be suitable for therapeutic use, some mineralogical, rheological and thermal properties should be respected in order to be topically applied. Our objective is to explore the suitability of three Tunisian commercial green clays traditionally used as facial and body masks by women in the region of Douiret (CD), Tozeur (CT) and Korbous (CK) in terms of their physicochemical structure chemical composition, heavy metals risk assessment, thermal properties, plasticity, rheology and their potential application as peloid with distilled and sodium chloride-rich sulfated thermal waters from hot spring in the region of hammam Lif and Korbous and sea waters. The mineralogy of samples (clay fraction and associated minerals) was determined by X-ray powder diffraction and FT-IR analysis, and the chemical composition was obtained by ICP. The main clay fraction of the samples was smectite and illite with significant amount of kaolinite. Regarding their mineralogical properties, the samples with a high amount of smectite fraction are more suitable for use in Tunisian spas and for the application as peloids. The thermal analyses of clay powders shows a specific heat value comparable to those use used in spas. Also the muds showed a low cooling rate which is necessary for therapeutic use. Rheological properties of peloids prove their thixotropic characteristics.

Bentonite Clays for Therapeutic Purposes and Biomaterial Design.

BACKGROUND: Bentonite is a natural clay composed mainly of montmorillonite with other associated minerals such as feldspar, calcite and quartz. Owing to its high cation exchange, large surface area and ability to form thixotropic gels with water and to absorb large quantities of gas, it presents a large medicinal application. OBJECTIVE: This review focuses on the promising potential of bentonite clays for biomaterial design and for therapeutic purposes. METHODS: PubMed, ACS publications and Elsevier were searched for relevant papers. We have also evaluated the references of some pertinent articles. RESULTS: Healing properties of bentonite are derived from the crystalline structure of the smectite group, which is composed of two octahedral alumina sheets localized between two tetrahedral silica sheets. This structure is behind the ability to intercalate cationic bioactive agents and undergoes interaction with various toxic species and exchanging in return species such as Fe3+, Cu2+, Al3+ Ca2+ or Na+, presenting antibacterial activity and providing essential minerals to the body. Furthermore, due to to its layered structure, bentonite has wide application for the design of biomaterials providing, thus, the stability of bioactive agents and preventing them from aggregation. CONCLUSION: Numerous publications have cited bentonite extensive applications as an alternative and complementary treatment for numerous health conditions as a detoxifying agent and for the preparation of several bionanocomposites.

Mismatch Repair Deficiency in Endometrial Cancer: Immunohistochemistry Staining and Clinical Implications.

INTRODUCTION: DNA mismatch repair (MMR) deficiency is associated with increased risk of developing several types of cancer and is the most common cause of hereditary endometrial cancer. Identification of the microsatellite instability (MSI) phenotype in endometrial carcinoma is important given that such tumors are frequent. OBJECTIVE: The objective of this study was to assess the utility of immunohistochemistry (IHC), a simple and fast technique, in detecting MSI status in endometrial carcinoma and evaluate the correlation between the MSI phenotype and the various anatomo-clinical parameters. METHODS: IHC expression of 4 markers (MLH1, MSH2, PMS2, and MSH6) was studied. For all IHC markers, a combined score based on the intensity of nuclear labeling and the percentage of labeled cells was defined to establish a score. Correlation between MSI phenotype and different clinicopathologic parameters was evaluated using statistical analysis (software STATA and the Fisher exact test). RESULTS: The mean age of the patients was 58.6 years. Positive staining was highly extended (score 3) with 79% to 100% of marked cells. Less than 10% of positive tumor cells were seen in 3% of cases for MSH6 and PMS2. Abnormal MMR IHC was detected in 10 cases (22.22%). Seven tumors showed loss of MLH1/PMS2. The loss of MSH2/MSH6 was observed in 1 case. The loss of MLH1 or PMS2 was seen only in 2 cases. The number of MSI positive status was 10 cases (22.7%). Correlation between clinicopathologic parameters showed MMR deficiency was significantly associated with low-grade tumor and localized stage. There was no positive correlation between age, histologic subtype, or myometrium invasion. CONCLUSIONS: In summary, detection of DNA MMR deficiencies by IHC can effectively diagnose the MSI phenotype in endometrial carcinoma. Correlation between clinicopathologic parameters showed MMR deficiency was significantly associated with low-grade tumor and localized stage.

Esthesioneuroblastoma metastatic to the breast in a young woman.

