This document describes a study analyzing an epidermoid cyst and ridged warts that developed on a patient's feet. Histological and DNA analysis found human papillomavirus 60 (HPV 60) in the cysts, warts, and a connected eccrine duct. Immunohistochemical staining found the cyst expressed markers identical to epidermis layers, not eccrine ducts. A 3D reconstruction from serial sections showed the smallest cyst connected to an eccrine duct. This supports the idea that palmoplantar epidermoid cysts can develop from epidermoid metaplasia of eccrine ducts infected with HPV 60.
This study reviewed 50 inflammatory soft tissue lesions surgically removed and diagnosed histologically over a 30-year period from 1978-2007 at the University of Calabar Teaching Hospital in Nigeria. Onchocerciasis accounted for 60% of the lesions, followed by histoplasmosis at 20%. Other identified conditions included mycetoma, molluscum contagiosum, tuberculosis, leishmaniasis, rhinoscleroma, and blastomycosis. The lesions presented most commonly in children and young adults aged 5-15 years. Onchocercal nodules were widely distributed but predominantly in the chest wall. Histoplasmosis lesions were found in the clavicle, shoulder, ankle,
Ancient Remnants: Biomolecules in PaleopathologyGino Fornaciari
Diagnosis of ancient tumors and infectious diseases depends on the specific detection of cancer cells and pathogens in buried individuals; these fields of research are known as paleoncology and paleomicrobiology, two emerging disciplines which have benefited from technological advances.
Over the last years, aDNA limitations due to potential contamination by modern DNA and altered aDNA, together with the high costs, have led to the development of alternative methods for the detection and characterization of non nucleotidic biomolecules, including proteins.
We review some past studies with a major impact in soft tissue paleopathology in Italy and discuss the relevance of these materials to study ancient diseases. We mention among others: in 1986, smallpox virus in a 16th century Italian mummy; in 1989, syphilitic treponemes in an Italian mummy of the same age; in 1992, Trypanosoma cruzi in a pre-Columbian mummy with megavisceral syndrome; in 1996, K-ras mutation in the adenocarcinoma of Ferrante I of Aragon, King of Naples in the 15th century; in 2003, a sequence of Human Papilloma Virus (HPV) in a Renaissance Italian mummy.
In conclusion, immunohistochemistry and electron microscopy, two morphological disciplines which, compared to ancient DNA studies, have been rather neglected in the past years, can still be useful and have to be revaluated in Paleopathology.
The future potential of these researches should be considered in managing the preservation of bioarchaeological specimens stored in laboratories and museums.
This document summarizes a study on the recurrence rates of odontogenic keratocysts (OKCs) treated between 1971-1983. 44 patients with OKCs were included, with recurrence found in 8 cases (18%). All recurrences were in thin-walled cysts (Forssell group la). Decompression treatment using polyethylene drainage tubes in 12 large cysts resulted in thickening of the cyst walls and no recurrences after 7-17 years. The decompression treatment appears to reduce recurrence risks of OKCs compared to standard cystectomy alone.
RNA plays an essential role in biology by carrying genetic information from DNA and helping to synthesize proteins. It was discovered in the late 1950s that an intermediary RNA copy of a gene, called messenger RNA (mRNA), is required to translate genetic information stored in DNA into proteins. This established the central dogma of molecular biology whereby genetic information flows from DNA to RNA to protein. Some viruses also use RNA as their genetic material. Carl Woese later hypothesized that an "RNA world" may have existed before DNA and proteins, where RNA served both genetic and catalytic functions essential for life.
This document provides a historical overview of the classification of nasopharyngeal carcinoma (NPC) from the early 20th century to the present. Early schemes divided NPC into epitheliomas and lymphosarcomas. In the 1920s, the entity of lymphoepithelioma was described based on the mixture of epithelial and lymphoid cells. Through the mid-20th century, NPC was further classified into lymphoepithelioma, transitional cell carcinoma, and squamous cell carcinoma, though distinguishing between types was difficult. Current WHO classification divides NPC into keratinizing and nonkeratinizing types, but histological gradations exist and prognostic significance is unclear. Future classifications may be based
This study investigated using the omentum as an in vivo bioreactor to repopulate decellularized human internal mammary arteries (IMA). Sixteen decellularized IMA scaffolds were implanted in rat omentums for 8 or 12 weeks. Histological analysis found the grafts were completely patent and showed progressive recellularization of smooth muscle cells over the media layer. Staining also showed normal collagen formation and angiogenesis around the grafts. The results suggest this technique shows promise for experimental vascular graft applications, but further studies in larger animals are needed before using in humans.
This document summarizes research on fabricating a tissue-engineered pre-vascularized skin flap. Researchers used pluronic F127 to create a hierarchical network of macro and microchannels within a collagen matrix containing fibroblasts. The channels were seeded with endothelial cells, smooth muscle cells, and pericytes. Keratinocytes were seeded on top to form an epidermis. Multiphoton microscopy showed the channels were lined with vascular cells and supported by pericytes in an anatomical arrangement. Fibroblasts proliferated throughout, and the epidermis remained stable, demonstrating the successful creation of a pre-vascularized full thickness skin flap with stable vascularity.
This study reviewed 50 inflammatory soft tissue lesions surgically removed and diagnosed histologically over a 30-year period from 1978-2007 at the University of Calabar Teaching Hospital in Nigeria. Onchocerciasis accounted for 60% of the lesions, followed by histoplasmosis at 20%. Other identified conditions included mycetoma, molluscum contagiosum, tuberculosis, leishmaniasis, rhinoscleroma, and blastomycosis. The lesions presented most commonly in children and young adults aged 5-15 years. Onchocercal nodules were widely distributed but predominantly in the chest wall. Histoplasmosis lesions were found in the clavicle, shoulder, ankle,
Ancient Remnants: Biomolecules in PaleopathologyGino Fornaciari
Diagnosis of ancient tumors and infectious diseases depends on the specific detection of cancer cells and pathogens in buried individuals; these fields of research are known as paleoncology and paleomicrobiology, two emerging disciplines which have benefited from technological advances.
Over the last years, aDNA limitations due to potential contamination by modern DNA and altered aDNA, together with the high costs, have led to the development of alternative methods for the detection and characterization of non nucleotidic biomolecules, including proteins.
We review some past studies with a major impact in soft tissue paleopathology in Italy and discuss the relevance of these materials to study ancient diseases. We mention among others: in 1986, smallpox virus in a 16th century Italian mummy; in 1989, syphilitic treponemes in an Italian mummy of the same age; in 1992, Trypanosoma cruzi in a pre-Columbian mummy with megavisceral syndrome; in 1996, K-ras mutation in the adenocarcinoma of Ferrante I of Aragon, King of Naples in the 15th century; in 2003, a sequence of Human Papilloma Virus (HPV) in a Renaissance Italian mummy.
In conclusion, immunohistochemistry and electron microscopy, two morphological disciplines which, compared to ancient DNA studies, have been rather neglected in the past years, can still be useful and have to be revaluated in Paleopathology.
The future potential of these researches should be considered in managing the preservation of bioarchaeological specimens stored in laboratories and museums.
