Vestibular presentation in platybasia

The platybasia consists of an upward bulge or invagination of the occiput near the foramen magnum. These patients mostly presents with neurological symptoms. The present case is a rare variant presenting with vestibular disorders only.     

Cytomegalovirus pneumonia prior to engraftment following T-cell depleted bone marrow transplantation

CMV pneumonia is a frequent complication of allogeneic bone marrow transplantation (BMT). It usually appears 23 months following transplantation and is associated with a high mortality rate. The incidence of CMV pneumonia in our T-lymphocyte depleted allogeneic BMT recipients, transplanted between 1987–1991, was 18 out of 197 (9.2%) patients. In 3 patients (1.5% of allogeneic BMT recipients), pneumonia occurred prior to marrow engraftment, on days 12–16 post BMT. These patients did not develop acute GVHD in contrast to 9/11 patients who had acute GVHD in addition to developing CMV pneumonia between engraftment and day +100 (p<0.03). Furthermore, these three patients did not receive steroid therapy as opposed to 14/15 patients who were treated with steroids and eventually contracted CMV pneumonia post-engraftment (p<0.01). The three patients did not have two additional risk factors known for the development of CMV pneumonia: increasing age and a diagnosis of acute myeloblastic leukemia (AML) as the primary disease. Despite prompt diagnosis and therapy with ganciclovir and high doses of intravenous immunoglobulin (IVIG), two of the patients died. Tcell depleted BMT may be a risk factor for development of CMV pneumonia occurring prior to engraftment. In the era of post-BMT anti CMV prophylaxis, one should be aware that life-threatening CMV pneumonia may appear prior to engraftment and consider aggressive CMV prophylaxis.     

Cell mediated and humoral immunity in chronic suppurative otitis media

The present study was carried out on 75 patients suffering from chronic otitis media and 25 healthy age and sex matched controls. The T. rosette percentage were depressed in malnouirished immunity (CMI), but once malnutrition was treated the CMI was improved. Anergy to challenge does of 2 : 4 DNCB was not observed in any groups. Weak response was observed in 4% of controls, 18.7% of chronic otitis media patients and 5.7% of post treatment cases. Serum IgG, IgA and IgM levels were elevated in chronic otitis media patients from controls but once the infections were eliminated by treatment their values became insignificant (p 0.05) from controls. Presence of Malnutrition significantly contributed to suppression of CMI response but no suppression of humoral immunity was observed.     

Surgical treatment of papillary thyroid carcinoma

Four hundred and thirty-seven patients with papillary thyroid carcinoma were treated from April 1963 to December 1989. The main treatment was surgery which was divided into 4 types: lobectomy combined with neck dissection (RND or MND); total thyroidectomy; isthmusectomy plus lobectomy; lobectomy combined with RND and then followed by contralateral MND. The 10-year survival rates of these four groups were 88.6%, 89.5% 80% and 80%, respectively. The overall 5, 10 and 15-year survival rates were 92.7%, 87.9%, 79.4%. Lymph node metastasis was present in 80%. The authors believe that functional neck dissection is indicated if the number of lymph node is limited and the size is small.     

CHANGES OF SERUM ALPHA FETOPROTEIN BEFORE AND AFTER RADIOIMMUNOTHERAPY IN PATIENTS WITH HEPATOCELLULAR CARCINOMA

ＣＨＡＮＧＥＳＯＦＳＥＲＵＭＡＬＰＨＡＦＥＴＯＰＲＯＴＥＩＮＢＥＦＯＲＥＡＮＤＡＦＴＥＲＲＡＤＩＯＩＭＭＵＮＯＴＨＥＲＡＰＹＩＮＰＡＴＩＥＮＴＳＷＩＴＨＨＥＰＡＴＯＣＥＬＬＵＬＡＲＣＡＲＣＩＮＯＭＡＺｅｎｇＺｈａｏｃｈｏｎｇ;曾昭冲;ＴａｎｇＺｈａｏ...     

Lactic dehydnogenase activity in head and neck cancer

Serum and tissue lactic dehydrogenase (LDH) levels were estimated in patients with head and neck cancer. The levels were found to be significantly higher both in serum as well as tissue of these patients. The rise was nearly to the same extent in all the patients irrespective of the site, character, histopathology or stage of the disease. Further after, radiotherapy the levels remained unaltered. The rise in LDH levels in patients with head and neck cancer suggests increased rate of glycolysis in the tissue and that the rise in serm could be due to its release from the tissue.     

