Apropos of 148 cases]

Gynecomastia is the most frequently breast lesion in males. 148 patients (mean age 24,7 years) operated in our department were reviewed with a mean follow-up of five years. Gynecomastia occurred most frequently during puberty (77,7 %), was bilateral (86,5%) and idiopathic (89,9%). The size of the enlargement was evaluated according to Simon's-classification based on breast-volume and skin-redundancy. 17 (11,5%) stage 1, 77 (52%) stage 2A, 32 (21,6%) stage 2B, 22 (14,9%) stage 3. Clinical examination and mammography determined the consistency of gynecomastia: adipose or firm. 4 different surgical managements were used: 17 (11,5%) subcutaneous mastectomies, 4 (2,7%) liposuctions, 110 (74,3%) liposuctions associated with subcutaneous mastectomy, 17 (11,5%) total mastectomy. All techniques gave good morphologic results. Nonetheless, the authors recommend the combination «liposuction and subcutaneous mastectomy», as this technique presents many advantages: small intraoperative blood loss, good skin redraping, short hospital stay, complete histologic examination of the material removed.

A new nomogram of urinary flow rate and volume based on multiple measurements per healthy adult Japanese men using a portable uroflowmeter (P-Flowdiary®)

BACKGROUND

To develop a nomogram of urinary volume and flow based on the data of Japanese men without lower urinary tract symptoms and multiple flows per participant whose characteristics were clear.

METHODS

Overall, 101 Japanese male volunteers without lower urinary tract symptoms aged between 20 and 59 years were enrolled. A portable uroflowmeter (P-Flowdiary®) was used to record urinary information (flow rate and volume) for 2 successive days. The model (quadratic, linear, or logarithmic regression) most fit for the relationship between maximum flow rate and voided volume was determined. The maximum flow rate at > 150 mL was compared among the 20-29-, 30-39-, 40-49-, and 50-59-year age groups. Nomograms appropriate for the age groups were created.

RESULTS

The mean age, International Prostate Symptom Score, and Overactive Bladder Symptom Score were 38.5 years, 0.42, and 0.24, respectively. The quadratic regression model was the most fit because its mean coefficient determination was 0.93 ± 0.06. The mean maximum flow rate was significantly lower in the 50-59-year age group (21.8 ± 5.05 mL/s, P < 0.01) than in the younger groups (24.14 ± 4.94, 24.05 ± 6.99, and 24.64 ± 5.72 mL/s). The 2 nomograms are Y = 28.99 {1 - exp(- 0.01 × X)} and Y = 25.67 {1 - exp(- 0.01 × X)} for the 20-49- and 50-59-year age groups, respectively.

CONCLUSIONS

The nomogram can predict maximum flow rate based on voided volume in Japanese men aged 20-59 years without lower urinary tract symptoms.

Inertial biometry from commercial 3D body meshes

Body segments inertial parameters (or, more generally encompassing humans and animal species, inertial biometry), often necessary in kinetics calculations, have been obtained in the past from cadavers, medical 3D imaging, 3D scanning, or geometric approximations. This restricted the inertial archives to a few species. The methodology presented here uses commercial 3D meshes of human and animal bodies, which can be further re-shaped and 'posed', according to an underlying skeletal structure, before processing. The sequence of steps from virtually chopping the mesh to the estimation of inertial parameters of body segments is described. The accuracy of the method is tested by comparing the estimated results to real data published for humans (male and female), horses, and domestic cats. The proposed procedure opens the possibility of remarkably expanding biomechanics research when body size and shape change, or when external tools, such as prosthesis and sport material, take part in biological movement.

The bronchus-associated-lymphoid tissue (BALT) an unique lymphoid organ in man and animals

The development structure and number of bronchus-associated lymphoid tissue (BALT) will be described in many different animals (like chicken, rabbit, mouse, rat, farm animals and particular the pig, monkey) and these data compared to healthy man and in human diseases. The term induced BALT should not be used because it is a tertiary lymphoid structure, which lacks the contact to a bronchus and does not consist of the important area (dome area) which is essential for antigen uptake of microbial stimuli, which are essential in the development of BALT. Mycoplasma seems to play a critical role as shown in pigs but there not been documented in other species like rabbits. More studies have to be performed in health and disease (e.g. in apes) to document the structural and functional basis to use BALT as an entry site for vaccination protocols.