This document summarizes a study on the recurrence rates of odontogenic keratocysts (OKCs) treated between 1971-1983. 44 patients with OKCs were included, with recurrence found in 8 cases (18%). All recurrences were in thin-walled cysts (Forssell group la). Decompression treatment using polyethylene drainage tubes in 12 large cysts resulted in thickening of the cyst walls and no recurrences after 7-17 years. The decompression treatment appears to reduce recurrence risks of OKCs compared to standard cystectomy alone.
RNA plays an essential role in biology by carrying genetic information from DNA and helping to synthesize proteins. It was discovered in the late 1950s that an intermediary RNA copy of a gene, called messenger RNA (mRNA), is required to translate genetic information stored in DNA into proteins. This established the central dogma of molecular biology whereby genetic information flows from DNA to RNA to protein. Some viruses also use RNA as their genetic material. Carl Woese later hypothesized that an "RNA world" may have existed before DNA and proteins, where RNA served both genetic and catalytic functions essential for life.
This document provides a historical overview of the classification of nasopharyngeal carcinoma (NPC) from the early 20th century to the present. Early schemes divided NPC into epitheliomas and lymphosarcomas. In the 1920s, the entity of lymphoepithelioma was described based on the mixture of epithelial and lymphoid cells. Through the mid-20th century, NPC was further classified into lymphoepithelioma, transitional cell carcinoma, and squamous cell carcinoma, though distinguishing between types was difficult. Current WHO classification divides NPC into keratinizing and nonkeratinizing types, but histological gradations exist and prognostic significance is unclear. Future classifications may be based
This study investigated using the omentum as an in vivo bioreactor to repopulate decellularized human internal mammary arteries (IMA). Sixteen decellularized IMA scaffolds were implanted in rat omentums for 8 or 12 weeks. Histological analysis found the grafts were completely patent and showed progressive recellularization of smooth muscle cells over the media layer. Staining also showed normal collagen formation and angiogenesis around the grafts. The results suggest this technique shows promise for experimental vascular graft applications, but further studies in larger animals are needed before using in humans.
This document summarizes research on fabricating a tissue-engineered pre-vascularized skin flap. Researchers used pluronic F127 to create a hierarchical network of macro and microchannels within a collagen matrix containing fibroblasts. The channels were seeded with endothelial cells, smooth muscle cells, and pericytes. Keratinocytes were seeded on top to form an epidermis. Multiphoton microscopy showed the channels were lined with vascular cells and supported by pericytes in an anatomical arrangement. Fibroblasts proliferated throughout, and the epidermis remained stable, demonstrating the successful creation of a pre-vascularized full thickness skin flap with stable vascularity.
Carcinoma neuroendocrino del setto un rarissimo tumore nasaleMerqurio
This document presents a case report of a 73-year-old male with a rare small cell neuroendocrine carcinoma arising from the nasal septum. The patient presented with right-sided nasal obstruction, hyponasal speech, and recurrent epistaxis. Imaging showed a mass in the right nasal cavity extending to surrounding structures. The tumour was removed endoscopically and pathology confirmed a small cell neuroendocrine carcinoma. Due to the aggressive nature of this tumour type, the patient received combined chemotherapy and radiation in addition to surgery. At a 10-month follow-up the patient remained free of disease. Small cell neuroendocrine carcinoma of the nasal cavity is an extremely rare and aggressive tumour that is difficult to diagnose but requires
Carcinoma neuroendocrino del setto un rarissimo tumore nasaleMerqurio
This document presents a case report of a 73-year-old male with a rare small cell neuroendocrine carcinoma arising from the nasal septum. The patient presented with right-sided nasal obstruction, hyponasal speech, and recurrent epistaxis. Imaging showed a mass in the right nasal cavity extending to surrounding areas. The tumour was removed endoscopically and found to be a small cell neuroendocrine carcinoma based on histology and immunohistochemistry. Due to the aggressive nature of this tumour type, the patient received combined chemotherapy and radiation in addition to surgery. At a 10-month follow-up the patient remained free of disease. Small cell neuroendocrine carcinoma of the nasal cavity is an extremely rare and aggressive
Human amniotic membrane was examined for its immunogenicity using experimental xenotransplantation models. Strong expression of class I and II antigens as well as Fas ligand was observed in the amniotic membrane. Approximately 50% of epithelial cells remained viable after cryopreservation for several months. When transplanted to the limbus, intracorneal space, and under the kidney capsule of hosts, the amniotic membrane elicited only a mild immune response with few infiltrating host cells, whereas skin grafts were rejected. The results suggest that the amniotic membrane is an immune-privileged tissue that may be useful for applications on and inside the cornea due to its low immunogenicity.
A three-month-old American Quarter horse filly presented with bilateral blepharospasm, ocular discharge, and corneal ulcers involving both eyes as well as periocular and perioral erosions and ulcerations. Necropsy found severe ulcerations around both eyes and on the lips. Histopathology revealed intranuclear viral inclusions in epithelial cells of affected areas. Samples tested positive for Equine Herpesvirus 3 (EHV-3) via PCR and virus isolation, representing the first reported case of EHV3-associated keratitis. The filly's dam also presented with genital lesions and tested positive for EHV-3.
Propionibacterium acnes bacteriophage capsid protein structure determined by ...Joshua Chiou
- Cryo-electron microscopy was used to determine the 3.74 angstrom resolution structure of the Propionibacterium acnes bacteriophage capsid.
- The capsid protein displays a HK97-like fold with characteristic features including an N-arm, E-loop, central beta-sheets, and long alpha-helix.
- Individual subunits are stabilized through isopeptide bonds in a manner similar to the chainmail structure seen in HK97 capsids.
Multiphoton microscopy was used to study spermatogenesis in rat testes at different developmental stages. It was able to identify the stage of spermatogenesis in seminiferous tubules without labels. Tubules with and without sperm showed differences in fluorescence that could be used to distinguish them. Imaging rat testes with multiphoton microscopy resulted in minimal DNA fragmentation, indicating low risk of damage. Multiphoton microscopy has potential to help identify sperm-containing tubules during testicular sperm extraction in humans, improving outcomes and reducing risks.
Syringoma is a benign eccrine sweat gland tumor affecting mostly females at puberty projected with multiple soft papules usually 1-2 mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter, as a benign eccrine sweat gland tumor. The sites of predilection are lower eyelids, and cheeks. The regions of tendency are cheeks and lower eyelids. Syringoma of the vulvar is a rare disorder few cases of which have been reported in literature.
Abstract Syringoma is a benign eccrine sweat gland tumor affecting mostly females at puberty projected with multiple soft papules usually 1-2 mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter, as a benign eccrine sweat gland tumor. The sites of predilection are lower eyelids, and cheeks. The regions of tendency are cheeks and lower eyelids. Syringoma of the vulvar is a rare disorder few cases of which have been reported in literature.
Syringoma is a benign eccrine sweat gland tumor affecting mostly
females at puberty projected with multiple soft papules usually 1-2
mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter,
as a benign eccrine sweat gland tumor. The sites of predilection are
lower eyelids, and cheeks. The regions of tendency are cheeks and
lower eyelids. Syringoma of the vulvar is a rare disorder few cases
of which have been reported in literature.
