Traumatic iliac muscle hematoma: A rare etiology of quadriceps palsy (case report).

INTRODUCTION AND IMPORTANCE: Quadriceps palsy is a sign of femoral nerve injury. Classically it is a compression of the nerve by a haematoma of the iliopsoas muscle in haemophiliacs and patients on anticoagulants. Could this haematoma form after a trauma in a healthy athlete? CASE PRESENTATION: We report a case of 16-year-old kickboxer with no previous history who had been complaining of the left groin for 3 weeks after being struck in the left iliac fossa. The examination revealed a complete palsy of the left quadriceps with anesthesia of the anterior aspect of the thigh. Femoral nerve involvement was suspected. MRI of the pelvis revealed a large hematoma of the left iliac muscle compressing the femoral nerve. Blood tests did not show any abnormalities. Surgical evacuation of the hematoma with neurolysis of the femoral nerve was performed. Six months postoperatively, the patient had fully recovered from their neurological deficit and was able to return to all his normal activities. CLINICAL DISCUSSION: The post-traumatic etiology of iliopsoas muscle hematoma compressing the femoral nerve in the absence of any hematological cause is rare. Few cases have been published (39 in 75 years). According to the literature, treatment is conservative if the paralysis is partial, but it must be surgical in case of complete paralysis. CONCLUSION: This rare pathology of the adolescent must be known to avoid any prejudicial diagnostic error for the often athletic patient. Whatever the diagnostic delay, a surgical procedure is necessary in case of complete paralysis of the femoral nerve.

SMAD3, Cell proliferation and lymph nodes metastasis in breast cancer hormone-dependent.

INTRODUCTION: Tumor Growth Factor-ß (TGF-ß) is a multifunctional cytokine that plays a crucial role in various biological processes. TGF-ß is also involved in various pathologies including breast cancer (BC). BC is strongly dependent on hormone receptors such as Estrogen receptors (ERa, ERb) and Progesterone Receptor (PR). AIM: To audit the potential cross-talk between TGF-ß and the molecular distribution of hormone receptors (ERs and PR). METHODS: The current study analyzes the expression patterns of SMAD3, ERα, ERß and PR in 40 breast tumor tissues using qRT-PCR. Furthermore, the Ki-67 and HER2/neu status have been detected by Immunohistochemistry. RESULTS: Our results show a decrease in the SMAD3 expression in 27 of the 40 cases while its expression is increased in the remaining 13 cases (p=0.003). The over-expression of SMAD3 is associated with high tumor grades. Moreover, there is a significant positive correlation between SMAD3+ with a high proliferative index and metastases (p=0.001 and p=0.01respectevely). The SMAD3 expression relative to (ERα, ERß) subgroups shows a significant association of SMAD3+ with the (ERα+, ERß+) subgroups (p=0.009). The same is true for PR, our results show a significant association of SMAD3+ with PR+ (p=0.02). Moreover, analysis of the expression of molecular subgroups (SMAD3+, ERα+, ERß+) and (SMAD3+, PR+) compared to clinical and pathological information shows a significant association with high grade tumors, a high proliferation index (p=0.02, p= 0.01 respectively) and lymph node infiltration. CONCLUSION: It is concluded that SMAD3 can promote cell proliferation and metastases in (ERα+, ERß+) and PR+ breast cancer.

Pelvic leiomyoma associated with intermediate risk prostate cancer: A case report.

Pelvic leiomyoma in male patients is a very rare occurrence and its association with prostate cancer is a unique clinical situation. This study reports a new case of a 9 cm pelvic Leiomyoma associated with intermediate-risk localized prostate cancer in a 68-year-old patient. The leiomyoma was discovered fortuitously after an MRI was performed in the context of prostate cancer work-up. Surgical excision of the pelvic mass along with a radical prostatectomy were performed and the diagnosis of leiomyoma was confirmed by histopathology.

Segmental renal vein thrombosis: An unusual complication of acute pyelonephritis.

