Baclofen (fun drug) and ethanol combined poisoning in humans: A histopathology and morphometry model

Background– This study intends to address the scarcity of data regarding the pathogenesis of Baclofen poisoning in humans, which has seen a recent increase, worldwide, especially amongst the young people. Another reason for the conduction of this study was lack of the substantial data about the histo-pathological findings of lungs, in synergistic toxicity of Baclofen with Ethanol, in-spite of it being very common in humans, and both being respiratory depressant with similar mechanism of action.Purpose– The authors aimed to understand the pathogenesis of fatal poisonings in humans due to Baclofen in combination with Ethanol via an animal research model. The enhancement of the overall scientific literature by extending research along the lines of the handful studies available in this regard was another adjunct goal of the study.Material and methodsFifteen Wistar rats were divided into control and test group of five and ten subjects respectively. The test group was further divided into two sub-groups of five each, with Baclofen administered to one, and it in conjunction with Ethanol to the other, in lowest dosages adjusted for the humans. Rats in both the groups were euthanized by dislocation of the cervical vertebrae for the histopathology examination.ResultsCapillary and venous plethora, hemorrhages in the inter-alveolar septi, hemorrhages into the alveoli and sludging was seen in the 1st sub-group. The plethora of venules, capillaries and arterioles, with sludging by the WBC (white blood corpuscle) infiltrates was seen in the 2nd sub-group. Desquamation of the ciliated epithelium and edematous thickening of the intra-alveolar septi, along with features suggestive of the peri-vascular edema was seen in the 2nd sub-group. The morphometric analysis of the micro vessels showed a significantly higher value of the arteriolar diameter in the 2nd sub-group, in comparison to 1st, but the venular diameter in the two sub-groups did not differ to any extent.     

Diagnostic Criteria OF Classical Carcinoids

The classical (mid-gut) carcinoids of the intestinal tract display a characteristic light microscopic morphology. However, sometimes intestinal tumours are seen resembling carcinoids and differential diagnostic difficulties arise. in the present study silver stains and immunoreactivities to chromogranin A + B, cytokeratins and epithelial membrane antigen (EMA) were evaluated as diagnostic adjuncts in six classical carcinoids and six intestinal carcinomas with carcinoid-like features. All classical carcinoids were argentaffin and argyrophil and contained a majority cell population with chromogranin immunoreactivity while only one carcinoid-like carcinoma was chromogranin-immunoreactive and the stained cells in that case represented a minority of the tumour cell population. the cytokeratins were shown to be non-discriminatory. However, EMA expression occurred in five intestinal carcinomas and in the majority of the tumour cells of four of these cases, while only one classical carcinoid displayed a few EMA positive cells. Thus, silver stains in combination with chromogranin A + B and EMA appears to be of value to discriminate between classical carcinoids and carcinoid-like intestinal carcinomas. Further when intestinal carcinoids and carcinoid-like carcinomas are diagnosed with the aid of various tumour markers both qualitative and quantitative considerations must be made.     

Incidental Epidermolytic Hyperkeratosis in Progressive Systemic Sclerosis

Incidental epidermolytic hyperkeratosis (EH) has been reported in a variety of lesions. We describe here incidental EH in a patient with progressive systemic sclerosis (PSS). We reviewed 108 skin biopsies from our cases of PSS and localized scleroderma, but this finding was seen only in the present case. Focal acantholytic dyskeratosis is analogous to EH, but we believe that this case is most consonant with EH. Since there has been no other report of EH in PSS, this association may be coincidental.     

Study on the effect of Chinese herbal medicine in regulating peritoneal lymphatic stomata and enhancing drainage of ascites in mice with liver fibrosis

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隆突性皮肤纤维肉瘤16例临床分析

目的 探讨隆突性皮肤纤维肉瘤(DFSP)的临床特点及治疗。方法 收集我院经组织病理检查确诊的DFSP16例，并对其进行分析。结果 本组病例术前诊断为DFSP3例，误诊7例，术后复发6例，复发2次以上2例，转移1例。结论 DFSP是一种好发于真皮的低度恶性软组织肿瘤，局部手术切除后复发率较高，宜采用扩大切除术治疗。     

A case of skin metastasis of lung carcinoma associated with superior vena cava syndrome

An unusual case of lung carcinoma with both skin metastasis and superior vena cava syndrome (SVCS) is reported. The histological type of the primary lesion as taken by punch biopsy was small cell carcinoma consisting of relatively small cells with hyperchromatic nuclei and scanty cytoplasm. The cutaneous metastatic lesion consisted of large cells with light-staining nuclei and small cells with deep-staining nuclei; it had foci of glandular elements by light microscopy. Neurosecretory granules characteristic of small cell carcinoma were found in the tumor cell cytoplasm by electron microscopy. Cutaneous metastatic rates, complication rates of SVCS, and histological varieties of small cell lung carcinomas are discussed.     

乳牙深龋的临床表现与牙髓组织学变化的分析

目的:分析深龋乳牙临床症状体征与牙髓组织病理学变化的关系.方法:选择深龋乳磨牙治疗前做详细的患儿主诉和临床检查记录,术中切除冠髓作组织病理学检查,比较二者的相关性.结果:深龋乳牙的患儿主诉和常规临床检查与其牙髓病理改变无显著关系;乳牙邻面深龋冠髓炎症发生率显著增高(P＜0.01).结论:临床治疗乳牙深龋尤其是邻面深龋,应考虑到牙髓炎症改变,采取积极的牙髓治疗方法.     

Myocardial structure as a determinant of pre- and postoperative ventricular function and long-term prognosis after valve replacement for aortic stenosis

Background Long-term results after aortic value replacement for aorticstenosis can be correlated to a cardiac-related pre-operativerisk profile. This predictability indicates that there is acommon basis in subtle or overt structural abnormalities ofleft ventricular myocardium. Methods and Results Forty-nine patients aged 24–82 (mean 61) years, with aorticstenosis had a full wall thickness transmural biopsy of theleft ventricular antero-lateral free wall during aortic valvereplacement. Echocardiography and radionuclide ventriculographywere performed prior to, and 18 months (n=41) after, the operation.Postoperative follow-up to a maximum of 7·7 years was100% complete. Pre-operatively, all patients had an increasein both the left ventricular mass index (202±67g.m^–2)and the muscle cell diameter (41±8µm); other morphologicaldata included a muscle cell nucleus volume of 752±192µm³,a muscle cell mass index of 163±54g.m^–2, and afibrous tissue mass index of 39±16g.m^–2. Patientswith a pre-operative episode of clinical left ventricular failure(n=19) had significantly greater morphological variables thanthose without. Pre-operative ejection fraction and other measuresof systolic function correlated inversely with the morphologicaldata, except for the fibrous tissue mass index; diastolic functionindices correlated inversely with all the morphological variables.At the 18-month re-study, the same general picture was noted,but with an underlying strengthening, especially of the musclecell mass index. Overall, the mass index dropped to 152±51g.m^–2(P<0·0001),but in 17% of the patients it became normal; the mass indexat 18 months was directly correlated to morphological variables.A high muscle cell nucleus volume was identified as an independentpredictor of early and late mortality. Conclusion Abnormalities of the hypertrophied left ventricular muscle celland the degree of muscle hypertrophy are, to some degree, underlyingdeterminants of pre-operative symptomatology, pre- and postoperativeventricular function, and early and late mortality after valvereplacement for aortic stenosis. Incomplete hypertrophy regressionafter valve replacement, being indicative of impaired results,was related to pre-operative myocardial structural abnormalities.