Pelvic ultrasound findings in different forms of sexual precocity

Recently produced reference curves for various ultrasound dimensions were used to retrospectively assess 67 pelvic ultrasound scans carried out at the initial presentation in girls with sexual precocity. At presentation the group with precocious puberty had significantly increased uterine lengths and ovarian volumes compared with the normal population, and a significantly increased fundal–cervical ratio. Ovarian volume was also significantly increased in thelarche and thelarche variant. The fundal–cervical ratio was significantly increased in thelarche variant. There was considerable overlap between individuals with sexual precocity and normal subjects. The ultrasound findings that best discriminated early or precocious puberty from other forms of sexual precocity were the presence of a midline endometrial echo, and a uterine length above the 97th centile for age. An entirely normal pelvic ultrasound at presentation did not rule out the possibility of precocious puberty.     

Treatment for locally advanced esophageal carcinoma complicated by fistulas: Case report

Two cases of advanced esophageal carcinoma complicated by fistula formation, treated with esophageal prostheses followed by chemotherapy or concurrent chemoradiotherapy, are reported. Chemoradiotherapy may be indicated in esophageal carcinoma cases with fistulas if an excellent antitumor response is expected. However, the indication for prosthesis insertion should be limited due to the risk of perforation, which may be a lethal complication.     

Interleukin-10, interleukin-6 and interferon-gamma gene polymorphisms in melanoma patients

The immune response against melanoma can be influenced by cytokines with potentially opposite effects on tumour cell growth, such as interleukin-10 (IL10), interleukin-6 (IL6) and interferon-gamma (IFNgamma). Our objective in this study was to investigate whether polymorphisms in the regulatory regions of IL10, IL6 and IFNgamma genes are associated with the development of primary cutaneous melanoma and/or the prognosis of this tumour. We studied genotypic variations at positions -1082, -819 and -592 in the IL10 promoter, -174 in the IL6 promoter and +874 in the IFNgamma intron 1 in 42 melanoma patients and 48 healthy controls. These two populations showed very similar genotypic frequencies for IL10, IL6 and IFNgamma gene polymorphisms. There was a significant increase in the prevalence of IL10 low expression genotypes, specially the ACC/ATA genotype, among patients with a poorer prognosis. In contrast, IL6 promoter and IFNgamma intron 1 gene polymorphisms did not correlate with melanoma prognosis. These data indicate that investigation of polymorphisms in the regulatory regions of IL10, IL6 and INFgamma genes does not seem to be useful for predicting the risk of development of primary cutaneous melanoma. However, IL10 low expression genotypes may be associated with a poorer outcome in melanoma patients.     

Primary low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT)-type of the liver in a patient with hepatitis C virus infection

We report a case of primary low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT)-type of the liver presenting as a solitary mass in a patient with hepatitis C virus infection. A 73-year-old male was referred to our hospital because of a solitary mass in the liver, which was identified by ultrasonography during a routine follow-up study for his hepatitis C virus carrier status. A fine-needle biopsy was performed and the mass was diagnosed as non-Hodgkin's lymphoma. A detailed investigation showed no evidence of lymphoma in other sites. Left lateral segmentectomy was performed. Histologic examination showed diffuse, monotonous infiltration of centrocyte-like cells that are CD 19(+), CD 20(+), sIgM-lambda(+), CD 3(-), CD 5(-), CD 10(-). The patient received no adjuvant chemotherapy and is alive and disease free 34 months after surgery.     

Efficacy and safety of polaprezinc as a preventive drug for radiation-induced stomatitis

BACKGROUND: Radiation-induced stomatitis is one of the adverse effects of total body irradiation(TBI). We examined the usefulness of oral polaprezinc as a preventive drug for stomatitis. PATIENTS AND METHODS: The present study was conducted with 19 patients who were diagnosed with hematologic malignancy and who underwent TBI as pretreatment for bone marrow transplantation, peripheral blood stem transplantation, or cord blood stem cell transplantation. Eleven patients ingested the suspension of polaprezinc and 2% carmellose sodium (carboxymethylcellulose sodium: CMC) beginning the day before TBI(P-CMC group), while the other eight patients did not ingest P-CMC(control group). The severity of stomatitis was assessed in each group during a four-weeks period. RESULTS: Stomatitis (Grade: > or = 3) developed in one of 11 patients in the polaprezinc group and in 4 of 8 patients in the control group(P = 0.046). The times at which stomatitis development ranged between weeks 1 and 2 after the onset of TBI in the two groups. No adverse reaction owing to the ingestion of P-CMC was observed. CONCLUSIONS: These results suggested the efficacy and safety of polaprezinc as a preventive drug for radiation-induced stomatitis.     

Features of transient hypogammaglobulinaemia in infants screened for immunological abnormalities

The incidence of transient hypogammaglobulinaemia of infancy (THI) detected in a major paediatric centre over a 10 year period was examined. A total of 2468 subjects less than 2 years of age had an IgG measurement taken between July 1979 and March 1990. Subjects with known immunodeficiencies were excluded. Fifteen patients were classified as having THI with an initial IgG level less than the fifth centile followed by a second measurement within the normal range. A further 24 patients were identified as having possible THI with a single low IgG concentration. There were 60,174 live births each year in Victoria in the years 1979-88. This gives an incidence of proved THI of 23 per 10(6) births, and including proved and probable THI an incidence of 61 per 10(6) live births. Of those patients with proved THI 12/15 had symptoms of either atopic disease or food allergy/intolerance and three had gastrointestinal symptoms without any evidence of atopic disease. At presentation 12/15 (80%) were IgA deficient and 9/15 had IgM concentrations less than the 20th centile for age. It is suggested that in view of the preponderance of atopic and food intolerant patients that subclinical protein loss from the bowel due to allergic inflammation may be a contributing factor to the development of THI in some patients.