Renal vein thrombosis is not a common manifestation in the context of acute pyelonephritis. We report the case of a 29-year-old female diabetic patient that was admitted to our department for an episode of complicated acute pyelonephritis. Initial imaging showed a left lower polar abscess of 27 mm and urine cultures grew community acquired K. Pneumoniae. Two days after the patient was discharged, she was readmitted with worsening symptoms. Repeat imaging showed stability in the size of the abscess and revealed a left lower segmental vein thrombosis. The patient responded favorably to antibiotics and heparin-warfarin therapy.

Bilateral renal hydatid disease associated with complex urolithiasis: A case report.

INTRODUCTION AND IMPORTANCE: The association of bilateral renal hydatid cysts and complex urolithiasis is unprecedented. We herein report the case of a patient presenting with both diseases. CASE PRESENTATION: A 56-year-old female patient with a history of chronic kidney disease presented with right flank pain. Imaging revealed bilateral kidney cystic lesions associated with right spontaneous large ureteric streinstrasse and multiple calyceal stones. The right sided mass was exophytic and measured 56 mm and the left sided lesion measured 35 mm. Semi rigid right ureteroscopy was performed along with a right partial nephrectomy and a right pyelotomy which allowed for renal and ureteral stone extraction. Histopathology report concluded to a hydatid cyst. The decision was to monitor the left-sided lesion. CLINICAL DISCUSSION: The association of bilateral renal hydatidosis and right urolithiasis is unprecedented in literature. The lesion presented a differential diagnosis problem with a cystic malignancy. Thus, the decision was to perform a right partial nephrectomy. The combination of ureteroscopy and a single right flank incision was sufficient to treat the renal lesion as well as to obtain stone free status. Once the histopathological report concluded to a hydatid cyst, the decision was to monitor the left sided lesion. A more aggressive approach could be proposed however it would have been detrimental to the patient's renal function. CONCLUSION: When presented with an association of bilateral renal masses and urolithiasis, a methodical step-by-step approach is necessary in order to treat both diseases while minimizing patient morbidity.

STAT-5 and STAT-6 in Breast Cancer: Potential Crosstalk With Estrogen and Progesterone Receptors Can Affect Cell Proliferation and Metastasis.

Background: Signal transducers and activators of transcription 5a and 6 (STAT5a and STAT6) play a critical role in tumorigenesis of mammary glands. Based on previous studies, the breast cancer is largely dependent on hormone receptors. Consequently, it is very interesting to decipher the relationship between the STAT5a and STAT6 expression and the molecular distribution of estrogen receptors (ERs) and progesterone receptors (PRs) in mammary tumors. Methods: Our study analyzed the expression of STAT5a and STAT6, ERα, ERß and PR in 40 breast tumor tissues using quantitative real-time polymerase chain reaction (qRT-PCR). Furthermore, the Ki-67 and HER2 status were detected using immunohistochemistry. Results: STAT5a and STAT6 were retained in the majority of the cases studied. Increasing of STAT5a and STAT6 is significantly associated with ERs and PR. The coexpression of both STAT5a and STAT6 with ERs and PR is associated with high tumor grades. Moreover, the coexpression of STAT5a and STAT6 with ERα and PR is associated with a high proliferation index. In addition, (STAT6 + ERß+) and (STAT6 + PR+) breast cancer subgroups are associated with lymph node infiltration (P = 0.001 and P = 0.03, respectively). Conclusions: Our study results provide an interaction between STAT5a and STAT6 with ERs and PR inducing cell proliferation. Coexpression of STAT5a and STAT6 with ERs and PR can predict sensibility to hormonal therapy.

Deverra tortuosa (Desf.) DC from Saudi Arabia as a new source of marmin and furanocoumarins derivatives with α-glucosidase, antibacterial and cytotoxic activities.