BACKGROUND: Metastases to the breast are rare and can be missed without knowledge of the clinical history. We report an unusual breast metastasis originating in an olfactory neuroblastoma. CASE: A breast metastasis from esthesioneuroblastoma occurred in a 20-year-old woman 2 years after the onset of the disease. The aspirates were hypercellular and composed of cellular aggregates and single cells with a monomorphic appearance. The cytoplasm was scanty and inconspicuous. The nucleus was large, with granular, hyperchromatic chromatin. Mitoses and apoptotic bodies were numerous. Because we were unaware of the past history at the time of the cytologic analysis, a definitive diagnosis was made only after pathologic study. CONCLUSION: Esthesioneuroblastoma metastatic to the breast must be considered in the differential diagnosis of breast metastases. Fine needle aspiration, in conjunction with clinical information, can be effective in the diagnosis of esthesioneuroblastoma metastatic to the breast.

[The value of cytology in the diagnosis of extragonadal germ cell tumors]. / Apport de la cytoponction dans le diagnostic des tumeurs germinales extragonadiques.

Extragonadic germinal tumors are frequently mixed tumors. When a metastatic sacrococcygeal teratoma is clinically suspected in children, a yolk-sac tumor component could be judiciously demonstrated by either an elevated serum level of alphafoetoprotein (AFP), or fine needle aspiration cytology. We report the case of a 25 month aged girl presenting a metastatic sacrococcygeal tumor (lymph node and bone metastasis) with high level of AFP (34.100 microg/ml). Fine needle aspiration cytology identified the yolk sac tumor component, characterized by papillae and glandular clusters, composed of pale isomorphic cells with vesicular and nucleolated nucleus and some intracytoplasmic hyaline globules. The yolk sac tumor component could not be identified in the sacrococcygeal surgical specimen, exclusively composed of immature teratoma.

[Pseudo-angiomatous hyperplasia of mammary stroma: a case with gigantomastia]. / L'hyperplasie pseudo-angiomateuse du stroma mammaire. A propos d'un cas compliqué de gigantomastie.

Pseudo-angiomatous hyperplasia of mammary stroma (PASH) is a histopathological entity which is a microscopic fortuitous finding in mammary biopsies performed for different reasons. It may be symptomatic and appears then as a palpable lump. The term pseudo-angiomatous emphasizes the characteristic aspect of the stroma simulating a vascular tumor. We report a case of PASH in a 71 year-old woman who presented a recurring breast mass with rapid swelling of the mammary gland (70 x 60 x 20 cm) treated by mastectomy. PASH must be distinguished from a well-differentiated angiosarcoma. It is ruled out by immunohistochemistry.

[Extra-nodal Rosai-Dorfman disease: a case report with thyroid involvement]. / La maladie de Rosai-Dorfman extra-ganglionnaire: à propos d'une localisation thyroïdienne.

Extra nodal involvement by Rosaï-Dorfman disease (RDD) is not rare but remains poorly described clinically and microscopically. We report a case of RDD involving the thyroid and revealed by a 15 mm cold nodule developed on an ancient goiter. The patient was a 53 year old North African woman. She also presented an involvement of cervical lymph nodes, respiratory tract and right kidney. Microscopic analysis of thyroid revealed a diffuse and dense infiltrate of large pale histiocytes with few features of lymphophagocytosis. To the best of our knowledge, this is the fifth case reported in the literature. In previous reported cases, thyroid RDD was associated to constant lymph node involvement (massive lymphadenopathy in 3 cases and occult in one case) and no other extra nodal localization except the respiratory tract in one case. The characteristic features of lymphophagocytosis must be searched with great care.

[Langerhans cell histiocytois of the thyroid: a rare disease not to be ignored]. / L'histiocytose langerhansienne de la thyroïde: une localisation rare à ne pas méconnaître.

Thyroid involvement by Langerhans cell histiocytosis is rare. We report the case of a ten-year old boy who presented with a 5 cm goitre. He was treated for diabetes insipidus 14 months before. Thyroid isotopic scan showed hypoactivity of right lobe and revealed a cold left nodule. The patient was treated by right lobo-isthmectomy with adjuvant corticotherapy and chemotherapy (vinblastine). He is well with 12 months follow-up. Microscopic analysis demonstrated a diffuse infiltrate of thyroid parenchyma by sheets of CD1a positive Langerhans cells associated with lymphocyte foci. This case is remarkable by the abundance of Langerhans cells and scarcity of eosinophils. The diagnosis of thyroid langerhans cell histiocytosis should not be ignored in both children and adult patients.