Per oral endoscopic myotomy in a pediatric patient with achalasia.

Introduction: Achalasia is the most common primary motor disorder of the esophagus. Its reported incidence is low, even more in pediatric patients. Laparoscopic Heller myotomy is the current stan dard of treatment.

[Follow up for a cohort of patients with biliary atresia: late surgery and development of biliary cysts].

Unlabelled: Since the introduction of Kasai’s hepatic portoenterostomy, the prognosis of patients with biliary atresia has improved. The presence of intrahepatic biliary cysts or bile lakes has been reported in some patients after the intervention. Bile lakes have been related to cholangitis and a poor outcome.

Compensatory lung growth in NOS3 knockout mice suggests synthase isoform redundancy.

Nitric oxide synthase 3 (NOS3) produces nitric oxide (NO) in endothelial cells, which stimulates cyclic guanosine monophosphate (cGMP) production and thereby mediates pulmonary vasodilation. Inhibition of cGMP enzymatic cleavage by sildenafil might be involved in lung growth stimulating processes in pulmonary hypoplasia. The aim of this study was to discover insights into the transcriptional regulation of NOS3 in a mouse model of compensatory lung growth (CLG).

Characterization of endothelial progenitor cells mobilization following cutaneous wounding.

Bone marrow (BM)-derived endothelial progenitor cells (EPCs) are known to play an important role in neovascularization and wound healing. We investigated the temporal effects of cutaneous wounding on EPC surface markers within the peripheral blood and BM, and to better understand the role of the stromal cell-derived factor-1 alpha (SDF-1alpha/CXCR4) axis on EPC mobilization after wounding. FVB/NJ mice were administered bilateral 8 mm circular full-thickness skin wounds.

Prenatal pulmonary hypertension index: novel prenatal predictor of severe postnatal pulmonary artery hypertension in antenatally diagnosed congenital diaphragmatic hernia.

Purpose: This study aim to assess the potential of prenatal predictors of postnatal severe pulmonary artery hypertension (PAH) in isolated left congenital diaphragmatic hernia (CDH) and to define a new prenatal pulmonary hypertension index (PPHI).

Methods: A retrospective chart review of CDH patients between May 2005 and October 2008 was conducted. Ten patients with systemic/suprasystemic and 9 patients with subsystemic pulmonary hypertension at 3 weeks of age were identified.

Long-term nitric oxide synthase inhibition in rat pregnancy reduces renal kallikrein.

This study was performed to test the hypothesis that long-term nitric oxide synthase (NOS) inhibition during pregnancy may alter the predominance of the vasodilator kallikrein system. Sprague-Dawley rats were treated with the competitive inhibitor of NOS N(omega)-nitro-L-arginine (L-NNA, 50 mg. kg(-1).

Pedal giant cell tumor of tendon sheath.

The authors present a brief review of giant cell tumor of tendon sheath and three case reports. A discussion emphasizing the histologic characteristics of this lesion demonstrates the benign-to-malignant variability of these neoplastic growths. Special attention is directed to a case with aggressive histologic characteristics.

Primary biphasic synovial sarcoma of the pleura.

Synovial sarcoma most commonly occurs in the peri-articular regions of the extremities. The present report describes a rare case of primary biphasic synovial sarcoma of the pleura in an 18-year-old female. The diagnosis was made on the basis of light microscopy, immunohistochemistry, electron microscopy and the characteristic translocation found on cytogenetic analysis.

Fine needle aspiration cytology of small cell neuroendocrine carcinoma of the breast. A case report.

Background: Neuroendocrine tumors, usually small cell (oat cell) carcinomas, are almost always primary in the lungs and are highly malignant. Similar tumors have recently been described to occur in various extrapulmonary sites, such as the uterine cervix and prostate. We report a primary neuroendocrine carcinoma of the breast in a female first diagnosed by fine needle aspiration biopsy (FNAB).

Small cell carcinoma of gallbladder: report of two cases.

Extrapulmonary small cell carcinoma has been reported from multiple sites, including the gallbladder. Small cell carcinoma of the gallbladder is a very rare tumor, found usually in elderly women and associated with cholelithiasis. It carries a grave prognosis, metastasizing early and causing death shortly after diagnosis.

Pulmonary botryomycosis in a patient with AIDS.

We describe the clinical and pathologic findings of the first reported case of pulmonary botryomycosis in a patient with AIDS. Botryomycosis is an uncommon, chronic, suppurative disease that is often mistaken clinically and histologically for a fungal infection. The patient responded to systemic antibiotic therapy.

[Changes in relevant attitudes of nurses after one year of working with Balint groups].

The present study was carried out in the Popovaca Psychiatric Hospital and the examinees were nurses (N = 44) allocated to educative work in Balint groups. Authors discuss if any change may occur in the attitude towards some relevant notions during the one-year educative work in Balint groups. A graphic form of semantic differential was used as the measuring instrument.