Deverra tortuosa (Desf.) DC (Syn. Pituranthos tortusus (Desf.) Benth. & Hook.f.) is a species belonging to the Apiaceae family that is common in the Northern Region of Saudi Arabia. The plant is well known in traditional medicine along the Arabian ecoregion. In the framework of the present study, the crude extract of n-hexane and ethyl acetate of the seeds were fractionated to purify major bioactive secondary metabolites. Five compounds were identified for the first time from the seeds of D. tortuosa: Marmin 1, Pituranthoside 2, Isoimperatorin 3, Bergapten 4 and Isopimpinellin 5. Their structures were elucidated using 1D and 2D NMR, (ESI)-MS and IR spectroscopic analyses. The cytotoxic, α-glucosidase and antibacterial activities of the pure phytochemicals were also evaluated.

The flavonoid, kaempferol-3-O-apiofuranosyl-7-O-rhamnopyranosyl, as a potential therapeutic agent for breast cancer with a promoting effect on ovarian function.

It is widely known that breast cancer cells eventually develop resistance to hormonal drugs and chemotherapies, which often compromise fertility. This study aimed to investigate the effect of the flavonoid, kaempferol-3-O-apiofuranosyl-7-O-rhamnopyranosyl (KARP), on 1) the viability of MCF-7 breast cancer cells and 2) ovarian function in rats. A dose-dependent decrease in MCF-7 cell survival was observed, and the IC50 value was found to be 48 µg/ml. Cells in the control group or those exposed to increasing concentrations of KARP experienced a similar generation of reactive oxygen species and induction of apoptosis. For the rats, estradiol levels correlated negatively to KARP dosages, although a recovery was obtained at administration of 30 mg/kg per day. Noteworthily, when compared against the control, this dosage led to significant increases in mRNA levels for CYP19, CYP17a, CCND2, GDF9, and INSL3 among the treatment groups, and ER1 and ER2 mRNA levels decreased in a dose-dependent manner. KARP shows great promise as an ideal therapy for breast cancer patients since it induced apoptosis and autophagy in cancerous cells without harming fertility in our animal model. Future investigations on humans are necessary to substantiate these findings and determine its efficacy as a general line of treatment.

Synthesis of magnetite derivatives nanoparticles and their application for the removal of chromium (VI) from aqueous solutions.

Nowadays there is a continuously increasing worldwide concern for the development of efficient wastewaters treatment technologies. Among the heavy metal ions, chromium holds a distinct position due to its high toxic nature to biological systems. This study aims to assess magnetite derivatives nanoparticles for the removal of Cr(VI) species. Crystalline magnetite-rich (Magn) and pure maghemite (Magh) nanoparticles were produced by the polyol method and by subsequent heat treatment of Magn, respectively. The XRD analysis confirmed the formation of nanosized single phase cubic spinels with a cell parameter of 8.3710(2)Å for Magn and 8.3401(2)Å for Magh, consistent with those of a magnetite-rich ferrite and maghemite, respectively. TEM analysis showed that the two nanoferrites possessed comparable mean particle size of ∼15nm. Magn and Magh showed superparamagnetic behavior at room temperature and reasonable saturation magnetizations at 300K of 69 and 67emu.g-1, respectively. The Curie temperature of both nanoferrites exceeded 350°C allowing the materials to work in severe conditions. Room temperature, batch adsorption experiments of Cr(VI) onto maghemite nanoparticles were carried out at pH 2.0. Adsorption efficiency increased rapidly was the increase of the nanoparticles dose. For a 20mg.L-1 Cr(VI) solution a 100% removal was found with ∼3g.L-1 dose. Additionally, for a given dose (4.0g.L-1), the adsorption rate measured as a function of time for different Cr(VI) concentrations was very rapid; ∼90% of removable Cr(VI) species was achieved within 10min. The high rate of Cr(VI) uptake takes advantages of the high active surface chemistry of the nanoparticles. The adsorption of Cr(VI) onto Magh nanoparticles followed a pseudo-second order kinetics indicating a chemisorption process. Further, the Langmuir isotherm model was found to best describe the equilibrium data with a maximum adsorption capacity of 12.5mg.g-1 for an adsorbent dosage of 4.0g.L-1.

