North American Journal of Medicine and Science
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Oncocytoma of the Parotid Gland and its Mimickers: A Comprehensive Review
Get PDFOncocytomas are benign neoplasms composed of oncocytes; the large eosinophilic cuboidal to columnar cells with more than 60% of their cytoplasm occupied by mitochondria. Oncocytomas represent less than 1% of the salivary gland neoplasms and 82% to 90% of them occur in the parotid gland. Salivary gland oncocytomas constitute 2.5% of the parotid gland tumors. Despite the well-recognized morphology of this tumor, there is a wide range of neoplasms that may mimic oncocytoma and hence need to be considered in its differentialdiagnosis. A predominantly clear cell variant of oncocytoma may resemble a number of salivary gland neoplasms where clear cells may be prominent. In addition, oncocytic metaplasia may be a focal or an extensive component of other distinct salivary gland neoplasms. An awareness of all the possible “mimickers” of clear cell oncocytoma becomes more significant in view of the fact that most are malignant neoplasms with a poor prognosis
The Hard Truths of Health Care Reform: A Primary Care Perspective
Get PDFIn the past few weeks, I have answered dozens of inquiries on the same topic. What is my opinion on the current health care reform bill in Congress? The reforms really do bear a striking resemblance to what has been implemented in Massachusetts in the past 5 years. The simple easy truths are: 1) we will have expanded health care plans available to approximately 30 million Americans, 2) the plans will include mandates to provide incentives to individuals to participate, 3) health plans will not be able to exclude individuals based on pre-existing conditions.1 I would hope that these straightforward main elements of the plan would be generally acceptable to a majority of the political spectrum. But recent events have shown that the health plan is indeed very controversial. Unfortunately, I think the health reform plan is often misunderstood. Some of my patients wonder if their current health plans will be more restricted or changed by the reforms. They will not. There are fiscal conservatives that believe it will be too costly despite the Congressional Budget Office predictions that it will save money.......
Genetic Prognostic Markers in Neuroblastoma
Get PDFNeuroblastoma is the most frequent pediatric extracranial tumor. It arises from embryonic neural crest cells and exhibits significant heterogeneity of clinical presentation and biologic behavior. Despite the application of aggressive treatments and multiple risk stratifications, prognosis of advanced stage of neuroblastoma still remains poor. So it is still a challenge in its prognostic evaluation to both clinicians and basic scientists and it is necessary to explore more molecular factors that correlate with outcome of this disease and develop a statistical predictor of survival for neuroblastoma patients. In this review, we summarize recent findings of chromosome alteration, gene expression, microRNA profiles and gene methylation status in neuroblastoma as well as their implications for predictors of neuroblastoma prognosis
Telomere Length and Insulin Resistance
Get PDFIn humans, telomeres are repeating strings of TTAGGG sequences that protect chromosomal ends and maintain genomic stability. Telomere length is considered a critical marker of biological aging because telomeric DNA progressively shortens in dividing somatic cells and contributes to cell senescence, apoptosis, or neoplastic transformation. Recent studies have associated telomere shortening with insulin resistance and various age-related pathological conditions. In this review, we summarized the current available evidence concerning the role of telomere length in the development of insulin resistance
Pyelonephritis in an Immunocompromised Host Presented as a Drug Reaction-Like Syndrome
Get PDFIntroduction Infection is the leading cause of death in patients on chronic immunosuppression. Diagnosis of infection in these patients can be challenging as immunosuppressants can blunt systemic inflammatory response and therefore elude ready detection
The 2009 Swine-Origin H1N1 Influenza Virus and Its Implications to Public Health
Get PDFThe major public health event in 2009 is the outbreak of a new influenza virus infection in almost every region of the world. Because the original source of this virus was pigs, this virus was named “Swine-Origin Influenza A (H1N1) Virus (S-OIV)” in leading medical journals such as the New England Journal of Medicine. However, due to concerns regarding the potential for a misunderstanding that would lead the public to blame pigs for the outbreak as was the case in some Mideast countries where the national slaughter of pigs was started shortly after the outbreak, the World Health Organization (WHO) renamed the virus as “Type A H1N1 Influenza Virus”, which has generated significant confusion not only among the general public but also among healthcare professionals
Proud to be a Pathologist
