Systemic lupus erythematosus presenting as erythema annulare centrifugum.

A case of systemic lupus erythematosus presenting as erythema annulare centrifugum involving atypical sites (face, palm and sole) and raised serum angiotensin-converting enzyme levels has been illustrated.

Spindle cell lipoma masquerading as lipomatous pleomorphic adenoma: A diagnostic dilemma on fine needle aspiration cytology.

Spindle cell lipoma is a relatively uncommon benign adipocytic tumor that usually presents in subcutaneous fat of adult men. These are a rare form of lipoma, accounting for 1.5% of all lipomatous tumors, with a low rate of local recurrence and no risk of malignant behavior/dedifferentiation. Although few studies addressing the histological findings of spindle cell lipoma have been described, only a few descriptions of fine needle aspiration cytology (FNAC) findings have been documented in literature. We present a case of a 55-year-old male with a nodular swelling over left cheek (in the parotid region), which due to its location as well as prominent myxoid background prompted us to include the lipomatous salivary gland lesions in differential diagnosis. Our objective is to document and delineate the characteristic cytological features of spindle cell lipoma, which may permit a confident diagnosis on FNAC smears.

Pathophysiology of varicoceles in male infertility.

Varicoceles are found in 19 to 41% of infertile men, and is one treatable form of male infertility. The mechanism by which varicoceles cause the variable effect on male infertility and spermatogenesis is still unknown. Experimental animal models play a useful (but limited) role due to the sudden and variable iatrogenic nature of the varicoceles and the duration of the studies. Much of the human data are derived by the characterization of associated differences in measurable parameters between men with and without varicoceles. The role of hyperthermia, testicular blood flow and venous pressure changes, reflux of renal/adrenal products, hormonal dysfunction, autoimmunity, defects in acrosome reaction, and oxidative stress, in the pathophysiology of varicocele will be discussed.

Malakoplakia of bone. A case report.

BACKGROUND: Malakoplakia is an uncommon but distinctive granulomatous disease, characterized by an accumulation of histiocytes or Von Hansemann cells containing intracytoplasmic, laminated Michaelis-Gutmann bodies. CASE: A 3-year-old male presented with a tender swelling in the left gluteal region that had been present for one month. Smears made from a fine needle aspirate showed large histiocytic cells containing intracytoplasmic, basophilic, laminated, targetoid Michaelis-Gutmann bodies resembling Von Hansemann cells in malakoplakia. Histopathology confirmed the diagnosis of malakoplakia of bone. CONCLUSION: This case, histologically proven to be malakoplakia, demonstrated regression of the lesion following therapy. The characteristic cytologic features and presence of Von Hansemann cells may in themselves be diagnostic and obviate the need for biopsy.

N-(4-Biphenylyl)urea.

In the crystal structure of the title compound, C13H12N2O, N-H(anti)...O hydrogen bonds produce the so-called urea alpha-network and the N-H(syn) donor forms an unconventional N-H...pi hydrogen bond.

Inclusion adducts of 4,4-bis(4'-biphenylyl)cyclohexa-2,5-dienone: a clay mimic organic host.

In the lamellar architecture of the title crystal structure mediated by C-H...O hydrogen bonds, 1,2-dimethoxyethane and n-hexane are included in the hydrophobic galleries; isostructurality of these clathrates is a unique case of guest mimicry.

Finishing occlusion in Class II or Class III molar relation: therapeutic Class II and III.

The most frequent extraction regime consists of the removal of upper and lower premolars. Depending on anchorage requirements, camouflage treatment options, surgical intervention, or the absence of teeth in only one arch, it may become necessary to finalize the occlusion with a one-dental-unit discrepancy between the upper and lower dental arches. Guidelines are presented for finishing occlusions in Class II or Class III molar relation.

Pyrazine-2,3-dicarboxamide

In the crystal structure of the title diamide, C(6)H(6)N(4)O(2), linear tapes of carboxamide N-H.O and pyrazine C-H.N hydrogen-bond dimers are connected by N-H.O bonds to form a staircase-like pattern.