A Case Report of Primary Pulmonary Choriocarcinoma in a Man: Successful Combination of Surgery and Chemotherapy

Choriocarcinoma is a malignant tumor that typically appears in gonadal organs and primarily occurs in women of reproductive age. Being a primary extragonadal choriocarcinoma, primary pulmonary choriocarcinoma (PPC) is an extremely rare condition. Due to the rarity of PPC, no standardized treatment has been established so far. However, surgery combined with adjuvant chemotherapy appears to be the most optimal treatment. Here, we report a rare case of a man with PPC that was successfully treated with surgery followed by chemotherapy.

Inhibitory effect of metals on animal and plant glutathione transferases

Glutathione transferases (GSTs) represent a widespread enzyme superfamily in eukaryotes and prokaryotes catalyzing different reactions with endogenous and xenobiotic substrates such as organic pollutants. The latter are often found together with metal contamination in the environment. Besides performing of essential functions, GSTs protect cells by conjugation of glutathione with various reactive electrophiles. The interference of toxic metals with this functionality of GSTs may have unpredictable toxicological consequences for the organisms. In this review results from the recent literature are summarized and discussed describing the ability of metals to inhibit intracellular detoxification processes in animals and plants.

Radioecological modelling of Polonium-210 and Caesium-137 in lichen-reindeer-man and top predators

This work deals with analysis and modelling of the radionuclides ²¹⁰Pb and²¹⁰Po in the food-chain lichen-reindeer-man in addition to ²¹⁰Po and ¹³⁷Cs in top predators. By using the methods of Partial Least Square Regression (PLSR) the atmospheric deposition of ²¹⁰Pb and ²¹⁰Po is predicted at the sample locations. Dynamic modelling of the activity concentration with differential equations is fitted to the sample data. Reindeer lichen consumption, gastrointestinal absorption, organ distribution and elimination is derived from information in the literature. Dynamic modelling of transfer of ²¹⁰Pb and ²¹⁰Po to reindeer meat, liver and bone from lichen consumption, fitted well with data from Sweden and Finland from 1966 to 1971. The activity concentration of ²¹⁰Pb in the skeleton in man is modelled by using the results of studying the kinetics of lead in skeleton and blood in lead-workers after end of occupational exposure. The result of modelling ²¹⁰Pb and ²¹⁰Po activity in skeleton matched well with concentrations of ²¹⁰Pb and ²¹⁰Po in teeth from reindeer-breeders and autopsy bone samples in Finland. The results of ²¹⁰Po and ¹³⁷Cs in different tissues of wolf, wolverine and lynx previously published, are analysed with multivariate data processing methods such as Principal Component Analysis PCA, and modelled with the method of Projection to Latent Structures, PLS, or Partial Least Square Regression PLSR.

Fitz-Hugh-Curtis syndrome in a man positive for Chlamydia trachomatis

Fitz-Hugh-Curtis syndrome (FHCS) is characterized by perihepatic and pelvic inflammation and occurs mostly in women of childbearing age. Here, we report a case of FHCS caused by Chlamydia trachomatis in a 50-year-old man. The patient presented to our hospital with right upper quadrant abdominal pain, and enhanced computed tomography revealed perihepatic and pelvic free fluid and early-phase hepatic capsular enhancement. A urine specimen was positive for Chlamydia trachomatis. The patient was diagnosed with FHCS due to Chlamydia trachomatis infection. In conclusion, FHCS cannot be excluded when men present with right upper quadrant abdominal pain without significant signs of biliary tract disease.

Male breast cancer: diagnosis stages, treatment and survival in a country with limited resources (Burkina Faso)

BACKGROUND

Male breast cancer is a rare and less known disease. Therapeutic modalities affect survival. In Burkina Faso, male breast cancers are diagnosed in everyday practice, but the prognosis at short-, middle-, and long-term remains unknown. The objective of this study is to study the diagnosis stages, therapeutic modalities, and 5-year survival in male breast cancer at the General Surgery Unit of Yalgado Ouedraogo University Hospital from 1990 to 2009.

METHODS

A cohort longitudinal study concerning cases of breast cancer diagnosed in man. Survival was assessed using the Kaplan-Meier method and survival curves were compared through the LogRank test.

RESULTS

Fifty-one cases of male breast cancer were followed-up, i.e., 2.6% of all breast cancers. Stages III and IV represented 88% of cases. Eleven patients (21.6%) were at metastatic stage. Patients were operated in 60.8% of cases. The surgery included axillary dissection in 25 (80.6%) out of 31 cases. Lumpectomy was performed on 6.5% of patients (2 cases). Fifteen (29.4%) and 11 (21.6%) patients underwent chemotherapy and hormonal therapy, respectively. The FAC protocol was mostly used. Radiation therapy was possible in two cases. The median deadline for follow-up was 14.8 months. A local recurrence was noticed in 3.2% of cases. The overall 5-year survival rate was 49.9%. The median survival was over 5 years for stages I and II. It was 54 down to 36 months for stages III and IV.