Austin Andrology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Andrology.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all the areas of Andrology. Austin Andrology accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of andrology.
Austin Andrology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Background &Objective: Klebsiella pneumonia causes different serious nosocomial infections for human and several strains became multiple drug resistance .This study was conducted to describe the epidemiology and molecular typing of Klebsiella pneumonia with the extended spectrum of B lactamase enzyme in Gaza strip .Methods :A cross-sectional survey was conducted during the period of December 2008 to November2009. One hundred and fifty clinical specimens were collected from patients admitted in different wards . Results : Sixty six percentage of the isolates were K.pneumonia .These were isolated from different infected sites : urine 24% , sputum 14%, wound 11% , stool11% , blood14% , cerebrospinal fluid 11% , skin16% . The ESBLs was detected in 67% of the strains ,53% strains were resistant for more than eight antibiotics , PCR demonstrated different patterns for the presence of SHV(80%) , TEM(60%) enzyme and CTX-M(20%), PFGE Showed 10 clusters of genetically unrelated strains with high prevalence of polyclonal strains of Klebsiella pneumonia. Antibiotic resistance was found against Cephalothin(95.0%),Cefotaxime(82.0%),Ceftazidime(59.0%),Ceftriaxone(86.0%),Gentamicin(56.0%),Trimethoprim/sulphamethoxazole(47.0%)..Chloramphenicol(42%),Amikacin(33%),Aztreonam (32%) and Imipenem(0%). Interpretation, Conclusion : our findings showed that genetically-related isolates of K. pneumoniae producing SHV and TEM and CTX-M were present in Gaza Strip. Larger studies need to be done to better define the molecular epidemiology of ESBL producing K. pneumoniae and its clinical implications
Papillary Hidradenoma is a rare benign tumor of apocrine glands. Very limited number of case reports are available in the literature detailing the cytological features of papillary hidradenoma. Such a rare case specimen came in notice here at Pathology Department of SMS Medical College, Jaipur (Raj.) India. So, one such a rare case of papillary hidradenoma was explored with its cytological findings. A 30 year old female presented with a vulval cyst. Fluid from this cyst was sent for cytology with a clinical diagnosis of Bartholin cyst. The cytology suggested it to be a benign adnexal tumour by the presence of Biphasic pattern of cell arrangement which was further confirmed histologically. So whenever an middle aged female presents with a nodular lesion in the anogenital area, hidradenoma papilliferum should be kept in mind along with other conditions.
This document contains abstracts from presentations given at the 28th International Symposium on Pediatric Surgical Research held in Dublin, Ireland from September 24-26, 2015. The abstracts describe recent research on topics related to pediatric surgery, including analyses of enteric neural crest cell migration in mouse models of Hirschsprung's disease using 3D and 4D imaging, characterization of blood vessel formation by human adipose-derived endothelial cells in a 3D skin substitute, and the role of surfactant protein D in attenuating inflammation in an intestinal cell line with overexpression of toll-like receptor 4.
Comparative Study Of Pterygium Excision With Conjunctival Autograft,Wet Amnio...Dr. Jagannath Boramani
Presenter: Dr. Pavitra K. Patel, Co-authors: Dr. Sachin Daigavane,Dr. Mala Kamble, Department of Ophthalmology, Jawarharlal Nehru Medical College & Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha.
This study assessed the feasibility of generating colon tissue from decellularized colon scaffolds using tissue engineering techniques. Rat colon was successfully decellularized and the scaffolds were implanted either in the mesentery or in situ in the colon. Histological analysis after 9 months found that scaffolds implanted in the mesentery developed features of small intestine, while those implanted in situ in the colon developed features of colon tissue. The study highlights how the microenvironment influences tissue development from decellularized scaffolds and suggests this technique may be useful for generating intestinal tissues, though further studies are needed to evaluate its potential for producing longer tissue segments required for clinical applications.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Carcinoma neuroendocrino del setto un rarissimo tumore nasaleMerqurio
This document presents a case report of a 73-year-old male with a rare small cell neuroendocrine carcinoma arising from the nasal septum. The patient presented with right-sided nasal obstruction, hyponasal speech, and recurrent epistaxis. Imaging showed a mass in the right nasal cavity extending to surrounding structures. The tumour was removed endoscopically and pathology confirmed a small cell neuroendocrine carcinoma. Due to the aggressive nature of this tumour type, the patient received combined chemotherapy and radiation in addition to surgery. At a 10-month follow-up the patient remained free of disease. Small cell neuroendocrine carcinoma of the nasal cavity is an extremely rare and aggressive tumour that is difficult to diagnose but requires
Carcinoma neuroendocrino del setto un rarissimo tumore nasaleMerqurio
This document presents a case report of a 73-year-old male with a rare small cell neuroendocrine carcinoma arising from the nasal septum. The patient presented with right-sided nasal obstruction, hyponasal speech, and recurrent epistaxis. Imaging showed a mass in the right nasal cavity extending to surrounding areas. The tumour was removed endoscopically and found to be a small cell neuroendocrine carcinoma based on histology and immunohistochemistry. Due to the aggressive nature of this tumour type, the patient received combined chemotherapy and radiation in addition to surgery. At a 10-month follow-up the patient remained free of disease. Small cell neuroendocrine carcinoma of the nasal cavity is an extremely rare and aggressive
Human amniotic membrane was examined for its immunogenicity using experimental xenotransplantation models. Strong expression of class I and II antigens as well as Fas ligand was observed in the amniotic membrane. Approximately 50% of epithelial cells remained viable after cryopreservation for several months. When transplanted to the limbus, intracorneal space, and under the kidney capsule of hosts, the amniotic membrane elicited only a mild immune response with few infiltrating host cells, whereas skin grafts were rejected. The results suggest that the amniotic membrane is an immune-privileged tissue that may be useful for applications on and inside the cornea due to its low immunogenicity.
A three-month-old American Quarter horse filly presented with bilateral blepharospasm, ocular discharge, and corneal ulcers involving both eyes as well as periocular and perioral erosions and ulcerations. Necropsy found severe ulcerations around both eyes and on the lips. Histopathology revealed intranuclear viral inclusions in epithelial cells of affected areas. Samples tested positive for Equine Herpesvirus 3 (EHV-3) via PCR and virus isolation, representing the first reported case of EHV3-associated keratitis. The filly's dam also presented with genital lesions and tested positive for EHV-3.
Propionibacterium acnes bacteriophage capsid protein structure determined by ...Joshua Chiou
- Cryo-electron microscopy was used to determine the 3.74 angstrom resolution structure of the Propionibacterium acnes bacteriophage capsid.
- The capsid protein displays a HK97-like fold with characteristic features including an N-arm, E-loop, central beta-sheets, and long alpha-helix.
- Individual subunits are stabilized through isopeptide bonds in a manner similar to the chainmail structure seen in HK97 capsids.