SEARCH FOR HERPES SIMPLEX VIRUS TYPE2（HSV－2）AND HUMAN PAPILLOMAVIRUS（HPV）IN THE NORMAL AND ABNORMAL CERVICAL SAMPLES

ＳＥＡＲＣＨＦＯＲＨＥＲＰＥＳＳＩＭＰＬＥＸＶＩＲＵＳＴＹＰＥ２（ＨＳＶ－２）ＡＮＤＨＵＭＡＮＰＡＰＩＬＬＯＭＡＶＩＲＵＳ（ＨＰＶ）ＩＮＴＨＥＮＯＲＭＡＬＡＮＤＡＢＮＯＲＭＡＬＣＥＲＶＩＣＡＬＳＡＭＰＬＥＳＺｈａｎｇＷｅｉ;张伟;ＪｉｎＳｈｕｎｑｉａ...     

Therapeutical effect of activated human macrophages on a human tumor line growing in nude mice

Human peritoneal macrophages were collected from dialysis bags of renal patients on Continuous Ambulatory Peritoneal Dialysis (CAPD), during an inflammation-free period. The macrophage suspension was cultured in presence of bacterial lipopolysaccharide (LPS) and phorbol myristate acetate (TPA). The cultured macrophages were tested for therapeutic effectiveness against a human tumor-cell fine, RC43, implanted subcutaneously in NMRI nude mice. The macrophages were injected around the tumor starting from the 14th day after inoculation, when the tumor growth was already detectable (mean tumor size 7 mm). Three injections of macrophages on days 14, 18 and 21 induced hemorrhagic patches at the tumor site and almost complete regression of the tumor. One injection of macrophages cultured either in presence of LPS + TPA or of LPS + TPA + PGE2 resulted in marked slow-down of the tumor growth. Injection of either TNF-alpha (4000 U/mouse) or of PGE2 (150 ng/mouse) given at the site of the palpable small tumor had no effect. Macrophages cultured in medium or in medium supplied with either TPA, LPS or TPA + LPS, were not effective in nude mice bearing large (16 to 19 mm) tumors. The results obtained suggest that activated human macrophages might be therapeutically effective at certain stages of human cancer.     

A FAMILIAL 46 XY GONADAL DYSGENESIS AND HIGH INCIDENCE OF EMBRYONIC GONADAL TUMORS

ＡＦＡＭＩＬＩＡＬ４６ＸＹＧＯＮＡＤＡＬＤＹＳＧＥＮＥＳＩＳＡＮＤＨＩＧＨＩＮＣＩＤＥＮＣＥＯＦＥＭＢＲＹＯＮＩＣＧＯＮＡＤＡＬＴＵＭＯＲＳＥｈＺｈｅｎｇ;鄂征;ＬｉｕＷｅｉｌｉ;刘伟莉（ＤｅｐａｒｔｍｅｎｔｏｆＣｙｔｏｇｅｎｅｔｉｃｓ,Ｂｅｉｊｉｎ...     

Stapedectomy

With the proliferation in the varied techniques of surgery for restoration of hearing in patients with conductive loss secondary to otosclerosis, the need does arise for revision surgery in selected cases of corrigible failures or complications. The merits of stapedectomy employing the preserved posterior stapedial crus or homograft stapes prosthesis are discussed. Stapedotomy is suitable for obliterative otosclerosis. Revision stapedectomy should be attempted only by the experienced surgeon after critical appraisal of all factors likely to benefit the patient.     

SYNERGISM BETWEEN PHOTODYNAMIC THERAPY OF ALUMINUM SULFONATED PHTHALOCYANINE AND HYPERTHERMIA ON MOUSE HEPATOMA IN VIVO AND I

ＳＹＮＥＲＧＩＳＭＢＥＴＷＥＥＮＰＨＯＴＯＤＹＮＡＭＩＣＴＨＥＲＡＰＹＯＦＡＬＵＭＩＮＵＭＳＵＬＦＯＮＡＴＥＤＰＨＴＨＡＬＯＣＹＡＮＩＮＥＡＮＤＨＹＰＥＲＴＨＥＲＭＩＡＯＮＭＯＵＳＥＨＥＰＡＴＯＭＡＩＮＶＩＶＯＡＮＤＩＮＶＩＴＲＯＦｕＭａｉｗｕ;傅乃...     

