Verrucous Carcinoma of the Uterine Cervix Arising in a Giant Condyloma Acuminatum, Associated with Ichthyosis of the Endometrial Cavity

We describe a unique presentation of a cervical verrucous carcinoma (VC) associated with ichthyosis of the uterine cavity in an 80-year old woman. Areas of transition from a giant condyloma (GC) were present in the VC. This paper also includes a review of the relevant literature. VC of the cervix is an uncommon malignancy, and transition of a GC to VC is an interesting finding, confuting the theory that they represent distinct entities, with different risk factors. Differently from GC, VC is considered to be causally related to HPV in a minority of instances. Our results of p16 immunohistochemistry, the surrogate marker of high-risk human papillomavirus (HPV) infection, appear to speak against the causal role of HPV in the pathogenesis of VC. Ichthyosis uteri may occasionally be associated with a cervical or endometrial malignancy; however, we are not aware of any patient showing VC, GC and ichthyosis uteri at the same time

In the name of truth: People’s reactions to ingroup and outgroup members who self-disclose a severe error

Usually people consider morality traits to be highly valuable, both in themselves and in others. Moreover, they tend to select moral groups and are often motivated to protect the positive identity of their groups by derogating immoral ingroup members. However, sometimes even moral ingroup members could represent a threat to the group and therefore be negatively evaluated, such as in the case of people who report another person’s wrongdoing (whistleblowing). To date an investigation of people’s judgments of someone who self- disclose his/her own wrongdoing is still missing. Our study aims to investigate how group members react to an ingroup and an outgroup member who confessed to having committed a severe wrongdoing. Results of a study conducted by using a real episode concerning a surgeon who confessed a fatal error, confirm our expectation; even if medical students appreciated the confession of the surgeon, they are less positive in evaluating his behavior compared to other student

Early histologic findings of pulmonary SARS-CoV-2 infection detected in a surgical specimen

Despite the current pandemic season, reports on pathologic features of coronavirus disease 19 (Covid-19) are exceedingly rare at the present time. Here we describe the pathologic features of early lung involvement by Covid-19 in a surgical sample resected for carcinoma from a patient who developed SARS-CoV-2 infection soon after surgery. The main histologic findings observed were pneumocyte damage, alveolar hemorrhages with clustering of macrophages, prominent and diffuse neutrophilic margination within septal vessels, and interstitial inflammatory infiltrates, mainly represented by CD8+ T lymphocytes. These features are similar to those previously described in SARS-CoV-2 infection. Subtle histologic changes suggestive pulmonary involvement by Covid-19 may be accidentally encountered in routine pathology practice, especially when extensive sampling is performed for histology. These findings should be carefully interpreted in light of the clinical context of the patient and could prompt a pharyngeal swab PCR test to rule out the possibility of SARS-CoV-2 infection in asymptomatic patients

Laser welding of tailored blanks made of Al-Si-coated 22MnB5 steel using a filler wire and a variable energy distribution laser optics

Laser welding of Al-Si-coated steels for hot stamping in automotive applications is problematic due to the mixing of the coating layers inside the molten pool that weakens the resulting weld seam. In this case, the most common welding procedure to overcome this issue consists in removing the Al-Si layer through laser ablation prior to the joining. This method continues to be the most widely used by major producers of tailor welded blanks, although in situ ablation of the Al-Si coating can be costly and time consuming. In this work, a novel approach consisting in joining as-received (i.e., not decoated) materials using a filler wire and an innovative variable energy distribution laser optics is introduced and tested on tailor welded blanks made of 22MnB5. Tensile tests of specimens obtained from a 3(3) full factorial design of experiment have shown an average value of ultimate tensile strength of 1523 MPa, which is much higher than the one usually observed in as-received welded then hot-stamped conditions and aligned with hot-stamped base material values. Hardness test results (494-543 HV0.5) were in the typical hot-stamped base material range of values as well, while SEM-EDS analyses detected no ferrite inclusions inside the fusion zone. Variations of the main process parameters have been considered on an iso-thickness and iso-material configuration, empirically demonstrating the stability and reliability of the proposed methodology as well as its suitability for production purposes

Black and pink. Single lesion or double diagnosis?

