Pityriasis rosea-like drug eruption due to bupropion: a case report.

Pityriasis rosea (PR) is a common, acute, and self-limited inflammatory skin disease. The typical clinical presentation includes the appearance of a primary "herald" patch followed within days to weeks by the onset of secondary scaly skin eruptions distributed along the skin tension line in most cases. Although PR is a well-known and relatively common disease, its cause is still not completely understood. However, viral agents, autoimmunity, psychogenic status, and numerous drugs have been proposed as possible factors to PR. Bupropion is known to cause hypersensitivity reactions. We present a clinical case of PR eruption caused by the use of bupropion. To the best of our knowledge, this is the first published case of PR associated with bupropion use.

Physical activity and cardiovascular disease risk factors in urban school children.

Although the clinical signs of cardiovascular disease (CVD) are not evident until adulthood, many of the risk factors have their roots in early childhood. The aim of this study was to examine physical activity levels (PA) and the incidence of CVD risk factors in a small population (n=102) of primary school children in Dublin. Risk factors measured included overweight/obesity, blood lipids, blood pressure (BP), physical fitness and PA levels. Over a quarter of the group were overweight/obese (n = 29, 28%). Despite relatively good fitness levels, PA levels were low with less than half the group (n = 44, 46%) participating in the recommended 1 hour/day. Fewer girls reported spending > 1 hour/day at PA compared to boys (n = 14 v n = 30). Six children had elevated cholesterol levels and five children had higher than normal BP values. Sixteen children demonstrated clustering of CVD risk factors and in those who were inactive the risk was greater. Our data suggest that in children as young as 10 years significant risk factors already exist. Furthermore, the low level of PA in girls provides a target for health promotion programmes.

Two maxillary lesions containing bony/calcified shells.

Because of the close anatomical relationship between the maxillary sinus and the adjacent dental region, determining the primary site of cysts in these regions can be a diagnostic dilemma. In this article, two cases with similar radiological findings are presented. These cases had lesions involving the maxillary sinus and the adjacent alveolar process; the lesions were surrounded with egg-shaped, linear opacities. Diagnoses of a residual radicular cyst in one case and a calcified mucocoele (which is very rare) in the other case were predicted with the help of radiological findings and were confirmed surgically and histopathologically.

Heterotopic gastric mucosa in gallbladder associated with kidney agenesis and congenital hip dysplasia.

Heterotopic gastric tissue in the gallbladder is an extremely rare condition. There is not any specific clinical or laboratory finding and correct diagnosis is not possible before histopathological examination. Preoperative diagnosis usually resembles a polypoid Lesion or a fixed gallstone. We reported a 34-year-old female patient with heterotopic gastric mucosa in the gallbladder associated with congenital hip dysplasia and kidney agenesis. Laparoscopic cholecystectomy was performed and histopathology of the resected specimen showed that the "polyp" consisted of heterotopic gastric mucosa with glands of body and fundic type. Some cases of heterotopia in the gallbladder come from metaplasia, and may be one of the causes of gall bladder cancer. We discussed the clinical and histologic features of heterotopic gastric tissues and reviewed reported cases in the literature.

Multinodular leiomyoma of the esophagus with internodular hydropic degeneration and bulbous serosal protrusions similar to cotyledonoid uterine leiomyoma.

Leiomyoma is the most common benign tumor of the esophagus, and usually occurs as a solitary mass. We report a case of esophageal leiomyoma which shows multinodular growth pattern with bulbous serosal protrusions. The patient was a 26-year-old woman who had an esophageal ulcerated mass near the gastroesophageal junction. Clinical findings were consistent with carcinoma of the gastric cardia. Based on the clinical diagnosis, total gastrectomy with distal esophagectomy was performed. Histologic appearance of the resected specimen was consistent with leiomyoma which had a multinodular growth pattern.

Geniculo-temporo-parotideal neurofibroma of the facial nerve. A case report.

Preoperative diagnosis of facial nerve neurofibroma is difficult when it presents as an asymptomatic parotideal mass. Facial nerve tumor suspicion arises during parotid surgery, histopathologic evaluation confirms diagnosis and postoperative imaging demonstrates a nerve tumor and its extension. We present the multimodality imaging findings of a 43-year-old man with a solitary neurofibroma involving the whole facial nerve continuously from geniculate ganglion to parotideal segment as the first case in the literature.

Validation of a point of care lipid analyser using a hospital based reference laboratory.