Growth factors and hematopoietic recovery

Availability of hematopoietic growth factors (GC-SF, GM-CSF, erythropoietin,etc.) has started a new arena of dose-intensification. The use of such growth factors has resulted in faster hematopoietic recovery of cancer patients and now offers several new treatment modifications. These include: (1)dose-intensification without hematopoietic stem cell support, (2) speedier hematopoetic recovery after hematoablative therapy and stem cell transplantation (allogeneic or autologous); (3) use of combination of growth factors, and (4) improvement in the delivery of anti-microbial drugs which are toxic towards hematopoietic cells (Gancyclovir, Bactrim,etc.). The above treatment strategies are under active clinical trials and can provide improved, cost-effective methods of treating patients with cancer.     

Expression of gap junction protein Cx43 in cultured human normal and malignant lung cells

Gap junctional intercellular communication-exchange of small molecules and ions between contiguous cells through membranous gap junctional channels-is essential for growth control and tissue homeostasis. This work concerns the functional expression of gap junction protein connexin 43 (Cx43) in normal human lung cells and the changes in lung carcinoma cells. By using Northern blot hybridization analysis and Cx43 immunocytochemical methods, it was observed that cultured normal human embryonic lung cells expressed a high level of Cx43 in both mRNA and protein levels. The Cx43 immunofluorescence was localized at cell membrane regions corresponding to the location of gap junctions. These normal lung cells were competent of intercellular communication function as detected by Lucifer yellow dye transfer. In contrast to normal cells, Cx43 mRNA and protein was not detectable in the carcinoma PG cell line. These tumor cells were defective of intercellular communication function. These results demonstrate that Cx43 is expressed in normal cultured human embryonic lung cells but not in lung tumor cells. The lack of intercellular communication in the lung tumor cell line correlates with dysfunctional intercellular communication. The suggestive role of Cx as a tumor suppersor gene is discussed.     

Bone marrow transplantation for acute lymphoblastic leukemia(all)

Advances in the treatment of childhood acute lymphoblastic leukemia (ALL) have been striking while results have been less impressive in adults who develop this disease. Obvious differences in a patient’s ability to withstand cytotoxic therapy may account, in part, for these findings, but the biologic behaviour of the disease in the two age groups appears to be different; relapses are more frequent and cures less common in adults. In fact, age alone appears to be the most important prognostic factor in ALL. The demonstration of the efficacy of bone marrow transplantation in advanced disease as well as the marked improvements in supportive care and the development of effective high-dose cytotoxic preparative regimens, especially those which use total body irradiation, however, have paved the way for transplantation in first complete remission. Formerly, most adult ALL patients who underwent bone marrow transplant did so in relapse, or in second or subsequent remission. In most studies 40–50 % of first remission adult patients attain long-term disease-free survival after allogeneic and autologous bone marrow transplant. Relapses are considerably higher in the autologous transplant group when compared to the allogeneic group, but the latter population may experience increased morbidity and mortality due to graft-versus-host disease and opportunistic infection. These differences may reflect the beneficial graft-versus-leukemia effect in the allograft as well as infusion of autoiogous leukemia cells in the autograft but neither transplant subtype appears superior. Compared to more conventional approaches, however, transplantation may offer improved disease-free survival, although patient selection appears to significantly influence outcome. These many inherent biases must be noted when comparing markedly different approaches,e.g. transplantversus conventional therapy. The challenge of demonstrating which therapy is superior for adult ALL patients can only be addressed in a well-designed, prospective, randomized trial.     

Carboplatin-liposomes (CPL) in immunodeficient mice: Improved antitumor activity for breast carcinomas and stimulation of hematopoiesis

Carboplatin-liposomes (CPL) have been shown to possess a strong stimulatory activity on the hematopoiesis in immunocompetent mice. As we were interested in studying this pharmacological characteristic in parallel with any antitumour effects which might be expected for the encapsulated cytostatic, we used a panel of six human breast carcinomas xenotransplanted to nude mice. The antitumor activity as well as the hematopoietic effects of the vesicles were studied in comparison to, and in combination with, the free drug. Carboplatin was encapsulated into reverse phase evaporation vesicles (REV) and injected i.p. as a single dose of 75 mg kg^-1 into tumor-free and breast-carcinomabearing animals, respectively. Following a single application of CPL in nude mice, a significant increase of the WBC numbers to about three times for that of the normal level could be observed over a period of at least 28 days. The elevation was due to an increase in both circulating granulocytes and lymphocytes. The peripheral effect was accompanied by a relative decrease of spleen cellularity, while the number of bone marrow cells was hardly affected. There was no influence detectable on circulating blood cells in SCID mice. However, a rather high toxicity of CPL for this immunodeficient mouse strain was noticed. In the panel of breast carcinomas used, free carboplatin and CPL displayed a different pattern of therapeutic efficiencies. In four of the five tumor models tested, a combination of the free with the liposomal drug showed a significant inhibition of tumor growth while effectively preventing a drug-induced ieukopenia. As a result, CPL may be recommended in tumor therapy protocols for future clinical trials in order to relieve a cytostatic-induced bone marrow suppression.     