Crystal engineering in the gem-alkynol family; synthon repetitivity and topological similarity in diphenylethynylmethanols: structures that lack O-H.O hydrogen bonds

The structures of four para-substituted derivatives of diphenylethynylmethanol have been determined [ditolylethynylmethanol, di(4-chlorophenyl)ethynylmethanol, di(4-bromophenyl)ethynylmethanol and bis(4,4'-biphenylyl)ethynylmethanol]. The dimethyl, dichloro, dibromo and diphenyl compounds have been analysed using X-ray diffraction at 150 K, and the dichloro compound has also been studied using neutron diffraction at 150 K. In common with the parent diphenylethynylmethanol [Garcia, Ramos, Rodriguez & Fronczek (1995). Acta Cryst. C51, 2674-2676], all four derivatives fail to form the expected strong O-H.O hydrogen bonds due to steric hindrance. Instead, the supramolecular structural organization in this family of gem-alkynols is mediated by a variety of weaker interactions. The two most acidic protons, O-H and C[triple-bond]C-H, participate in weak hydrogen bonds to pi-acceptors, forming synthons that stabilize all five structures. These primary interactions are reinforced by a variety of other weak hydrogen bonds involving C-H donors and the hydroxy-O as an acceptor, and by halogen.halogen interactions in the dichloro and dibromo compounds.

Halogen trimer synthons in crystal engineering: low-temperature X-ray and neutron diffraction study of the 1:1 complex of 2,4, 6-tris(4-chlorophenoxy)-1,3,5-triazine with tribromobenzene

The title complex has been studied using low-temperature X-ray (150 K) and neutron (100 K) diffraction. Molecules of the triazine host form a two-dimensional hexagonal network mediated by trigonally symmetric Cl(3) synthons having Cl.Cl interactions of 3.441 (3) A, a C-Cl.Cl angle of 165 degrees and a Cl.Cl-C angle of 105 degrees, close to the ideal values of 180 and 90 degrees, respectively. The guest molecules are of an appropriate size to fit the hexagonal networks and interact with the host via C-H.pi (phenyl) and C-Br.pi (phenyl) interactions which stabilize the overall structure. Both C-donor bond vectors are directed more closely towards the mid-point (X) of an individual aromatic bond, rather than the ring centroid, with H.X 2.817 (9) A and C-H.X 174.0 (9) degrees, and Br.X 3.353 (4) A and C-Br.X 158.1 (2) degrees.

Vasectomy reversal for the post-vasectomy pain syndrome: a clinical and histological evaluation.

PURPOSE: The cause of the post-vasectomy pain syndrome is unclear. Some postulated etiologies include epididymal congestion, tender sperm granuloma and/or nerve entrapment at the vasectomy site. To our knowledge nerve proliferation has not been evaluated previously as a cause of pain. Vasectomy reversal is reportedly successful for relieving pain in some patients. We report our experience and correlate histological findings in resected vasal segments with outcome to explain the mechanism of pain in these patients. MATERIALS AND METHODS: We retrospectively reviewed the records of 13 men who underwent vasectomy reversal for the post-vasectomy pain syndrome. We compared blinded histological evaluations of the vasal ends excised at vasectomy reversal in these patients with those of pain-free controls who underwent vasectomy reversal to reestablish fertility. Controls were matched to patients for the interval since vasectomy. Histological features were graded according to the degree of severity of vasitis nodosum, chronic inflammation and nerve proliferation. RESULTS: Mean time to pain onset after vasectomy was 2 years. Presenting symptoms included testicular pain in 9 cases, epididymal pain in 2, pain at ejaculation in 4 and pain during intercourse in 8. Physical examination demonstrated tender epididymides in 6 men, full epididymides in 6, a tender vasectomy site in 4 and a palpable nodule in 4. No patient had testicular tenderness on palpation. Unilateral and bilateral vasovasostomy was performed in 3 and 10 of the 13 patients, respectively. Postoperatively 9 of the 13 men (69%) became completely pain-free. Mean followup was 1.5 years. We observed no differences in vasectomy site histological features in patients with the post-vasectomy pain syndrome and matched controls, and no difference in histological findings in patients with the post-vasectomy pain syndrome who did and did not become pain-free postoperatively. CONCLUSIONS: No histological features aid in identifying a cause of pain or provide prognostic value for subsequent pain relief. Vasectomy reversal appeared to be beneficial for relieving pain in the majority of select patients with the post-vasectomy pain syndrome.

Crystal chemistry of some synthetic 2-oxa-steroids: conformation, packing motifs and isostructurality.