Multiphoton microscopy was used to study spermatogenesis in rat testes at different developmental stages. It was able to identify the stage of spermatogenesis in seminiferous tubules without labels. Tubules with and without sperm showed differences in fluorescence that could be used to distinguish them. Imaging rat testes with multiphoton microscopy resulted in minimal DNA fragmentation, indicating low risk of damage. Multiphoton microscopy has potential to help identify sperm-containing tubules during testicular sperm extraction in humans, improving outcomes and reducing risks.
Syringoma is a benign eccrine sweat gland tumor affecting mostly females at puberty projected with multiple soft papules usually 1-2 mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter, as a benign eccrine sweat gland tumor. The sites of predilection are lower eyelids, and cheeks. The regions of tendency are cheeks and lower eyelids. Syringoma of the vulvar is a rare disorder few cases of which have been reported in literature.
Abstract Syringoma is a benign eccrine sweat gland tumor affecting mostly females at puberty projected with multiple soft papules usually 1-2 mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter, as a benign eccrine sweat gland tumor. The sites of predilection are lower eyelids, and cheeks. The regions of tendency are cheeks and lower eyelids. Syringoma of the vulvar is a rare disorder few cases of which have been reported in literature.
Syringoma is a benign eccrine sweat gland tumor affecting mostly
females at puberty projected with multiple soft papules usually 1-2
mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter,
as a benign eccrine sweat gland tumor. The sites of predilection are
lower eyelids, and cheeks. The regions of tendency are cheeks and
lower eyelids. Syringoma of the vulvar is a rare disorder few cases
of which have been reported in literature.
Austin Andrology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Andrology.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all the areas of Andrology. Austin Andrology accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of andrology.
Austin Andrology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Background &Objective: Klebsiella pneumonia causes different serious nosocomial infections for human and several strains became multiple drug resistance .This study was conducted to describe the epidemiology and molecular typing of Klebsiella pneumonia with the extended spectrum of B lactamase enzyme in Gaza strip .Methods :A cross-sectional survey was conducted during the period of December 2008 to November2009. One hundred and fifty clinical specimens were collected from patients admitted in different wards . Results : Sixty six percentage of the isolates were K.pneumonia .These were isolated from different infected sites : urine 24% , sputum 14%, wound 11% , stool11% , blood14% , cerebrospinal fluid 11% , skin16% . The ESBLs was detected in 67% of the strains ,53% strains were resistant for more than eight antibiotics , PCR demonstrated different patterns for the presence of SHV(80%) , TEM(60%) enzyme and CTX-M(20%), PFGE Showed 10 clusters of genetically unrelated strains with high prevalence of polyclonal strains of Klebsiella pneumonia. Antibiotic resistance was found against Cephalothin(95.0%),Cefotaxime(82.0%),Ceftazidime(59.0%),Ceftriaxone(86.0%),Gentamicin(56.0%),Trimethoprim/sulphamethoxazole(47.0%)..Chloramphenicol(42%),Amikacin(33%),Aztreonam (32%) and Imipenem(0%). Interpretation, Conclusion : our findings showed that genetically-related isolates of K. pneumoniae producing SHV and TEM and CTX-M were present in Gaza Strip. Larger studies need to be done to better define the molecular epidemiology of ESBL producing K. pneumoniae and its clinical implications
Papillary Hidradenoma is a rare benign tumor of apocrine glands. Very limited number of case reports are available in the literature detailing the cytological features of papillary hidradenoma. Such a rare case specimen came in notice here at Pathology Department of SMS Medical College, Jaipur (Raj.) India. So, one such a rare case of papillary hidradenoma was explored with its cytological findings. A 30 year old female presented with a vulval cyst. Fluid from this cyst was sent for cytology with a clinical diagnosis of Bartholin cyst. The cytology suggested it to be a benign adnexal tumour by the presence of Biphasic pattern of cell arrangement which was further confirmed histologically. So whenever an middle aged female presents with a nodular lesion in the anogenital area, hidradenoma papilliferum should be kept in mind along with other conditions.
This document contains abstracts from presentations given at the 28th International Symposium on Pediatric Surgical Research held in Dublin, Ireland from September 24-26, 2015. The abstracts describe recent research on topics related to pediatric surgery, including analyses of enteric neural crest cell migration in mouse models of Hirschsprung's disease using 3D and 4D imaging, characterization of blood vessel formation by human adipose-derived endothelial cells in a 3D skin substitute, and the role of surfactant protein D in attenuating inflammation in an intestinal cell line with overexpression of toll-like receptor 4.
Comparative Study Of Pterygium Excision With Conjunctival Autograft,Wet Amnio...Dr. Jagannath Boramani
Presenter: Dr. Pavitra K. Patel, Co-authors: Dr. Sachin Daigavane,Dr. Mala Kamble, Department of Ophthalmology, Jawarharlal Nehru Medical College & Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha.
This study assessed the feasibility of generating colon tissue from decellularized colon scaffolds using tissue engineering techniques. Rat colon was successfully decellularized and the scaffolds were implanted either in the mesentery or in situ in the colon. Histological analysis after 9 months found that scaffolds implanted in the mesentery developed features of small intestine, while those implanted in situ in the colon developed features of colon tissue. The study highlights how the microenvironment influences tissue development from decellularized scaffolds and suggests this technique may be useful for generating intestinal tissues, though further studies are needed to evaluate its potential for producing longer tissue segments required for clinical applications.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
Cisto metap ecrina hpv
1. C L I N I C A L A N D LA B O R A T O R Y I N V E S T I G A T I O N S DOI 10.1111/j.1365-2133.2005.06562.x
Human papillomavirus-associated plantar epidermoid cyst
related to epidermoid metaplasia of the eccrine duct
epithelium: a combined histological,
immunohistochemical, DNA–DNA in situ hybridization and
three-dimensional reconstruction analysis
K. Egawa, N. Egawa* and Y. Honda
Departments of Dermatology and Surgical Pathology, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto 860-0811, Japan
*Division of Cancer Cell Research, Institute of Medical Science, University of Tokyo, Minato-ku, Tokyo 108-8639, Japan
Summary
Correspondence Background We recently proposed that certain palmoplantar epidermoid cysts may
Kiyofumi Egawa. be related to eccrine ducts and that human papillomavirus (HPV) 60 may play a
E-mail: kuroibo@kaiju.medic.kumamoto-u.ac.jp role in their pathomechanism. However, the origin of palmoplantar epidermoid
cysts is still controversial.
Accepted for publication
9 October 2004
Objectives To examine the contribution of eccrine ducts and HPV 60 in the devel-
opment of epidermoid cysts.
Key words: Methods Five epidermoid cysts and four ridged warts that had developed on the
eccrine duct, epidermoid cyst, human soles of a patient were studied histologically, immunohistochemically and by
papillomavirus 60, inclusion cyst, metaplasia DNA–DNA in situ hybridization. Using serial sections obtained from its entire
body, a three-dimensional reconstruction (3DR) analysis was performed on the
Conflicts of interest:
None declared. smallest cyst to analyse the relationship between the epidermoid cyst, eccrine
duct and the overlying epidermis.