CONCLUSION

Diagnosis is late. The lack of immunohistochemistry makes it difficult to define the proportion of their hormonal dependence. Surgery is the basic treatment. Five-year survival is slow and the median survival depends on the diagnosis stage. It can be improved through awareness-raising campaigns and the conduct of individual screening.

[Breast cancer in men: about 40 cases and literature review]

Breast cancer in men is rare, accounting for approximately 1% of all breast cancers and less than 1% of all neoplasias in men. This study aimed to highlight the clinical histological, prognostic and therapeutic features of this rare tumor in order to contribute to improve the management of these patients. We conducted retrospective study of 40 patients whose data were collected at the Mohammed VI Center for Cancers Treatment in Casablanca from January 2000 to December 2012. The average age was 62 years, the mean consultation time was 12 months, self-exam of a peri-areolar nodul was the main reason for consultation in 90% of cases. Infiltrating ductal carcinoma was the predominant histological type in 90% of cases. Multimodal treatment was based on mastectomy followed by adjuvant therapy including chemotherapy, radiation therapy and/or hormonal therapy, depending on tumor stage and its histological features. The mean follow-up time was 38 months, patient's evolution was characterized by complete remission in 16 patients (40%), local recurrence in 3 patients (7.5%) and metastatic recurrence in 5 patients (12.5%). Metastases mainly occurred in the bones (62%), followed by the lungs and the liver. 10 patients (25%) died. Breast cancer in men is similar to breast cancer in women. However it has its own peculiarities, hence the importance of conducting broader prospective randomised studies in order to improve the treatment and the prognosis of this disease with a high psychosocial impact.

Differences in drug use between men and women: an Italian cross sectional study

BACKGROUND

Drugs are the most important treatment option for most diseases, and the majority of medical consultations result in a prescription. Women and men receive different drug prescriptions and differ in therapeutic response to pharmacological therapy. This disparity is due to biological factors (sex differences) or/and behavior, lifestyle and life experience (gender differences). Sex differences in drug use have been demonstrated in several therapeutic areas; however, there is a lack of overviews on sex and gender differences of drug use in an entire population.

METHODS

We conducted a descriptive cross - sectional drug use study, involving the entire Italian population in 2012, aimed at showing and analyzing differences between men and women as regards their exposure to drugs. The data source was IMS LifeLink Treatment DynamicsTMLRx Database and it included all prescribed drugs reimbursed by the Italian National Healthcare System in 2012 and covered 90% of the entire Italian population. The information about the prescriptions was stratified by men and women and age. Drug consumption was expressed as DDD/ 1000 ab die. Exposure to drug prescriptions was expressed as period prevalence (the proportion of the population dispensed ≥1 prescription in 2012 per 1000 inhabitants). Differences of prevalence between men and women were expressed as crude and age adjusted risk ratios with 95% CI.

RESULTS

Our findings suggested that the largest differences in drug prescriptions regarded drugs affecting bone structure and mineralization (RR 15.9), calcium (RR 8.6) and thyroid therapy (RR 5.4), dispensed more to women than men. Otherwise ACE inhibitors were more commonly used in men.

CONCLUSIONS

This is the first study exploring difference in drug use between men and women and carried out on the entire Italian population. Our findings showed substantial differences between men and women in term of prevalence of drug prescriptions. Some differences in drug use may be explained by sex differences (variations in disease prevalence and severity, pathophysiology, or by other biological differences), other differences need further investigation to explain the apparent lack of a rational medical explanation for some findings. The findings may subsequently be used to plan future studies to address differences suggesting inequity in treatment approaches.

