A randomised controlled trial comparing Triadcortyl® with 10% glycerine–ichthammol in the initial treatment of severe acute otitis externa

Acute otitis externa is a common clinical condition accounting for a large proportion of patients attending the otolaryngology department, although milder cases are often managed in primary care. Treatment of the most severe forms of otitis externa involves aural toilet, followed by the application of a topical preparation, commonly in the form of an ear canal dressing. A prospective single-blind randomized controlled trial was performed to compare the efficacy of 10% glycerine-ichthammol (GI) solution and Triadcortyl((R)) (TAC) ointment, both applied as ear canal dressings, in the initial management of severe acute otitis externa. A total of 64 patients were studied. Both treatment modalities were proven efficacious in the treatment of severe acute otitis externa. Although there was a statistically significant improvement of pain parameters in the TAC group, we found no significant differences in clinical findings between the two groups. Therefore, it is recommended that GI dressing can be used instead of an antibiotic dressing as an initial treatment of severe acute otitis externa on the basis of cost, avoidance of resistance and toxicity.     

Paclitaxel Induces Apoptosis in AIDS-Related Kaposi's Sarcoma Cells

Paclitaxel is a microtubule stabilizing drug that causes dividing cells to arrest and then undergo apoptosis. It also has antiangiogenic activity because it alters cytoskeletal structure, affecting migration and invasion. Paclitaxel is an effective treatment for AIDS-related Kaposi's sarcoma (KS). KS is a tumor in which there is marked proliferation of endothelial cells in addition to the tumor cells, which themselves share many markers with activated (proliferating) endothelial cells.We sought to determine the mechanism by which paclitaxel exerts its anti-KS tumor effects. In vitro, KS cells are very sensitive to paclitaxel, with half-maximal growth inhibition observed at 0.8 nM. Inhibition of migration of KS cells was also observed at nanomolar concentrations of the drug. Paclitaxel induced cell cycle arrest with an accumulation of cells in sub-G1.This was accompanied in vitro by various events typical of apoptosis: phosphorylation of two anti-apoptotic proteins Bcl-2 and Bcl-(xL) , release of cytochrome c into the cytoplasm, cleavage and activation of caspase-3. In vitro results were borne out by studies of KS tumor xenografts in nude mice. Paclitaxel (10 mg/kg) inhibited tumor growth by 75% over 21 days. Histological examination of the tumors revealed a decrease in proliferative index, a decrease in the number of mitotic figures and an increase in apoptotic cells compared to tumors from untreated mice.     

Use of monoclonal antibodies in immunocytochemical localization of estrogen receptors in ovarian cancer

Ovarian cancer specimens from 45 patients were assayed for the presence of estrogen receptor (ER) utilizing highly specific monoclonal antiestrophilin antibodies and the peroxidase-antiperoxidase technique. Results were compared with the conventional ER determination of the dextran charcoal method (DCC) and were in concordance in 91% of cases. This technique was also used to analyze ER in fine needle aspiration biopsy specimen from four patients with metastatic ovarian tumor. These results suggest that antireceptor monoclonal antibody in immunohistochemical analysis is an effective tool in the evaluation of estrogen receptor content in ovarian cancer. This technique can be easily performed at community hospitals and may be extended to the evaluation of fine needle aspiration biopsies and to analyze specimens of insufficient size for biochemical assay.     

The potential value of mammographically guided fine-needle aspiration biopsy of nonpalpable breast lesions

Nonpalpable breast lesions in 20 female patients were prospectively evaluated with a new technique of fine-needle aspiration biopsy (FNAB) under mammographic guidance. The patient age range was 37-82 years (mean: 60 years), and the mammographic indications for biopsy were microcalcifications (30%), mass (30%), mass with calcifications (25%), and asymmetric density (15%). Seven (35%) patients had significant risk factors for breast cancer. Prototype coaxial 19-gauge/22-gauge and 18-gauge/20-gauge needle systems (Cook, Inc., Bloomington, IN) were used for localization and biopsy. The technique involved needle localization of the target lesion with FNAB performed through the localizing needle after radiologic confirmation of position. A localizing wire then was inserted to allow each patient to proceed directly to the operating room for a standard needle localization open biopsy. Successful localization and aspiration was possible in 18 (90%) patients. Surgical excision was performed in all 20 patients and confirmed by specimen radiography in 17 (85%). A significant concordance of 94 per cent was found between the histologic results of the open biopsy specimens and the cytologic findings of aspirated specimens. These findings suggest that mammographically guided FNAB may offer a safe, reliable, and cost-effective alternative to open biopsy of nonpalpable breast lesions. Further study of this procedure is warranted to confirm its potential in this area.     

Telomerase inhibition by siRNA causes senescence and apoptosis in Barrett's adenocarcinoma cells: mechanism and therapeutic potential

Background  

In cancer cells, telomerase induction helps maintain telomere length and thereby bypasses senescence and provides enhanced replicative potential. Chemical inhibitors of telomerase have been shown to reactivate telomere shortening and cause replicative senescence and apoptotic cell death of tumor cells while having little or no effect on normal diploid cells.     

Nephronophthisis: a variant

The case report describes a young boy with renal, retinal, hepatic and cerebellar involvement in a rare syndrome. He had polyuria, deranged renal functions and cystic lesions in kidneys, which led to the diagnosis of nephronophthisis (NPH). Extra-renal involvement with night blindness, truncal ataxia, mental retardation and hepatosplenomegaly. Thus, every patient with NPH should be carefully examined for extra-renal involvement.     

Cloacogenic Carcinoma: A Study of Six Cases and Review of Literature

A clinicopathological study of six cases of cloacogenic carcinoma and review of the literature was undertaken. These tumors arise from transitional epithelium of the pectinate line. The tumors are often deceptive in the beginning and may often resemble small abscesses, fissures, or fistulas. Often they appear outside the mucosa and skin. Histologically, they are well, moderately, or poorly differentiated. Local excision is adequate for small noninfiltrating tumors. Pelvic radiation, combined with surgery for lesions greater than 2 cm with local extension and/or pelvic nodes, controls the pelvic disease. Well and moderately differentiated tumors have a better prognosis than squamous cell carcinoma. Overall survival rate is approximately 50%. Cure rate depends on the size of the lesion, differentiation of tumor, depth of invasion, duration of the symptoms, nodal involvement, lymphatic or vascular invasion, and contiguous organ invasion. Cloacogenic carcinoma is a better term than other names used in the literature for this tumor.