Fibroepithelioma of Pinkus (FeP) is an uncommon skin lesion considered to be a rare variant of basal cell carcinoma (BCC), even though some researchers have argued for its classifica- tion as a trichoblastoma. FeP appears frequently as a solitary, flesh-colored, well-demarcated plaque, typically localized on the lumbosacral area of patients aged 40 to 60 years. It often develops in patients with a history of BCC, most commonly in wome

Activation of Antioxidant and Proteolytic Pathways in the Nigrostriatal Dopaminergic System After 3,4-Methylenedioxymethamphetamine Administration: Sex-Related Differences

3,4-Methylenedioxymethamphetamine (MDMA, “ecstasy”) is an amphetamine-related drug that may damage the dopaminergic nigrostriatal system. To investigate the mechanisms that sustain this toxic effect and ascertain their sex-dependence, we evaluated in the nigrostriatal system of MDMA-treated (4 × 20 mg/kg, 2 h apart) male and female mice the activity of superoxide dismutase (SOD), the gene expression of SOD type 1 and 2, together with SOD1/2 co-localization with tyrosine hydroxylase (TH)-positive neurons. In the same mice and brain areas, activity of glutathione peroxidase (GPx) and of β2/β5 subunits of the ubiquitin-proteasome system (UPS) were also evaluated. After MDMA, SOD1 increased in striatal TH-positive terminals, but not nigral neurons, of males and females, while SOD2 increased in striatal TH-positive terminals and nigral neurons of males only. Moreover, after MDMA, SOD1 gene expression increased in the midbrain of males and females, whereas SOD2 increased only in males. Finally, MDMA increased the SOD activity in the midbrain of females, without affecting GPx activity, decreased the β2/β5 activities in the striatum of males and the β2 activity in the midbrain of females. These results suggest that the mechanisms of MDMA-induced neurotoxic effects are sex-dependent and dopaminergic neurons of males could be more sensitive to SOD2- and UPS-mediated toxic effects

Liver infection and COVID-19: the electron microscopy proof and revision of the literature

OBJECTIVE: COVID-19, the newly emerging infectious disease, has been associated with acute liver injury, often related to progression to severe pneumonia. The association between moderate-severe liver injury and more severe clinical course of COVID-19 has suggested that liver injury is prevalent in severe than in mild cases of COVID-19, while no difference in liver involvement has been reported between survivors and non-survivors. The spectrum of liver involvement during COVID-19 ranges from an asymptomatic elevation of liver enzymes to severe hepatitis. Only rarely, cases with acute hepatitis have been reported in the absence of respiratory symptoms. Both epithelial and biliary cells possess the angiotensin-converting enzyme-2 receptors that SARS-CoV-2 uses to be internalized. However, to our knowledge, no ultrastructural identification of the virus in liver cells has been reported to date. Here we provide evidence of SARS-CoV-2 in the liver of two patients, a 34-year-old woman and a 60-year-old man with COVID-19.PATIENTS AND METHODS: We investigated two patients with COVID-19 showing several virions within cytoplasmic vacuoles of cholangiocytes and in endothelial cells of hepatic sinusoids. In both patients, we performed histological and ultrastructural examinations by liver biopsy. After two months, both patients were free of symptoms, and the SARS-CoV-2 infection had resolved.RESULTS: Liver biopsy histological and ultrastructural examination showed liver injury and several virions within cytoplasmic vacuoles of cholangiocytes and in endothelial cells of hepatic sinusoids.CONCLUSIONS: Although most studies in COVID-19 have been focused on the lungs, recently, cholestatic liver pathology has been introduced in the spectrum of pathological changes related to COVID-19. To the best of our knowledge, those presented in this paper are the first images of hepatic SARS-CoV-2 infected liver cells. Our findings suggest a role for cholangiocytes and biliary structures in the COVID-19

The influence of flap design on patients’ experiencing pain, swelling, and trismus after mandibular third molar surgery: a scoping systematic review

Third molar removal surgery usually comes accompanied by postoperative discomfort, which could be influenced by the surgical approach chosen. This scoping systematic review aimed at compiling the available evidence focused on the influence of flap design, including envelope flap (EF), triangular flap (TF), and modified triangular flap (MTF), on postoperative pain, swelling, and trismus, as primary outcome measures, and any result mentioning healing promotion or delay, as secondary outcome measure, after mandibular third molar extraction surgery. An electronic search, complemented by a manual search, of articles published from 1999 to 2020 was conducted in the Medline (PubMed), EMBASE and Web of Science databases including human randomized controlled trials, prospective, and retrospective studies with at least 15 patients. The risk of bias of the included studies was assessed either with the Cochrane’s Risk of Bias tool or with the Newcastle-Ottawa scale. Every step of the review was performed independently and in duplicate. The initial electronic search recovered 2102 articles. After applying the inclusion criteria, 12 articles were included. For patient’s perceived postoperative pain, TF and MTF frequently reported better results than EF. For swelling, the literature is divided, despite a trend favoring EF. For trismus, data showed that its occurrence is mostly associated with the duration of the surgery rather than with the chosen flap. For healing, the limited data is inconclusive. Finally, randomized studies showed a high risk of bias, whereas nonrandomized studies were mostly of good quality and low risk of bias. Although there was no clear consensus regarding the influence of different flap designs for third mandibular molar extraction on postoperative clinical morbidities; the surgeon’s experience, estimated surgical difficulty, molar position and orientation, and surg ery duration should be considered when choosing among the different flap designs