NAFLD as a Sexual Dimorphic Disease: Role of Gender and Reproductive Status in the Development and Progression of Nonalcoholic Fatty Liver Disease and Inherent Cardiovascular Risk

Nonalcoholic fatty liver disease (NAFLD) spans steatosis through nonalcoholic steatohepatis, cirrhosis, and hepatocellular carcinoma (HCC) associated with striking systemic features and excess cardiovascular and liver-related mortality. The pathogenesis of NAFLD is complex and multifactorial. Endocrine derangements are closely linked with dysmetabolic traits. For example, in animal and human studies, female sex is protected from dysmetabolism thanks to young individuals’ ability to partition fatty acids towards ketone body production rather than very low density lipoprotein (VLDL)-triacylglycerol, and to sex-specific browning of white adipose tissue. Ovarian senescence facilitates both the development of massive hepatic steatosis and the fibrotic progression of liver disease in an experimental overfed zebrafish model. Consistently, estrogen deficiency, by potentiating hepatic inflammatory changes, hastens the progression of disease in a dietary model of nonalcoholic steatohepatitis (NASH) developing in ovariectomized mice fed a high-fat diet. In humans, NAFLD more often affects men; and premenopausal women are equally protected from developing NAFLD as they are from cardiovascular disease. It would be expected that early menarche, definitely associated with estrogen activation, would produce protection against the risk of NAFLD. Nevertheless, it has been suggested that early menarche may confer an increased risk of NAFLD in adulthood, excess adiposity being the primary culprit of this association. Fertile age may be associated with more severe hepatocyte injury and inflammation, but also with a decreased risk of liver fibrosis compared to men and postmenopausal status. Later in life, ovarian senescence is strongly associated with severe steatosis and fibrosing NASH, which may occur in postmenopausal women. Estrogen deficiency is deemed to be responsible for these findings via the development of postmenopausal metabolic syndrome. Estrogen supplementation may at least theoretically protect from NAFLD development and progression, as suggested by some studies exploring the effect of hormonal replacement therapy on postmenopausal women, but the variable impact of different sex hormones in NAFLD (i.e., the pro-inflammatory effect of progesterone) should be carefully considered.

Serological tools for detection of Trichinella infection in animals and humans

Trichinellosis is a serious foodborne zoonotic disease. It is an important threat to public health in both developing and developed countries. Human infections are strongly associated with consuming undercooked meat containing infective Trichinella larvae. The development of serological tools has enabled seroepidemiological studies and contributed to our knowledge on the importance of this parasite. Serological tests can also help the diagnosis of parasite infections in humans and the surveillance of animals. Generally speaking, serological techniques include detection methods for specific antibodies and for circulating parasite antigens in the serum or tissue fluids. Here, we present a comprehensive review of various methods used in the detection of antibodies against Trichinella and circulating parasite antigens in animals and humans.

[Bats and Viruses: complex relationships]

With more than 1 200 species, bats and flying foxes (Order Chiroptera) constitute the most important and diverse order of Mammals after Rodents. Many species of bats are insectivorous while others are frugivorous and few of them are hematophagous. Some of these animals fly during the night, others are crepuscular or diurnal. Some fly long distances during seasonal migrations. Many species are colonial cave-dwelling, living in a rather small home range while others are relatively solitary. However, in spite of the importance of bats for terrestrial biotic communities and ecosystem ecology, the diversity in their biology and lifestyles remain poorly known and underappreciated. More than sixty viruses have been detected or isolated in bats; these animals are therefore involved in the natural cycles of many of them. This is the case, for instance, of rabies virus and other Lyssavirus (Family Rhabdoviridae), Nipah and Hendra viruses (Paramyxoviridae), Ebola and Marburg viruses (Filoviridae), SARS-CoV and MERS-CoV (Coronaviridae). For these zoonotic viruses, a number of bat species are considered as important reservoir hosts, efficient disseminators or even directly responsible of the transmission. Some of these bat-borne viruses cause highly pathogenic diseases while others are of potential significance for humans and domestic or wild animals; so, bats are an important risk in human and animal public health. Moreover, some groups of viruses developed through different phylogenetic mechanisms of coevolution between viruses and bats. The fact that most of these viral infections are asymptomatic in bats has been observed since a long time but the mechanisms of the viral persistence are not clearly understood. The various bioecology of the different bat populations allows exchange of virus between migrating and non-migrating conspecific species. For a better understanding of the role of bats in the circulation of these viral zoonoses, epidemiologists must pay attention to some of their biologic properties which are not fully documented, like their extreme longevity, their diet, the population size and the particular densities observed in species with crowded roosting behavior, the population structure and migrations, the hibernation permitting overwintering of viruses, their particular innate and acquired immune response, probably related at least partially to their ability to fly, allowing persistent virus infections and preventing immunopathological consequences, etc. It is also necessary to get a better knowledge of the interactions between bats and ecologic changes induced by man and to attentively follow bat populations and their viruses through surveillance networks involving human and veterinary physicians, specialists of wild fauna, ecologists, etc. in order to understand the mechanisms of disease emergence, to try to foresee and, perhaps, to prevent viral emergences beforehand. Finally, a more fundamental research about immune mechanisms developed in viral infections is essential to reveal the reasons why Chiroptera are so efficient reservoir hosts. Clearly, a great deal of additional work is needed to document the roles of bats in the natural history of viruses.