Skin tests and specific immunotherapy in allergic rhinitis

Thirty clinically diagnosed patients of allergic rhinitis attending ‘Nasal Allergy Clinic’ at ENT department of Army Hospital, Delhi Cantonment were studied to identify the offending allergens by prick skin tests with standardised antigen extracts. 13 patients (43.3%) out of 30 were found suitable for immunotherapy. All these 13 patients were allergic to house dust mite. Only 9 patients (69.2%) out of 13 responded satisfactorily to immunotherapy and have been followed up for a varying peeriod of one to two years with no recurrence of original symptoms. Procedural and other related aspects of immunotherapy have been discussed and relevant literature on the subject has been reviewed.     

Lipoproteins in hypoxic tumor cells as traps of free radicals

We examined the role of main cell protective mechanisms in retaining the high resistance of ascitic cells (EAC, ZAH) to lipid peroxidation with respect to different stages of tumor-organism metabolic interactions. The following mechanisms were studied: (1) the activity of main EAC enzymatic antioxidants (GSH-Px, SOD); (2) changes in lipid metabolism, especially the content of the main PUFA (llnoleic and arachidonic fatty acids) in EAC cells; (3) comparison of intracellnlar resistance between EAC/ZAH cytoplasmic sections (containing LP-granules or not) to lipid peroxidation (initialized directly by UV-light). We found that the high resistance to lipid peroxidation was typical for cytoplasma sections (without LP-grannles) on all stages of tumor development in vivo. The intracellular LP-granules become the main sensitive targets for FR-action, but only in the chronic hypoxia state of EAC/ZAH tumor cells. The latter effect developed in close correlation with the following metabolic interactions: (1) increasing the proportion of PUFA (especially, arachidonic and linoleic acids) transported to EAC tumor cells from host organs and accumulated mainly in ttunor LPgranules, and (2) decreasing the cα-tocopherol content of these hypoxic EAC cells while no activation of the main cell antioxidative enzymes (GSH-Px, SOD) took place. The vitality and high resistance of EAC stationary cells were accompanied by the ‘paradoxical’ state with great differences between the resistance of the intracellnlar PUFA-rich granules and other cytoplasmic sections. A similar state was found in stationary ZAH cells. The cell state is in good agreement with the Dormandy’s suggestion that PUFA-rich granules can trap reactive radical species preventing their interaction with ‘critical’ PUFA-membranes.     

Localization of type I and type III procollagen mrnas in breast scirrhous carcinoma byin situ hybridization

Scirrhous carcinoma is characterized by remarkable amount of collagen fibrils, mainly type I and type III collagens. The origin of collagens is still under debate. cDNA fragments of type I and type III procollagens were subcloned into Gemini pGEM vectors to synthesize the³⁵S-labeled cRNA probes. Byin situ hybridization, we have found the fibroblasts surrounding the tumor cells and cords contained abundent type I and type III procollagen mRNAs which decreased with the distance of fibroblasts from the tumor cells. In all freshly prepared tissues, the tumor cells also contained significant pro α1 (I) and pro al (III) mRNAs, but no or little pro α2(I) mRNA. The results indicated that type I and type III collagens in human scirrhous carcinoma of breast are mainly produced by fibroblasts. Tumor cells also perticipate in the disposition of collagen fibrils, probably type I trimer and type III collagens in accordance with what was observed in biochemical analysis and cell culture studies.     

Proboscis Lateralis with congenital cleft palate

Proboscis Lateralis is a congenital malformation in the form of a tubular nostril arising from the inner canthus of the eye. In some cases, proboscis is the only congenital malformation while in the rest, it may be associated with nasal, ophthalamic, oral or intracranial abnormalities. A rare case of Proboscis Lateralis with Congenital Cleft Palate is presented     

Use of pericranial flap for reconstruction after craniofacial surgery

Total resection of lesions involving the anterior cranial base results in defect of variable size, leaving a communication between the nasal cavity and extracranial space. Potential complications of this include meningitis and CSF leaks. Repair by an inferiorly based pericranial flap was performed in 10 patients in each of whom the defect exceeded 1.5 cms in width. In 4 of them the repair was supplemented by a temporalis fascia graft for achieving a dural seal. In 8 other patients no repair was considered necessary. Use of this flap did not result in any complication.