Results Histological and DNA–DNA in situ hybridization analyses demonstrated
both homogeneous intracytoplasmic inclusion bodies pathognomonic for HPV
60 infection and HPV 60 DNA sequences not only in all of the epidermoid cysts
and ridged warts but also in the acrosyringeal portion of an eccrine duct, with
the dermal portion of which the smallest cyst had been revealed to connect by
3DR analysis. However, immunohistochemical analyses using antibodies against
human carcinoembryonic antigen (CEA), involucrin and several cytokeratins
(CKs) revealed that the immunoreactivity of the cyst was not identical to
that of the eccrine dermal duct but was identical to that of suprabasal layers of
the epidermis.
Conclusions It was clearly demonstrated that an HPV 60-associated epidermoid cyst
with immunoreactivities for CEA, involucrin and CKs which were identical to
those of the epidermis connected with the eccrine dermal duct, supporting the
idea that certain palmoplantar epidermoid cysts may develop following the epi-
dermoid metaplasia of eccrine ducts with HPV 60 infection.
Epidermoid cysts of palmoplantar location (palmoplantar epi- epidermoid cysts, with or without infection by human papil-
dermoid cysts) have been described as being caused by lomavirus (HPV) 60,5 and therefore proposed the alternative
implantation of epidermal fragments into the dermis as a pathogenic hypothesis that certain palmoplantar epidermoid
result of a penetrating or blunt injury.1 However, this assump- cysts may develop from eccrine ducts and that HPV 60 may
tion has been questioned, and the necessity of a search for a play a role in this development. However, on the basis of the
more common aetiology has been stressed.2 previous results,3–5 it is still likely that such epidermoid cysts
We previously observed3,4 that eccrine sweat ducts were can develop as a result of the implantation of epidermal frag-
frequently found in and ⁄or connecting with palmoplantar ments that contain eccrine ducts with or without HPV 60
Ó 2005 British Association of Dermatologists • British Journal of Dermatology 2005 152, pp961–967 961
2. 962 HPV-associated eccrine epidermoid cyst, K. Egawa et al.
infection from injuries as they do occasionally develop after
injuries3,6 and are mainly located beneath the weight-bearing
areas of the foot, i.e. the balls and heels.7
Indeed, Abe et al.8 and Ohnishi and Watanabe9 questioned
the hypothesis of an ‘eccrine duct origin of the epidermoid
cyst’ on the basis of the immunoreactivities of several cyto-
keratins (CKs) which were not identical to those of sweat
glands and ducts but were identical to those of suprabasal
layers of the epidermis in plantar epidermoid cysts with HPV
infection.
However, Egawa et al.10 proposed the idea that such a CK
profile in HPV-associated palmoplantar epidermoid cysts might
be a reflection of the epidermoid metaplasia of the eccrine
duct epithelium in the process of cyst formation in the eccrine
ducts, as it was revealed that the CK profile of cholesteatomas,
which are histologically defined as epidermoid cysts develop-
ing in the middle ear,11 cannot be used as a variable to decide
whether the origin of epidermoid cysts is epidermal or meta-
plastic.12 Thus, the origin of palmoplantar epidermoid cysts is
still controversial.
Three-dimensional reconstruction (3DR) analysis from serial
sections is now a powerful tool for increasing our comprehen-
sion of the relationships among structural components, for the
indication of the connections between components, and for
revealing the distribution of components.13–15 In the present
study, using serial sections obtained from the entire body of
an epidermoid cyst, we attempted 3DR analysis to demon- Fig 1. Three subcutaneous nodules (solid arrows) and two ridged
strate the fine structure of an HPV 60-associated epidermoid warts (open arrows) on the left sole.
cyst of eccrine duct origin, in combination with histological,
immunohistochemical and DNA–DNA in situ hybridization
analyses. excised specimens were fixed in 10% formalin, and proc-
essed with an automatic processor.
Materials and methods
Histopathology
Patient
Four-micrometre thick sections were obtained using a micro-
A 21-year-old Japanese woman presented to Kumamoto Uni- tome from all of the biopsy specimens, stained with haema-
versity Hospital in April 1995, with several subcutaneous nod- toxylin and eosin (H&E), and examined microscopically
ules and warts on the soles of her feet. She first noticed (Figs 2 and 3). From the smallest cyst, gross serial sections
several miliary-sized asymptomatic nodules on her soles were obtained from its entire body, and all sections were
3 months before presentation and 1 year after having had sev- numbered in the order of sectioning, from one side to the
eral plantar warts treated with cryotherapy, although she could other. Fifty serial sections were obtained from each of the
not say whether or not the nodules developed in the same other cysts. Every alternate section was stained with H&E for
positions as the treated plantar warts. The nodules had gradu- histological analysis (Fig. 3), whereas the remaining sections
ally enlarged and had come to cause tenderness during the were used for further examinations such as immunohisto-
previous 3 months. chemical and DNA–DNA in situ hybridization analyses.
At the time of her first visit, examination showed three
subcutaneous nodules of 5–8 mm diameter and two small
Processing of histological and immunohistochemical data
flat warty lesions with clinical features of ridged warts16,17
for computer analysis
on the left sole (Fig. 1) and one nodule of 7 mm diameter
on the right sole. Her health was otherwise good. After Using photomicrographs of histopathological and immunohis-
informed consent was obtained, all the lesions were tochemically stained sections (Fig. 4a), we made montages by
removed successfully by scalpel under local anaesthesia. tracing the outlines of the histological ductal structures expres-
However, about 6 months later, a further subcutaneous sing carcinoembryonic antigen (CEA) in serial sections in red,
nodule of similar size appeared on the left sole, with two and those of the cyst wall and the overlying epidermis in blue
ridged warts. They were also removed by scalpel. The (Fig. 4b).
Ó 2005 British Association of Dermatologists • British Journal of Dermatology 2005 152, pp961–967
3. HPV-associated eccrine epidermoid cyst, K. Egawa et al. 963
(Fig. 4d). The three-dimensional images were rotated along
various axes to analyse the relationship between the cyst,
eccrine ducts and the overlying epidermis.
Immunohistochemistry
An immunohistochemical procedure for human CEA,3,4,15,18
CKs8,9,19 and involucrin20 was performed on paraffin-embed-
ded sections by the avidin–biotin–peroxidase complex (ABC)
method,21 utilizing a Vectastain ABC kit (Vector Laboratories,
Burlingame, CA, U.S.A.). A polyclonal antibody to human CEA
(Dako, Glostrup, Denmark) and monoclonal antibodies to var-
ious CKs (OV-TL 12 ⁄30, RCK108 and AE1 ⁄AE3, Dako; LL002,
Biomeda, Foster City, CA, U.S.A.; and CAM5.2, Becton Dickin-
son, San Jose, CA, U.S.A.) and involucrin (Novocastra, New-
Fig 2. Histological features of a ridged wart. Vacuolar structures are castle-upon-Tyne, U.K.) were used as primary antibodies
seen in the thickened horny layer and homogeneous intracytoplasmic (Table 1). In the case of CKs, the procedure was performed
inclusion bodies are seen in the granular and upper spinous cell layers with or without proteinase K predigestion or autoclave heating
of the acanthotic epidermis. A tiny keratinous cyst is seen just beneath for antigen retrieval as described previously.22 Negative con-
the acanthotic epidermis (arrow). trols for immunostaining were performed by substituting the
primary antibodies with phosphate-buffered saline or nonim-
mune mouse or rabbit IgG.