The role of prolactin in andrology: what is new?

Prolactin (PRL) has been long deemed as a hormone involved only in female reproduction. However, PRL is a surprising hormone and, since its identification in the 1970s, its attributed functions have greatly increased. However, its specific role in male health is still widely unknown. Recently, low PRL has been associated with reduced ejaculate and seminal vesicle volume in infertile subjects. In addition, in men consulting for sexual dysfunction, hypoprolactinemia has been associated with erectile dysfunction and premature ejaculation, findings further confirmed in the general European population and infertile men. Several metabolic derangements, recapitulating metabolic syndrome, have also been associated with low PRL both in men with sexual dysfunction and from the general European population. In men with sexual dysfunction, followed-up for more than 4 years, low PRL was identified as an independent predictor of the incidence of major adverse cardiovascular events. Finally, an association with anxiety or depressive symptoms has been found in men with sexual dysfunction and from the general European population. While a direct role for impaired PRL function in the pathogenesis of these reproductive, sexual, metabolic and psychological disorders is conceivable, the possibility that low PRL is a mirror of an increased dopaminergic or a decreased serotonergic tone cannot be ruled-out. Hyperactivity of the dopaminergic system can explain only a few of the aforementioned findings, whereas a hypo-serotonergic tone fits well with the clinical features associated with low PRL, and there is significant evidence supporting the hypothesis that PRL could be a mirror of serotonin in the brain.

Encephalitozoon cuniculi infection among immunocompromised and immunocompetent humans in Egypt

BACKGROUND

Encephalitozoon cuniculi infects a wide range of homoeothermic animals, including man. Complications due to this microsporidian have been reported only in immunocompromised patients. Reports on E. cuniculi in immunocompetent humans are lacking, most probably, because it is not linked to any clinical manifestations in such hosts. The present work was carried out with the aim of studying, for the first time in Egypt, the prevalence of E. cuniculi infection of urinary tract among non-HIV immunocompromised patients and immunocompetent individuals. It tested also the influence of some factors on the risk of infection.

METHODS

Blood and urine samples were collected from 88 persons (44 non-HIV immunocompromised patients and 44 subjects as immunocompetent control group). IFAT serological assay and Weber's green modified trichrome stain (MTS) urine smears were carried out. Molecular study by PCR was also performed to detect DNA of E. cuniculi in urine samples. A full history sheet was fulfilled for each subject to test the suspected risk factors.

RESULTS

The IFAT examination confirmed the presence of antibodies against E. cuniculi in 44.3% of the human subjects. The seroprevalence of E. cuniculi was significantly higher in the immunocompromised patients compared with the immunocompetent individuals (77.3% versus 11.4%). Compared with IFAT (the gold standard), the sensitivity and specificity of Weber's green MTS smears were 69.23% and 89.80%. By using PCR, no positive cases were detected among human subjects.

CONCLUSION

A high prevalence of E. cuniculi infection in the studied individuals was noted. Although infection was found in some immunocompetent individuals, the immune status of the host remains the corner stone for occurrence of the infection.

Dosimetric analysis of (123)I, (125)I and (131)I in thyroid follicle models

Background

Radioiodine is routinely used or proposed for diagnostic and therapeutic purposes: ¹²³I, ¹²⁵I and ¹³¹I for diagnostics and ¹²⁵I and ¹³¹I for therapy. When radioiodine-labelled pharmaceuticals are administered to the body, radioiodide might be released into the circulation and taken up by the thyroid gland, which may then be an organ at risk. The aim of this study was to compare dosimetric properties for ¹²³I, ¹²⁵I and ¹³¹I in previously developed thyroid models for man, rat and mouse.

Methods

Dosimetric calculations were performed using the Monte Carlo code MCNPX 2.6.0 and nuclear decay data from ICRP 107. Only the non-radiative transitions in the decays were considered. The S value was determined for the cell nuclei in species-specific thyroid follicle models for mouse, rat and man for different spatial distributions of radioiodine.

