Fatima Obeidat

Familial disorder of sex determination in seven individuals from three related sibships

Abstract In humans, the sex of an individual is determined by the Y-chromosome-related SRY gene, which causes the differentiation of the undifferentiated gonads into testicular tissue. True hermaphrodites without a Y chromosome and XX males represent a sex determination error in which testicular tissue develops despite the absence of the SRY gene. Familial forms of XX true hermaphrodites and XX males exist in the literature, which also contains the two forms co-existing in the same family. In this report, we present a large family with seven affected individuals with phenotypes ranging from XX male to XX true hermaphrodite with predominance of female characteristics. We suggest that XX maleness and XX true hermaphroditism represent a continuum of the same disorder. We speculate on the mode of inheritance of this disorder in this particular family.

Biochemical Changes Induced by the Toxicity of Variable Sizes of Silver Nanoparticles

Background : Silver nanoparticles (SNPs) rapid involvement in industry and nanomedicine increased human exposure to variable forms of these particles, with possible potential risk on human health. Aims: The aim of this study is to investigate the biochemical changes induced by variable sizes of SNPs toxicity. Place and Duration of Study: Faculty of Medicine, The University of Jordan and the

Image-based discriminating morphological features for gastric atrophy assessment: a step to go further.

The aim of this study is to establish a basis for automated assessment of gastric atrophy according to the Updated Sydney System. We sought to minimize inter- and intra-observer variations in the application of the Sydney System. A total of 160 biopsies were examined by three pathologists and graded using the visual scale of the Updated Sydney System. A consensus was reached on 135 biopsies. Digital images were captured for the studied biopsies. Image processing techniques were used to extract four morphological features that uniquely discriminate each atrophy grade. The features are related to gland density and shape. To validate the reproducibility of these features, the K-Means clustering technique was used. We were able to grade the atrophy with an overall precision of 95.6%. Furthermore, the proposed features were able to distinguish four discrete grades without any significant overlap. This has not been achieved by previous studies.

An intelligent decision support system for quantitative assessment of gastric atrophy

Aims To build an automated decision support system to assist pathologists in grading gastric atrophy according to the updated Sydney system. Methods A database of 143 biopsies was used to train and examine the proposed system. A panel of three experienced pathologists reached a consensus regarding the grading of the studied biopsies using the visual scale of the updated Sydney system. Digital imaging techniques were utilised to extract a set of discriminating morphological features that describe each atrophy grade sufficiently and uniquely. A probabilistic neural networks structure was used to build a grading system. To evaluate the performance of the proposed system, 66% of the biopsies (94 biopsy images) were used for training purposes and 34% (49 biopsy images) were used for testing and validation purposes. Results During the training phase, a 98.9% precision was achieved, whereas during testing, a precision of 95.9% was achieved. The overall precision achieved was 97.9%. Conclusions A fully automated decision support system to grade gastric atrophy according to the updated Sydney system is proposed. The system utilises advanced image processing techniques and probabilistic neural networks in conducting the assessment. The proposed system eliminates inter- and intra-observer variations with high reproducibility.

Sporadic Lateral Ventricular Hemangioblastoma presenting with Intraventricular and Subarachnoid Haemorrhage

Intraventricular hemangioblastoma (HB) is very rare; few cases of intraventricular HB have been reported in the literature, either sporadically or in association with von Hippel-Lindau disease. Furthermore, the incidence of ventricular haemorrhage from HB seems to be uncommon. We report a unique case of sporadic HB of the right lateral ventricle presenting with intratumoural and intraventricular haemorrhage in addition to multifocal intracranial superficial siderosis, indicating the presence of a subarachnoid haemorrhage (SAH) as well. Such a combination has not been reported before. In the future, the detection of an intraventricular mass in association with ventricular haemorrhage, with or without SAH, should include HB as a differential diagnosis, particularly when the imaging appearances are not typical of the more common intraventricular tumours.