Three-dimensional reconstruction analysis
An image scanner (IX-4025; Canon, Tokyo, Japan) and a per-
DNA–DNA in situ hybridization
sonal computer (Apple Macintosh 8500) were used in the
3DR imaging. Montages of the serial sections obtained from HPV 60 DNA sequences were detected in formalin-fixed, paraf-
the entire body of the epidermoid cyst were displayed on a fin-embedded tissue sections using the DNA–DNA in situ hybrid-
television monitor (Multiscan 17s; Sony, Tokyo, Japan). The ization method as described previously.23,24 Hybridization was
outlines of the cysts and the eccrine ducts were digitized and performed at 37 °C for 16 h using digoxigenin-labelled HPV
stored on the computer to make a wire-frame of these in vivo 60 complete genome DNA which we had previously cloned
structures (Fig. 4c). Based on the wire-frame, three-dimen- from a plantar epidermoid cyst.3 The hybridization mixture
sional images of the structures were reconstructed using an consisted of 10% dextran sulphate, 2 · saline sodium citrate
image analysis program (Specular Infini-D; Specular, Amherst, (0Æ3% sodium chloride, 0Æ03 mol L)1 sodium citrate, pH 7Æ0),
MA, U.S.A.) and were displayed on the television monitor 400 lg mL)1 sheared herring sperm DNA (Sigma, St Louis,
Fig 3. Representative histological pictures
selected from the serial sections obtained
from the entire body of an epidermoid
cyst. Section numbers appear at the lower
left corner of each picture. Varying
histological features coming from a
hypertrophied eccrine dermal duct (no.
200, inset) connecting the apical portion
of the cyst with an acrosyringium in the
overlying epidermis are seen in the serial
sections. The ecrine duct, appearing as a
ductal structure in the apical portion of
the cyst wall (nos 180–190), goes
upwards through the dermis to the
acrosyringium (nos 200–210) and
connects with it in the overlying
epidermis (no. 220). The acrosyringium is
extremely dilated in the horny layer (no.
230).
Ó 2005 British Association of Dermatologists • British Journal of Dermatology 2005 152, pp961–967
4. 964 HPV-associated eccrine epidermoid cyst, K. Egawa et al.
Fig 4. Computer-based, three-dimensional
reconstruction (3DR) analysis of a human
papillomavirus 60-associated plantar
epidermoid cyst. (a) Histological section
(the same as Figure 3, no.190). (b)
Tracing of the outline of the histological
ductal structures expressing
carcinoembryonic antigen (red) and of the
cyst wall and overlying epidermis (blue).
(c) A wire-frame of the epidermoid cyst
generated by computer using a montage
of tracings obtained from all the serial
sections. (d) 3DR analysis visualizing the
fine structure of the epidermoid cyst
connecting with the eccrine dermal duct.
Table 1 Immunohistochemical staining in a human papillomavirus (HPV) 60-associated plantar epidermoid cyst
Normal eccrine gland
Secretory Eccrine
Antibody Specificity portion dermal duct Epidermis Cyst wall HD
CEA +++ +++ – – ++ (IML)
AE1 ⁄ AE3 CKs 10, 14–16, 19 ⁄ 1–8 +++ +++ +++ +++ +++
LL002 CK14 – ++ ++ (LL) ++ (OL) + (OL)
OV-TL 12 ⁄ 30 CK7 +++ – – – –
RCK108 CK19 + – – – –
CAM5.2 CKs 8, 18 +++ – – – –
Involucrin – – +++ (UL) +++ (IL) ++ (IL)
HD, hypertrophied eccrine dermal duct with which the HPV 60-associated epidermoid cyst connected; CEA, carcinoembryonic antigen;
CK, cytokeratin; IML, innermost layers; LL, lower layers; OL, outer layers; UL, upper layers; IL, inner layers; –, negative; +, weak; ++,
moderate; +++, strong.
MO, U.S.A.), 50% formamide and 2 lg mL)1 of probe DNA. (Figs 3 and 5c). The characteristic histological feature com-
The digoxigenin-labelled probe was detected by the streptavi- monly seen in all the ridged warts and the epidermoid cysts
din-biotinylated polyalkaline phosphatase detection system was the presence of eosinophilic homogeneous intracyto-
(DNA detection system; BRL, Gaithersburg, MD, U.S.A.). The plasmic inclusion bodies pathognomonic for HPV 60
phaeochromes used were nitroblue tetrazolium and 5-bromo- infection3–7,16,17,24–27 in the granular and upper spinous cell
4-chloro-3-indolylphosphate (Fig. 5). layers of the acanthotic epidermis of the ridged warts or in
the inner cell layers of the cyst wall (Figs 2 and 5c). Vacuolar
structures, also pathognomonic for HPV 60 infection,4,7 were
Results
also seen both in the horny layer of the ridged warts and in
keratinous material within the cyst cavity (Figs 2 and 5c).
Histology
In the serial sections obtained from the entire body of the
In the ridged warts, the epidermis was acanthotic with hyper- smallest cyst (Fig. 3), ductal structures coming from an eccrine
keratosis and partial hypergranulosis. In one lesion, a tiny dermal duct were seen between the apical portion of the cyst
keratinous cyst was seen just beneath the acanthotic epidermis and an acrosyringium in the overlying epidermis in the dermis
(Fig. 2). Epidermoid cysts were lined by stratified squamous that connects the two histological components (Fig. 3, nos.
epithelium, showing keratinization of the epidermoid type 190–220). The eccrine dermal duct was hypertrophied with
Ó 2005 British Association of Dermatologists • British Journal of Dermatology 2005 152, pp961–967
5. HPV-associated eccrine epidermoid cyst, K. Egawa et al. 965
duct but not the secretory portion. In contrast, OV-TL 12 ⁄30
(against CK7), RCK108 (against CK19) and CAM5.2 (against
CKs 8 and 18) stained only the secretory portion. A monoclo-
nal antibody against involucrin did not stain any portions of
the normal eccrine sweat gland.
Epidermis of the sole
CEA was expressed only in the acrosyringeal epithelium in the
epidermis. LL002 stained the lower cell layers; AE1 ⁄AE3
stained whole cell layers; OV-TL 12 ⁄30, RCK108 and CAM5.2
did not stain any cell layers; involucrin was expressed in the
upper cell layers of the epidermis.
Plantar epidermoid cyst
CEA was not expressed in the cyst wall but was expressed in
the acrosyringeal structures in the cyst cavity. LL002 stained
the outer cell layers; AE1 ⁄AE3 stained whole cell layers; OV-
TL 12 ⁄30, RCK108 and CAM5.2 did not stain any cell layers;
involucrin was expressed in the inner cell layers of the cyst
wall.