Results

For the species-specific single follicle models with radioiodine homogeneously within the follicle lumen, the highest S value came from ¹³¹I, with the largest contribution from the β particles. When radioiodine was homogeneously distributed within the follicle cells or the follicle cell nucleus, the highest contribution originated from ¹²⁵I, about two times higher than ¹²³I, with the largest contribution from the Auger electrons. The mean absorbed dose calculated for our human thyroid multiple follicle model, assuming homogenous distribution of for ¹²³I, ¹²⁵I, or ¹³¹I within the follicle lumens and follicle cells, was 9%, 18% and 4% higher, respectively, compared with the mean absorbed dose according to Medical Internal Radiation Dose (MIRD) formalism and nuclear decay data. When radioiodine was homogeneously distributed in the follicle lumens, our calculations gave up to 90% lower mean absorbed dose for ¹²⁵I compared to MIRD (20% lower for ¹²³I, and 2% lower for ¹³¹I).

Conclusions

This study clearly demonstrates the importance of using more detailed dosimetric methods and models than MIRD formalism for radioiodine, especially ¹²³I and ¹²⁵I, in the thyroid. For radioiodine homogeneously distributed in the follicle lumens our calculations for the human multiple follicle models gave up to 90% lower mean absorbed dose compared with MIRD formalism.

Performance and sex difference in ultra-triathlon performance from Ironman to Double Deca Iron ultra-triathlon between 1978 and 2013

It was assumed that women would be able to outperform men in ultra-marathon running. The present study investigated the sex difference in performance for all ultra-triathlon distances from the Ironman distance (i.e. 3.8 km swimming, 180 km cycling and 42 km running) in the ‘Ironman Hawaii’ to the Double Deca Iron ultra-triathlon distance (i.e. 76 km swimming, 3,600 km cycling and 840 km running) between 1978 and 2013. The changes in performance and in the sex difference in performance for the annual three fastest finishers were analysed using linear, non-linear and multi-variate regression analyses from 46,123 athletes (i.e. 9,802 women and 46,123 men). Women accounted for 11.9 ± 5.8% of the total field and their percentage was highest in ‘Ironman Hawaii’ (22.1%) and lowest in Deca Iron ultra-triathlon (6.5%). In ‘Ironman Hawaii’, the sex difference decreased non-linearly in swimming, cycling, running and overall race time. In Double Iron ultra-triathlon, the sex difference increased non-linearly in overall race time. In Triple Iron ultra-triathlon, the sex difference increased non-linearly in cycling and overall race time but linearly in running. For the three fastest finishers ever, the sex difference in performance showed no change with increasing race distance with the exception for the swimming split where the sex difference increased with increasing race distance (r² = 0.93, P = 0.001). The sex differences for the three fastest finishers ever for swimming, cycling, running and overall race times for all distances from Ironman to Deca Iron ultra-triathlon were 27.0 ± 17.8%, 24.3 ± 9.9%, 24.5 ± 11.0%, and 24.0 ± 6.7%, respectively. To summarize, these findings showed that women reduced the sex difference in the shorter ultra-triathlon distances (i.e. Ironman distance) but extended the sex difference in longer distances (i.e. Double and Triple Iron ultra-triathlon). It seems very unlikely that women will ever outperform men in ultra-triathlons from Ironman to Double Iron ultra-triathlon.

[Mixed breast carcinoma with melanocytic differentiation in a man]

INTRODUCTION

Male breast cancer is rare; the lobular type is exceptional. Only one case of mixed ductal and lobular type is reported in the literature. This is the first report on a mixed ductal and lobular carcinoma with melanocytic differentiation in a man. The aim of our study is to describe the clinicopathological characteristics of this rare type of breast tumor and to discuss its histogenesis.

CASE REPORT

A 63-year-old man presented with cutaneous ulceration of the left breast. Ultrasound of the breast revealed a solid hypoechoic lesion, 13 mm in diameter. Microscopic evaluation of the biopsy showed an invasive ductal carcinoma. The patient received three cycles of chemotherapy and lost of view. Then consulted for increasing of the tumor size reaching 3 cm. Histological examination of the mastectomy specimen showed a mixed ductal and lobular carcinoma with melanocytic differentiation, confirmed by the immunohistochemical study. The patient received adjuvant chemotherapy and the evolution was favorable with an average follow-up of 9 months.

CONCLUSION

Breast carcinoma with melanocytic differentiation is extremely rare; only seven cases are reported in the literature and all occurs in females. Its histogenesis is unclear; tumors exhibiting this combination of cell types may occur as collision or composite tumors.

Will women outrun men in ultra-marathon road races from 50 km to 1,000 km?