BACKGROUND: Lipid measurements are essential in cardiovascular disease management in primary care. However, utilizing hospital laboratories may result in excess patient travel, sample loss and repeat clinic visits. Point of care (POC) lipid measurement would overcome these difficulties but has not been validated in an Irish setting. AIM: To compare POC lipid profile measurements using a cholestech LDX analyser with a hospital reference laboratory (Lab). METHOD: One-hundred subjects (30 men, 70 women) participated. Finger prick and venous samples were analysed directly by Cholestech LDX and the Lab. RESULTS: A broad range of lipid values were measured. Absolute differences between POC and Lab measurements were insignificant except for a small over-estimation by the POC method of triglyceride 0.25 mmol/l (95% CI 0.17 to 0.24), and an underestimation of HDLc - 0.11 mmol/l (95% CI - 0.143 to -0.078). There were significant correlations between POC and Lab. levels; total cholesterol r=0.92, triglyceride r=0.93, HDLc r=0.92 and LDLc r=0.86 (all p< 0.0001). CONCLUSION: These results validate the use of the Cholestech LDX analyser for point of care lipid measurements in clinical practice, provided well trained operators are supported by a hospital laboratory delivering quality assurance support.

The effect of zinc aspartate pretreatment on ischemia-reperfusion injury and early changes of blood and tissue antioxidant enzyme activities after unilateral testicular torsion-detorsion.

BACKGROUND/PURPOSE: The aim of this study is to investigate the effect of zinc aspartate (ZA) pretreatment on ischemia-reperfusion (I/R) injury and blood and tissue antioxidant enzyme activity early after unilateral testicular torsion-detorsion (T/D). METHODS: Forty prepubertal male Sprague-Dawley rats (weight 160 to 220 g) were divided into 4 groups each containing 10 rats. Surgery was conducted under intraperitoneal 1-shot ketamine (50 mg/kg) anesthesia. The scrotum was entered through a midline incision. Rotating the left testis 720 degrees in a clockwise direction was the model of the testicular torsion. Group 1 was for the basal values. Group 2 had 4 hours T/D. Group 3 also had 4 hours T/D and pretreated with 50 mg/kg intraperitoneal ZA injection half an hour before detorsion. Group 4 was designed as a sham group. In the Group 2 and Group 3, the tunica vaginalis was opened, and left testicles were rotated clockwise 720 degrees and maintained in this torsion position by fixing with a silk suture to the scrotal wall. The scrotum was closed and 4 hours later reentered for testicular detorsion. After spermatic cord detorsion, the scrotum was closed. At the end of 4 hours detorsion period, bilateral orchiectomies were performed, and 5-mL intracardiac blood samples were taken. Blood and tissue superoxide dismutase (SOD), catalase (CAT) activities, and malondialdehyde (MDA) levels were measured, and histopathologic examination was performed. RESULTS: Group 2 and group 3 had decreased blood SOD and CAT activities and elevated MDA levels indicating I/R injury. The 2 groups were also different from each other for these parameters reflecting the beneficial effect of ZA pretreatment (P <.05). The decreased ipsilateral tissue SOD and CAT activities in group 2 were different from the other groups including group 3 (P <.05). Ipsilateral tissue MDA levels of both group 2 and group 3 were elevated. Group 2 had higher values than group 3 (P <.05). In addition, specimens from group 2 had a significantly greater histologic injury than group 3 (P <.05). These findings were also supporting the beneficial effect of ZA pretreatment. All measurements of contralateral tests were similar to the basal values for all groups (P >.05). CONCLUSIONS: ZA pretreatment reduces I/R injury by its antioxidant effects after unilateral testicular T/D and affects the antioxidant enzyme systems.

Correlation of proliferating cell nuclear antigen and bcl-2 expression with tumor front grading and metastasis in laryngeal squamous cell carcinoma.

This study was designed to examine the immunohistochemical expression of proliferating cell nuclear antigen (PCNA) and bcl-2 protein in 45 cases with advanced laryngeal squamous cell carcinoma who had undergone total laryngectomy with unilateral modified radical neck dissection, and the relation of this expression to some prognostic factors such as tumor front grading and neck lymph node metastases. Sections were reevaluated for routine histologic grade, tumor front grading and neck lymph node metastases, and were stained with monoclonal antibodies against PCNA and bcl-2. Significant correlation was present between the severity of PCNA expression and incidence of lymph node metastasis (p<0.05). No correlation was found between the severity of PCNA expression and tumor front grading. Bcl-2 expression did not associate with either parameters. In conclusion, PCNA is important in predicting prognosis and no association is present between the bcl-2 protein expression and prognostic factors.