Hypertrophied eccrine dermal duct with stratified
squamous epithelium with which an epidermoid cyst
connected
Fig 5. Histological localization of human papillomavirus (HPV)
60 DNA sequences. A high-power view of the same section The innermost cell layers of the stratified epithelium of the
(a,c; haematoxylin and eosin) and a serial section (b,d; DNA–DNA hypertrophied eccrine dermal duct expressed CEA. Expression
in situ hybridization) of Figure 3, no. 230. Homogeneous of involucrin was also noted in the inner cell layers; LL002
intracytoplasmic inclusion bodies (a,c) and HPV 60 DNA sequences stained the outer cell layers; AE1 ⁄AE3 stained whole cell
(b,d) are seen in the acrosyringeal epithelium (a,b) as well as in the
layers; OV-TL 12 ⁄30, RCK108 and CAM5.2 did not stain any
cyst wall (c,d).
cell layers of the duct.
The results are summarized in Table 1.
stratified squamous epithelium (Fig. 3, no. 200, inset); the
acrosyringium was extremely dilated in the horny layer
DNA–DNA in situ hybridization
(Fig. 3, no. 230; Fig. 5a); and the homogeneous intracytoplas-
mic inclusion bodies were seen in the acrosyringeal epithelium HPV 60 DNA sequences were detected in all the epidermoid
(Fig. 5a) as well as in the epidermoid cyst (Fig. 5b). cysts and ridged warts. In the smallest epidermoid cyst ana-
Ductal structures suggestive of eccrine ducts were observed lysed with 3DR, the DNA sequences were identified both in
in three of the other four epidermoid cysts, using 50 serial the acrosyringeal portion of the eccrine duct (Fig. 5b) and in
sections obtained from each cyst. the cyst connecting with its dermal portion (Fig. 5d).
Three-dimensional reconstruction analysis Discussion
The analysis clearly demonstrated that the smallest epidermoid Implantation of epidermal fragments into the dermis has been
cyst connected with the eccrine dermal duct (Fig. 4d). thought to be the main cause of palmoplantar epidermoid
cysts.1 Although we have proposed an alternative pathogenic
hypothesis that certain palmoplantar epidermoid cysts may
Immunohistochemical observations
develop from eccrine ducts and that HPV (especially HPV 60)
may play a role in this development,3,4,10,17 there has been a
Normal eccrine sweat gland
lack of direct evidence to support this hypothesis.
A polyclonal antibody against CEA and a monoclonal antibody HPV 60 was initially identified25,26 in and isolated5 from
AE1 ⁄AE3 (against CKs 10, 14–16, 19 ⁄1–8) stained all the plantar epidermoid cysts with homogeneous intracytoplasmic
secretory, dermal duct and acrosyringeal portions of the ec- inclusion bodies, and was also subsequently found in flat
crine sweat gland. LL002 (against CK14) stained the dermal lesions retaining the appearance of dermal ridges on their
Ó 2005 British Association of Dermatologists • British Journal of Dermatology 2005 152, pp961–967
6. 966 HPV-associated eccrine epidermoid cyst, K. Egawa et al.
surface (ridged warts).16,17 Thus, the clinical morphology of appearance of CKs characteristic of stratified and cornifying
HPV 60-induced lesions also remains unclear. In the present epithelia, indicating a true change in the differentiation of the
study, using 3DR analysis, it was clearly demonstrated that an middle ear epithelium.12 Interestingly, HPV has also been
HPV 60-associated plantar epidermoid cyst connected with the identified in cholesteatoma.31
dermal portion of an eccrine duct. HPV 60 DNA sequences Although the epidermoid cyst analysed with 3DR in this
were identified not only in the epidermoid cyst but also in study connected with an eccrine dermal duct, the immunore-
the acrosyringeal portion of the eccrine duct by DNA–DNA activities for CEA, involucrin and several CKs of the cyst wall
in situ hybridization. All the other plantar epidermoid cysts and were not identical to those of normal eccrine dermal ducts
ridged warts that developed simultaneously on the same but were identical to those of the suprabasal layers of the
patient also harboured HPV 60 DNA sequences, suggesting a epidermis, as observed by Abe et al.,8 Ohnishi and Watanabe9
close association between the lesions and HPV 60 infection. A and Yokogawa et al.32 This suggests that the immunoreactivi-
tiny keratinous cyst, which might be a precursor of an HPV ties of the palmoplanatar epidermoid cysts may also be an
60-associated plantar epidermoid cyst, was also seen just indication of the metaplastic origin of the cysts from eccrine
beneath the acanthotic epidermis of a ridged wart. ducts. In the present case, the eccrine dermal duct with
In a previous report, two plantar epidermoid cysts were which the epidermoid cyst connected was hypertrophied
attached to the epidermis and open to the surface in a patient with stratified squamous epithelium and expressed both CEA
with multiple plantar epidermoid cysts harbouring both HPV and involucrin, suggesting a transitional form of the squa-
60 DNA sequences and eccrine ducts,3 suggesting that the mous metaplasia of the eccrine duct epithelium.
cysts developed from the acrosyringeal or uppermost portions However, as Epstein and Kligman have suggested that kera-
of eccrine ducts. As HPV 60 was frequently identified in tinizing cysts may develop from any part of the epithelial sys-
palmoplantar epidermoid cysts concomitantly with eccrine tem,33 further studies are still required to determine whether
ducts,3,4 we assumed that HPV 60 had a high affinity for the cases in which neither HPV infection nor an association
eccrine duct epithelia and played a role in cyst formation.17 with eccrine ducts has been found in ordinary histological sec-
Supporting this idea, recent studies28,29 have suggested that tions reflect a false-negative result or are an indication of epi-
papillomaviruses, including HPVs, may target epidermal stem dermal inclusion cysts resulting from the implantation of
cells, which may exist in association with eccrine ducts in the epidermal fragments.
human palmoplantar skin.29
In the context of the previous findings and the results of
Acknowledgments
the present case, we speculate that HPV 60 initially infects the
upper parts of the eccrine duct, such as the acrosyringeal epi- We thank Ms Chiemi Shiotsu and Ms Yoshiko Sonoda for tech-
thelium, where ridged warts develop, and then migrates into nical assistance and Gyohei Egawa, Haruki Egawa and Motoe
various parts of the dermal portions of the eccrine duct, where Egawa for help in drawing montages of histological pictures.
the virus-associated epidermoid cysts develop.
It has been revealed that HPV 60-associated palmoplantar
References
epidermoid cysts occasionally develop in association with pre-
ceding blunt or penetrating injuries. The cysts are mainly 1 MacKie RM. Epidermal skin tumours. In: Textbook of Dermatology
located beneath the weight-bearing areas of the foot, i.e. the (Champion RH, Burton JL, Ebling FJG, eds), 5th edn. Oxford:
Blackwell Science, 1992; 1459–504.
balls and heels;7 an HPV 60-associated plantar epidermoid cyst
2 Pinkus H. Epidermoid cysts or epidermal inclusion cysts? Arch Der-
developed just beneath a plantar wart when the wart was
matol 1975; 111:130.
being treated with cryotherapy;6 multiple epidermoid cysts 3 Egawa K, Honda Y, Inaba Y et al. Multiple plantar epidermoid cysts
harbouring both HPV 60 DNA sequences and eccrine ducts harboring carcinoembryonic antigen and human papillomavirus
developed on the sole of a football player.3 DNA sequences. J Am Acad Dermatol 1994; 30:494–6.