It has been assumed that women would be able to outrun men in ultra-marathon running. The present study investigated the sex differences in running speed in ultra-marathons held worldwide from 50 km to 1,000 km. Changes in running speeds and the sex differences in running speeds in the annual fastest finishers in 50 km, 100 km, 200 km and 1,000 km events held worldwide from 1969–2012 were analysed using linear, non-linear and multi-level regression analyses. For the annual fastest and the annual ten fastest finishers, running speeds increased non-linearly in 50 km and 100 km, but not in 200 km and 1,000 km where running speeds remained unchanged for the annual fastest. The sex differences decreased non-linearly in 50 km and 100 km, but not in 200 and 1,000 km where the sex difference remained unchanged for the annual fastest. For the fastest women and men ever, the sex difference in running speed was lowest in 100 km (5.0%) and highest in 50 km (15.4%). For the ten fastest women and men ever, the sex difference was lowest in 100 km (10.0 ± 3.0%) and highest in 200 km (27.3 ± 5.7%). For both the fastest (r² = 0.003, p = 0.82) and the ten fastest finishers ever (r² = 0.34, p = 0.41) in 50 km, 100 km, 200 km and 1,000 km, we found no correlation between sex difference in performance and running speed. To summarize, the sex differences in running speeds decreased non-linearly in 50 km and 100 km but remained unchanged in 200 km and 1,000 km, and the sex differences in running speeds showed no change with increasing length of the race distance. These findings suggest that it is very unlikely that women will ever outrun men in ultra-marathons held from 50 km to 100 km.

Will women soon outperform men in open-water ultra-distance swimming in the 'Maratona del Golfo Capri-Napoli'?

This study investigated the change in sex differences across years in ultra-distance swimming performances at the 36-km 'Maratona del Golfo Capri-Napoli' race held from 1954 to 2013. Changes in swimming performance of 662 men and 228 women over the 59-year period were investigated using linear, non-linear and hierarchical regression analyses. Race times of the annual fastest swimmers decreased linearly for women from 731 min to 391 min (r (2)  = 0.60, p < 0.0001) and for men from 600 min to 373 min (r (2)  = 0.30, p < 0.0001). Race times of the annual top three swimmers decreased linearly between 1963 and 2013 for women from 736.8 ± 78.4 min to 396.6 ± 4.5 min (r (2)  = 0.58, p < 0.0001) and for men from 627.1 ± 34.5 min to 374.1 ± 0.3 min (r (2)  = 0.42, p < 0.0001). The sex difference in performance for the annual fastest decreased linearly from 39.2% (1955) to 4.7% (2013) (r (2)  = 0.33, p < 0.0001). For the annual three fastest competitors, the sex difference in performance decreased linearly from 38.2 ± 14.0% (1963) to 6.0 ± 1.0% (2013) (r (2)  = 0.43, p < 0.0001). In conclusion, ultra-distance swimmers improved their performance at the 'Maratona del Golfo Capri-Napoli' over the last ~60 years and the fastest women reduced the gap with the fastest men linearly from ~40% to ~5-6%. The linear change in both race times and sex differences may suggest that women will be able to achieve men's performance or even to outperform men in the near future in an open-water ultra-distance swimming event such as the 'Maratona del Golfo Capri-Napoli'.

ALG1-CDG: a new case with early fatal outcome

Congenital disorders of glycosylation (CDG) are a growing group of inherited metabolic disorders where enzymatic defects in the formation or processing of glycolipids and/or glycoproteins lead to variety of different diseases. The deficiency of GDP-Man:GlcNAc2-PP-dolichol mannosyltransferase, encoded by the human ortholog of ALG1 from yeast, is known as ALG1-CDG (CDG-Ik). The phenotypical, molecular and biochemical analysis of a severely affected ALG1-CDG patient is the focus of this paper. The patient's main symptoms were feeding problems and diarrhea, profound hypoproteinemia with massive ascites, muscular hypertonia, seizures refractory to treatment, recurrent episodes of apnoea, cardiac and hepatic involvement and coagulation anomalies. Compound heterozygosity for the mutations c.1145T>C (M382T) and c.1312C>T (R438W) was detected in the patient's ALG1-coding sequence. In contrast to a previously reported speculation on R438W we confirmed both mutations as disease-causing in ALG1-CDG.