Expression of androgen receptor in invasive ductal breast carcinomas: a clinicopathological study from Jordan

BACKGROUND The clinical relevance of androgen receptors (ARs) expressed in breast cancer cells and the suggested prognostic impact has been an area of active research. The prevalence rate of AR expression in breast cancer has never been reported among Jordanian patients. OBJECTIVE Determine the expression rate of ARs among invasive ductal breast cancer cases of different stages and molecular subtypes. Also, analyze the relationship between AR expression and clinicopathologic and immunohistochemical criteria, and assess the impact of AR expression on survival. DESIGN Retrospective medical record review. SETTING Tertiary care hospital in Amman, Jordan. PATIENTS AND METHODS Our study comprised only of cases of invasive ductal breast carcinoma of no special type among females from records during a 10-year period between 2006 and 2015. Immunohistochemical staining was considered positive if more than 10% of tumor nuclei showed positive staining. MAIN OUTCOME MEASURES The expression rate of ARs and the association of the expression rate with the clinicopathologic features of invasive breast cancer. SAMPLE SIZE 293. RESULTS Immunohistochemical staining for AR revealed positive staining in 180 (61.4%) cases, including approximately 50% of triple-negative breast cancer cases. AR positivity correlated with estrogen receptor (ER) status (P=.007) and smaller T size (P=.014). However, no significant association was found with any of the other variables. AR expression was positively associated with overall survival (P=.022) in general and in ER-positive cases (P=.012). However, in the multivariate Cox regression model, AR was not independently associated with survival. CONCLUSIONS These results were consistent with international reports showing a significant relationship of AR expression with ER status. In addition, AR expression was significantly associated with smaller tumor size. Although AR status was not independently associated with survival, our data suggest AR is a good prognostic factor. LIMITATIONS Some clinical data were missing.

Mixed Epithelial Stromal Tumor of the Kidney (MESTK): A Case Report

Mixed epithelial stromal tumor of the kidney (MESTK) is a newly introduced and rare kidney tumor subtype; approximately 100 cases have been reported. We report a case of MESTK with detailed clinicopathological findings, presented to emergency department with gross hematuria and clot retention managed by radical nephrectomy. Although MESTK are benign tumors, they cannot be distinguished from other malignant neoplasms until after nephrectomy due to lack of typical radiological features. They can cause serious sequelae; including gross hematuria and serious drop in hemoglobin as the case we present here shows. This is why it is important to early diagnose and treat this condition. This case highlights the importance of early introduction of imaging in patients presenting with gross hematuria. Failure to diagnose this lesion as the underlying cause of hematuria may lead to recurrence and malignant transformation.

Congenital insensitivity to pain and anhydrosis due to a rare mutation and that is complicated by inflammatory bowel disease and amyloidosis: a case report

Patients with congenital insensitivity to pain and anhydrosis syndrome are at risk for renal amyloidosis and inflammatory bowel disease. Physicians caring for such patients should be aware of these complications.

Uterine Lipoleiomyoma : A Case Report

Uterine lipleiomyoma is a rare variant of leiomyoma with reported prevalence of 0.03% to 0.2%. Lipoleiomyomas of the uterus are typically found in postmenpausal women and in most cases are asymptomatic and are associated with ordinary leiomyomas. This rare tumor is composed of an admixture of mature adipocytes and benign smooth muscle cells. The histogenesis for this tumor is still controversial. We report a case for a fifty- seven year old postmenopausal female presented to the gynecological department with pelvic pain and heaviness. Abdominopelvic ultrasound and MRI showed a pelvic mass. The patient underwent total abdominal hysterectomy and found to have myometrial mass measured 11x11x6.5 cm which was obliterating the endometrial canal. The histopathological diagnosis was consistent with lipoleiomyoma. The uterus showed multiple small leiomyomas. We report this case because of its rarity.

Isolated Multiple Bilateral Thyroid Metastases from Prostatic Adenocarcinoma: Case Report and Literature Review

Solitary metastasis from prostate adenocarcinoma to thyroid gland is very rare and usually associated with other distal metastasis. This report describes for the first time isolated multiple bilateral thyroid metastasis from prostatic adenocarcinoma. A 67-year-old man who is known as a case of prostatic adenocarcinoma was admitted to a hospital as a case of a multinodular goiter on the basis of clinical and CT scan findings. Total thyroidectomy was performed and histopathology result showed adenomatous goiter containing bilateral metastatic prostatic adenocarcinoma. This is the first report of isolated multiple bilateral thyroid gland metastasis from prostatic adenocarcinoma without other distal metastasis. Such lesions are very rare and can be misdiagnosed, so high index of suspicion for thyroid metastasis should be always maintained in all oncology patients with isolated thyroid mass because early resection and thyroidectomy will change the prognosis for patient.