Get PDFMy fascination on pathologic basis of disease dates back to the time when I was a medical student learning basal ganglia disease in China in the late 1970s. I never dreamed of practicing medicine in the United States of America until early 1992 when I entered my second year of postdoctoral training at Massachusetts General Hospital with my own NIH grant and met a physician from Columbia. He was a postdoctoral fellow in the lab next to ours. We became close friends. He strongly encouraged me to take the American medical board exam. I initially hesitated because I was not sure about my skills in the English language and I had been away from clinical practice for over 10 years. I explained my uneasiness to my friend and he offered his help. He let me use his board-review books. Thus, I tried the step one board exam and was surprised to have a decent score. I was determined to continue. After an intense review for a few more months after my regular working hours, I took and passed the step two
Prevalence and Socioeconomic Status Correlation of Depressive Symptoms among Children Living in Urban Beijing
Get PDFBackground: The prevalence of depressive symptoms among children is rapidly increasing all over the world. The objective of this study was to investigate the prevalence of depressive symptoms and its socioeconomic characteristics among children living in urban Beijing of China. Results: The prevalence of depressive symptoms in children aged 7-12 years was 11.6%, which included 14.7% among boys and 8.3% among girls. The children aged 11-12 years had a significantly higher prevalence of depressive symptoms (18.7%) as compared to the younger ones. The likelihood of depressive symptoms in children tended to increase significantly with the decreasing in their father’s education level, mother’s education level, and family income level. A significantly higher likelihood of depressive symptoms was also observed among children whose parents were farmers, unemployed, self-employed, or those whose fathers were waiters and/or whose mothers were soldiers or policewomen.Conclusions: Depressive symptoms are common in children living in urban Beijing, especially among children in families with low socioeconomic status
Immunodeficiency, Gastrointestinal Candidiasis, Wheat and Dairy Sensitivity, Abnormal Urine Arabinose, and Autism: A Case Study
Get PDFA child with autism was found to have complete IgA deficiency (serum IgA <6 mg/dL; normal 33-235 mg/dL), Candidiasis of the gastrointestinal tract based on evaluation of stool testing and elevated urine arabinose, and elevated serum antibodies to wheat and dairy products. The pretreatment urinary arabinose concentration (341 mmol/mol creatinine in this child was nearly six times the mean value (60.4 mmol/mol creatinine, n=20) of normal children and over ten times the median value (31.0 mmol/mol creatinine) of normal controls. After antifungal therapy for four months, the urine was retested. At that time the urine arabinose was measured at 51 mmol/mol creatinine, a value only 15% of the baseline sample. Restriction of wheat and dairy products from the diet and antifungal therapy led to a significant decrease in autistic behaviors and increased rate of learning. The Childhood Autism Rating Scale (CARS), an observational measure of various aspects of autism, for the child has decreased from a rating of 43 (severely autistic) prior to introduction of these therapies to a value of 29 (non-autistic) after therapy
Case Review on Testicular Cancer
Get PDFThe risk of testicular cancer is thought to be higher among men seeking infertility treatment compared with the general population. Confirmation of this risk in a large US cohort of at-risk patients is lacking. This study explored the association between male infertility and subsequent development of testicular cancer in a US-based cohort. METHODS: A total of 51 461 couples evaluated for infertility from 1967 to 1998 were recruited from 15 California infertility centers. We linked data on 22 562 identified male partners to the California Cancer Registry. The incidence of testicular cancer in this cohort was compared with the incidence in an age-matched sample of men from the general population using the Surveillance Epidemiology and End Results program. We analyzed the risk for testicular cancer in men with and without male factor infertility using a Cox proportional hazards regression model. RESULTS: Thirty-four post-infertility-diagnosis cases of histologically confirmed testicular cancer were identified. Men seeking infertility treatment had an increased risk of subsequently developing testicular cancer (standardized incidence ratio, 1.3; 95% confidence interval, 0.9-1.9), with a markedly higher risk among those with known male factor infertility (2.8; 1.5-4.8). In multivariable analysis, men with male factor infertility were nearly 3 times more likely to develop testicular cancer compared with those without (hazard ratio, 2.8; 95% confidence interval, 1.3-6.0). CONCLUSION: Men with male factor infertility have an increased risk of subsequently developing testicular cancer, suggesting the existence of common etiologic factors for infertility and testicular cancer