A comparison of bioactive aqueous extracts and polysaccharide fractions from roots of wild and cultivated Cochlospermum tinctorium A. Rich

In Malian traditional medicine the roots of Cochlospermum tinctorium are used in the treatment of gastric ulcer, but extending harvesting is causing a growing concern of a dramatic reduction in the wild plant population. In the present study cultivation of C. tinctorium is evaluated, and structural components and bioactive properties of crude water extracts and isolated polysaccharide fractions from roots of wild and cultivated C. tinctorium are compared. The crude water extracts were shown to contain starch, pectin- and inulin-type polysaccharides, in addition to phenolic substances and protein, while the isolated acidic polysaccharide fractions contained mainly monosaccharides typical for pectins. The monosaccharide compositions of the polysaccharide fractions from roots of wild versus cultivated plants were comparable, albeit the yields in the cultivated roots were lower. Furthermore, the crude extracts and isolated polysaccharide fractions from wild and cultivated roots exhibited similar complement fixating activities, but were not able to activate macrophages. The crude extracts from cultivated roots were also shown to be moderate radical scavengers. The present study has shown that roots of cultivated C. tinctorium contain the same types of bioactive polysaccharides as the wild roots. However, in order to utilize roots of cultivated C. tinctorium in traditional medicine the cultivation method should be improved.

The use of hormones indicators in human saliva in diagnosing parodontitis in pregnant women

AIMS:

The purpose of this work– was to study the dynamics of biochemical parameters of human saliva and analyze the features of the chemical composition of the saliva of women with abnormal pregnancy and in periodontitis against pregnancy.

MATERIALS AND METHODS:

The study included four groups of women: a control group of nonpregnant women of childbearing age (10), pregnant women with physiological pregnancy (24-28 weeks) without any signs of periodontal disease (10), pregnant with a generalized periodontitis I--II degrees in remission (10), women with pathological pregnancy with no signs of periodontal inflammation (10). In each of the groups over two samples of saliva were collected, the first collection of saliva in the morning on an empty stomach. Then mouthwash 0.9% sodium chloride solution was assigned and after 30 minutes the second portion of saliva. By enzyme immunoassay in samples of saliva of control groups of nonpregnant and pregnant women, as well as women with signs of a pathological course of pregnancy, the content of estriol, testosterone, and dehydroepiandrosterone sulfate was determined.

STATISTICAL ANALYSIS USED:

Statistical data analysis was performed by the standard technique using Student's t-test.

RESULTS:

The results of biochemical analysis of saliva samples collected before rinsing the mouth with saline in groups of healthy nonpregnant and pregnant women were compared. It was established that during pregnancy the concentration of salivary estriol increases, but in pregnant women with periodontitis, the amount of this hormone in the saliva was significantly reduced. The highest content of testosterone in saliva samples, observed in healthy pregnant women, was significantly higher than nonpregnant women.

In pregnant women with periodontitis concentration of testosterone in saliva is reduced, while remaining significantly higher than its level in the saliva of nonpregnant women. The highest concentration of testosterone is observed in the saliva of healthy pregnant women with periodontitis, but the smallest concentration of testosterone is found in the saliva of nonpregnant women. Also the nonpregnant group has the lowest levels of DHEA in pregnancy, and its content increases almost threefold when periodontal disease further grows

CONCLUSIONS:

It was established that periodontitis against pregnancy is characterized by higher levels of salivary DHEA sulfate and lower estriol, compared with a control group of pregnant women.

Transport of glycosylphosphatidylinositol-anchored proteins from the endoplasmic reticulum

In this review on the transport of glycosylphosphatidylinositol-anchored proteins (GPI-APs), we focus on events that occur in the endoplasmic reticulum after the transfer of GPI to proteins. These events include structural remodeling of both the lipid and glycan moieties of GPI, recruitment of GPI-APs into ER exit sites, association with the cargo receptor, p24 protein complex, and packaging into COPII coated transport vesicles. Similarities with the transport of Wnt proteins are also discussed. This article is part of a Special Issue entitled: Functional and structural diversity of endoplasmic reticulum.

Biological and antigenic relationships between virus-induced porcine and human interferons

Endogenous interferon (IFN) made by the newborn piglet in response to enteric coronavirus TGEV (transmissible gastroenteritis virus) infection was identified as leukocytic IFN (IFN-α). Indeed, the antiviral activity found in the serum and in the urine of infected piglets displayed the same main biological and antigenic properties as the IFN induced in influenza-infected pig leukocytes. It is therefore concluded that most, if not all, circulating IFN activity must be derived from lymphoid cells. Moreover, it was shown that a high degree of antigenic homology exists between porcine and human IFN-α: antibodies to HuIFN-α could efficiently neutralize PorIFN-α, and they were used for its purification by immunoaffinity.