ERα and ERß co-expression: An indicator of aggressive tumors and hormonal sensitivity.

The estrogen receptors (ERs) ERα and ERß are important factors in breast cancer progression. Nevertheless, the molecular interplay between ERα and ERß and its clinical significance in breast cancer is controversial. The establishment of a clear association is required; therefore, the current study analyzed the expression patterns of ERα and ERß in 32 breast tumor tissues using reverse transcription-quantitative polymerase chain reaction. Furthermore, human epidermal growth factor receptor 2 (HER2) and the Ki-67 status were detected by immunohistochemistry. The results revealed that the ERα and ERß expression rates recorded were 68 and 65%, respectively. The ERα:ERß ratio exhibited a decline along with disease progression. ERα and ERß were found to be negatively correlated with HER2 status but positively correlated with Ki-67. Co-expression of ERα and ERß was associated with breast cancer aggressiveness, including higher histological grade and positive nodal status, which commonly occur following the menopause. In addition, in cases where ERß was coexpressed with ERα, HER2 expression was frequently found to be negative, whereas the Ki-67 index was upregulated. These data suggest that ERα and ERß co-expression may be an indicator of tumor aggressiveness and the sensitivity of hormonal therapy via the downregulation of HER2.

[Isoniazid acetylation in a group of Tunisian patients. Report of 620 patients]. / Profil acétyleur d'une population de tuberculeux Tunisiens. A propos de 620 cas.

Isoniazid is a first line antituberculosis drug metabolized mainly in the liver by the Nacetyltransferase. There are differences between individuals in acetylation metabolism. Subjects are thereby characterized as being rapid or slow acetylators. The purpose is to study the distribution pattern of acetylation in patients with tuberculosis followed up at the teaching Hospital of La Rabta. The determination of acetylator phenotype was carried out on 620 tuberculosis patients during a period of 12 years. There were 483 men and 137 women with a median age of 40.3 years. The test was investigated before drug regimen administration at the dose of 5 mg/kg. A blood sample was taken three hours after the first administration. The determination of acetylation profile was worked out by Vivien hypothesis. In our population 391 were low and 229 were fast acetylators. The median dose recommended within the test was 3.04 mg/kg/day. 56% of our patients were initially receiving high dose of isoniazid. An increase in serum transaminase was initially observed in 60 patients among whom 47 slow acetylators. After dose adaptation, 53 patients had improved their biological abnormalities. The majority of Tunisian population seem to belong to slow acetylators modal. The frequency of hepatotoxicity suggests reducing the recommended dose of isoniazid from 5 to 3 mg/kg/day.

[Obesity and life style in a population of male school children aged 6 to 10 years in Ariana (Tunisia)]. / Obesite et mode de vie dans une population d'ecoliers de la region de l'Ariana (Tunisie) ages de 6 à 10 ans.

The increase of the prevalence of the obesity in childhood puts in reason some factors of the environment and the way of life of the child that encourage the hold of weight at these topics of as much more that if they are exposed genetically. A prospective survey has been done close to 3148 school boy aged of 6 to 10 years and who were schooled in the gouvernorat of Ariana showed that the prevalence of the obesity is around 3.7%. A survey case/witness has been achieved in a second time on the way of life of the group of the obese matched to a group of children no obese. An intended questionnaire to parents of children of these 2 groups permitted to collect some informations concerning the weight and the present size of parents, habits of life of their children. The weight to the birth has been searched for in the school medical file or from the notebook of health of the child. The obesity of parents is one factor of risk of the child obesity. The short length of sleep (< 8 hours), the erosion between meals especially in the evening after the dinner, the daily consumption of sugary foods and sparkling drinks is the important risk factors exposing to the infantile obesity this group of age. These behaviours can be corrected by a strategy of prevention and nutritional education.