Hepatitis and glomerulonephritis in secondary syphilis.

In early secondary syphilis, predominant features of spirochetal infection may include hepatitis and glomerulonephritis. We report a 27-year-old woman with characteristic physical, laboratory, and microscopic findings of syphilitic hepatitis and glomerulonephritis; she responded to penicillin therapy and recovered completely. The importance of clinically and pathologically recognizing this treatable disease is emphasized.

Primary retroperitoneal angiosarcoma with eosinophilic globules. A combined light-microscopic, immunohistochemical, and ultrastructural study.

A poorly differentiated primary retroperitoneal angiosarcoma with abundant intracytoplasmic and extracytoplasmic eosinophilic globules containing alpha 1-antitrypsin and alpha 1-antichymotrypsin is presented. Recognition of these globules may facilitate future diagnoses of the neoplasm in this or other locations. To the best of our knowledge, this is the first article on a primary angiosarcoma of the retroperitoneum.

Testicular atrophy in homosexual AIDS patients: an immune-mediated phenomenon?

An immunopathologic analysis of the testes of 20 homosexual acquired immune deficiency syndrome (AIDS) patients was performed to investigate the hypothesis that the testicular atrophy of these patients represents an immune-mediated process. The findings were compared to those in a control group of heterosexual men without AIDS. The testes of the homosexual AIDS patients showed an overall lower degree of spermatogenesis with more prominent interstitial inflammation and thickening of the tubular basement membrane.

Diffuse neurofibroma of the pylorus: a cause of gastric outlet obstruction.

We describe a benign diffuse neurofibroma of the pylorus, unassociated with von Recklinghausen's neurofibromatosis, which was a cause of pyloric stenosis; epigastric discomfort, vomiting, and weight loss of 60 lb were the most prominent symptoms. Partial gastrectomy resulted in a cure. The literature on nerve-sheath tumors of the stomach is reviewed.

Giant median raphe cyst of the penis with diffuse melanosis of its epithelial lining.

Diffuse melanosis of the epithelial lining of an unusually large median raphe cyst of the penis is reported. Its light microscopic and ultrastructural features are described. The findings are discussed in the context of the published literature of genitourinary melanosis.

Melanocyte colonization of adenocarcinoma arising in an ovarian dermoid.

An adenocarcinoma which arose in a dermoid cyst of the ovary displayed areas of melanocyte colonization and pigmentation. Ultrastructural study revealed the presence of epithelial tumour cells and melanocytes; many tumour cells contained compound melanosomes, but not premelanosomes, suggesting transfer of melanin from melanocytes to tumour cells. Melanocyte colonization of malignant tumours is a curious phenomenon the significance of which remains to be elucidated.

Lead arthropathy: arthritis caused by retained intra-articular bullets.

The cases of 14 patients seen 6 weeks to 7 years after gunshot wounds with painful, restrictive joint disease and retained intra-articular bullets were reviewed. Twelve patients had radiographic findings characteristic of lead synovitis. The earliest finding was a fine, punctate deposition of radiopaque lead on the articular cartilage that resembled chondrocalcinosis but was of greater density.

Ultrastructural analysis of the effect of trimethoprim and sulphamethoxazole on the development of Chlamydia trachomatis in cell culture.

Folic acid antagonists have been demonstrated to cause gross changes in the morphology of chlamydial inclusions in cell culture. The ultrastructural changes were examined by electron microscopy in cultures of Chlamydia trachomatis treated with trimethoprim and sulphamethoxazole. Examination of these cultures demonstrated a failure of the reticulate bodies to develop into normal elementary bodies.

Fibrous hamartoma of infancy: an ultrastructural study.

The fine structures of three fibrous hamartomas of infancy were studied. All three components of these lesions were examined. The principal cells in the fibrous and myxoid areas were fibroblasts.

Malignant lymphoma of skin associated with postmastectomy lymphedema.

Malignant lymphoma developed in the dorsum of the hand in a patient with a long-standing postmastectomy lymphedema. The tumor subsequently spread to involve skin of the forearm and arm. Growth and spread of malignant cells within the stagnant dilated lymphatics are the likely cause of the characteristic nodular dissemination of the tumor in a lymphedematous extremity, regardless of the type of neoplasm.

Desmoplastic fibroma of the ulna. A case report.

This report of desmoplastic fibroma of bone (DFB) in the left ulna represents the 56th published case of the neoplasm. To the best of the authors' knowledge, the present case is the first instance of this type of excision of the distal ulna performed for DFB with a metallic prosthesis and successful restoration of distal radial ulnar anatomy and function.

Disseminated toxoplasmosis. Case report and review of the literature.

A 40-year-old man had disseminated toxoplasmosis preceded by miliary tuberculosis and associated with skin anergy. In previously reported cases of disseminated toxoplasmosis, the three organs most commonly involved were brain, heart, and lungs. The histopathologic picture of toxoplasmal lymphadenopathy was not present in our case or in previously reported cases.