In the present case, the cryotherapy performed on the pre- 4 Egawa K, Honda Y, Inaba Y et al. Detection of human papillomavi-
ceding plantar warts seemed to have a triggering role in the ruses and eccrine ducts in palmoplantar epidermoid cysts. Br J Der-
matol 1995; 132:533–42.
development of the multiple HPV 60-associated epidermoid
5 Matsukura T, Iwasaki T, Kawashima M. Molecular cloning of a novel
cysts. Thus, traumatic injuries and mechanical pressure, which
human papillomavirus (type 60) from a plantar epidermoid cyst
have long been thought to have a causative role in the implan- with characteristic pathological changes. Virology 1992; 190:561–4.
tation of epidermal fragments following cyst formation in the 6 Inaba Y, Egawa K, Muto K, Arao T. Detection of papillomavirus
dermis,1 may have a triggering role in the progression of the common antigens in plantar epidermoid cysts. Jpn J Dermatol 1990;
HPV 60-infected eccrine duct epithelium to the formation of 100:199–203.
the cyst. 7 Egawa K, Inaba Y, Ono T, Arao T. ‘Cystic papilloma’ in humans?
Demonstration of human papillomavirus in plantar epidermoid
Squamous metaplasia is assumed to be a possible source of
cysts. Arch Dermatol 1990; 126:1559–603.
cholesteatoma,12,30 which is histologically defined as an epi-
8 Abe H, Ohnishi T, Watanabe S. Does plantar epidermoid cyst with
dermoid cyst developing in the middle ear.11 The squamous human papillomavirus infection originate from the eccrine dermal
cell metaplasia was immunohistochemically characterized by a duct? Br J Dermatol 1999; 141:161–2.
loss of simple epithelial cell-related CKs accompanied by the
Ó 2005 British Association of Dermatologists • British Journal of Dermatology 2005 152, pp961–967
7. HPV-associated eccrine epidermoid cyst, K. Egawa et al. 967
9 Ohnishi T, Watanabe S. Immunohistochemical observation of cyto- between ABC and unlabeled antibody (PAP) procedures. J Histochem
keratins in keratinous cysts including plantar epidermoid cyst. Cytochem 1981; 29:577–83.
J Cutan Pathol 1999; 26:424–9. 22 Misumi S, Iyama K, Honda Y et al. Differential expression of base-
10 Egawa K, Kitasato H, Ono T. A palmar epidermoid cyst, showing ment membrane type-IV collagen a1, a2, a5 and a6 chains among
histological features suggestive of eccrine duct origin, developing the histological subtypes of adenoid cystic carcinoma. Virchows Arch
after a bee-sting. Br J Dermatol 2000; 143:469–70. 2004; 445:54–62.
11 Rosai J. Ear. In: Ackerman’s Surgical Pathology (Rosai L, ed.), 8th edn. 23 Egawa K, Sibasaki Y, de Villiers E-M. Double infection with human
St Louis: Mosby, 1996; 2509–17. papillomavirus 1 and human papillomavirus 63 in a single cell of a
12 Kuijpers W, Vennix PP, Peters TA, Ramaekers FC. Squamous lesion displaying only an HPV 63-induced cytopathogenic effect.
metaplasia of the middle ear epithelium. Acta Otolaryngol 1996; Lab Invest 1993; 69:583–8.
116:293–8. 24 Kawase M, Honda M, Niimura M. Detection of human papilloma-
13 Braverman MS, Braverman IM. Three-dimensional reconstructions virus type 60 in plantar epidermoid cysts and verruca plantaris by
of objects from serial sections using a microcomputer graphics sys- the in situ hybridization method using digoxigenin labeled probe.
tem. J Invest Dermatol 1986; 86:290–4. J Dermatol 1994; 21:709–15.
14 Salisbury JR, Whimster WF. Progress in computer-generated three- 25 Egawa K, Ono T, Arao T. Epidermoid cyst of the sole and human
dimensional reconstruction. J Pathol 1993; 170:223–7. papillomavirus. Jpn J Dermatol 1987; 97:493–5.
15 Honda Y, Egawa K, Baba Y, Ono T. Sweat duct milia—immuno- 26 Kimura S, Sato N, Shigeeki H. A report of two cases of plantar epi-
histological analysis of structure and three-dimensional reconstruc- dermoid cyst which have papillomavirus antigen. Hifu-Rinsho 1987;
tion. Arch Dermatol Res 1996; 288:133–9. 29:487–91.
16 Honda A, Iwasaki T, Sata T et al. Human papillomavirus type 27 Egawa K. New types of human papillomaviruses and intracytoplas-
60-associated plantar wart: ridged wart. Arch Dermatol 1994; mic inclusion bodies, a classification of inclusion warts according
130:1413–17. to clinical features, histology and associated HPV types. Br J Dermatol
17 Egawa K, Kasai S, Hattori N et al. A case of a human papillomavirus 1994; 130:158–66.
60-induced wart with clinical appearance of both pigmented and 28 Schmit A, Rochat A, Zeltner R et al. The primary target cells of the
ridged warts. Dermatology 1998; 197:268–70. high-risk cottontail rabbit papillomavirus colocalize with hair fol-
18 Pennys NS, Nadji M, McKinney EC. Carcinoembryonic antigen pre- licle stem cells. J Virol 1996; 70:1912–22.
sent in human eccrine sweat. J Am Acad Dermatol 1981; 29:577–83. 29 Egawa K. Do human papillomaviruses target epidermal stem cells?
19 Watanabe S, Ichikawa E, Takanashi S, Takahashi H. Immunohisto- Dermatology 2003; 207:251–4.
chemical localization of cytokeratins in normal eccrine glands, with 30 Sade J, Babiacki A, Pinkus G. The metaplastic and congenital origin
monoclonal antibodies in routinely processed, formalin-fixed, par- of cholesteatoma. Acta Otolaryngol 1983; 96:119–29.
affin-embedded sections. J Am Acad Dermatol 1993; 28:203–12. 31 Bergmann K, Hoppe F, Yukai H et al. Human papillomavirus DNA
20 Hudson DL, Weiland KL, Dooley TP et al. Characterization of in cholesteatomas. Int J Cancer 1994; 59:463–6.
eight monoclonal antibodies to involucrin. Hybridoma 1992; 11: 32 Yokogawa M, Egawa K, Dabenaka K et al. Multiple palmar epider-
367–79. moid cysts. Dermatology 2002; 205:398–400.
21 Hsu H-M, Raine L, Franer H. The use of avidin–biotin peroxidase 33 Epstein WL, Kligman AM. Epithelial cysts in buried human skin.
complex (ABC) in immunoperoxidase technique: a comparison Arch Dermatol 1957; 76:437–45.
Ó 2005 British Association of Dermatologists • British Journal of Dermatology 2005 152, pp961–967