The crystal structures of six synthetic 2-oxa-steroids (A-ring lactone steroids) have been determined by single-crystal X-ray diffraction. The conformation and hydrogen bonding in these oxa-steroids is compared with packing motifs in the natural steroids and the anabolic agent, Anavar. O-H...O hydrogen bonding with lactone carbonyl O is the preferred arrangement in molecules with a C-OH group. The donor H atoms of A, B and D rings participate in C-H...O interactions with lactone carbonyl O and D-ring hydroxyl/ketone O acceptor atoms. The conformation of the lactone ring in these analogues is different from the natural androgens because replacement of the C2-methylene group by an O atom changes the geometry of the A ring. Two structurally related lactone steroids provide the first example of O-H...O/C-H...O interaction mimicry and furthermore the two components form a binary solid solution. The O-H...O and C-H...O hydrogen bonds in 2-oxa-steroid crystal structures are analysed and the observed preferences discussed in terms of geometric and chemical factors.

Localized tenosynovial giant cell tumor of tendon sheath. A case report.

BACKGROUND: Localized tenosynovial giant cell tumor of tendon sheath (TGCT-L) is a benign, slowly growing lesion with a peak incidence in the third to fifth decade of life. It is thought to arise from the synovium of tendon sheaths, frequently affecting interphalangeal joints of the hands, feet, ankles and knees. Although the histopathologic appearances are well established, only a few reports describe the cytomorphology of this lesion. CASE: A 37-year-old female presented with a slowly growing, nontender mass located near the left ankle joint. The cytologic features of localized tenosynovial giant cell tumor of tendon sheath (TGCT-L) include abundant mononuclear histiocytic cells occurring singly and in three-dimensional tissue fragments, hemosiderin within histiocytes and a few multinucleated giant cells. Subsequently, the histopathologic examination of the surgical specimen was proven to be TGCT-L. CONCLUSION: Fine needle aspiration cytology can be used as a diagnostic tool for early and accurate detection of TGCT-L since the cytologic features combined with clinical details are sufficiently distinctive.

[Tris(4-tolyl)methyl]benzene.

The crystal structure of the title compound, C(28)H(26), in the monoclinic space group C2/c has a columnar packing arrangement with a 7.20 A axis, a feature common to several tetraphenylmethanes.

Leiomyosarcoma of the mesocolon--a case report.

Retroperitoneal leiomyosarcomas including those arising from the mesentery are rare. These account for 5.8% of all soft tissue sarcomas. Most of these tumors present in late life with female preponderance. Diagnosing these tumors at an early stage is difficult due to their location. Hence, most of them attain large sizes with metastases to distant sites at the time of diagnosis. We report a case of leiomyosarcoma arising from the sigmoid mesocolon due to it's rarity and unusual clinical presentation.

An immunopathological study of lichen planus.

Twenty-five patients with clinically diagnosed lichen planus were examined for direct immunofluorescence patterns in biopsies. The male to female ratio was 1:1.77. The peak incidence was observed in 11-20 years age group. Most (96%) of the patients presented with moderate to severe itching within two months of onset of symptoms. Sixty percent of the patients had violaceous papules; 20% had both papules and plaques. Simultaneous oral involvement was seen in 4% of cases; 8% showed nail changes. Thirteen patients had classical LP, 9 had lichen planus hypertrophicus, 2 had lichen planus actinicus, and one had lichen planopilaris. Direct immunofluorescence revealed fibrin deposition in 64% of cases as a linear pattern at dermo-epidermal junction, as coarse granular deposits of IgM sub-epidermally in 24 of cases and at the dermo-epidermal junction as C 3 in20% of cases. Civatte bodies were seen in 5 cases with H&E staining, but direct immunofluorescence for IgM, fibrin and C 3 was observed only in two cases. This suggests activation of complement and fibrinogen cascade. Whether this is the cause or effect of pathological processes in lichen planus remains to be determined.

Lichen Planus-a Clinico-histopathological.

The clinico-histopathological features of 75 patients of lichen planus were studied. The male to female ratio was 1:13. The largest number of patients (30.6%) fell into the 31-40 year age group. Two patients had systemic hypertension. There was no history of lichen planus in the family. All patients presented with severe itching within 1-2 months of onset. Papular lesions were seen in 72% and papules with plaques were seen 16%. Lower limbs were involved in 38% of cases. Mucosal involvement was seen in 24% in addition to skin involvement ; nail involvement hypertrophicus (17.3%). Lichen planopilaris and oral lichen planus were uncommon. Clinico-histopathological discrepancies were observed in 7 patients. Civatte bodies were seen in only 37% of cases.