Stage Ie malignant lymphoma of paranasal sinus —A report of 5 cases and review of literature

Primary lymphoma is the most common nonepithelial malignant tumour arising from the paranasal sinus region. It occurs mostly in middle aged and elderly patients with a nonspecific clinical profile resembling that of commoner epithelial sinonasal malignancies. Modified Rappaport’s and the Working Formulation are the frequently used histopathological classification systems. Radiation therapy is the mainstay of treatment with excellent local control of the disease. Most of the failures occur at distant sites outside the treatment area or in the form of disseminateed disease. Chemotherapy, though used in limited number of patients in some series, seems to have a better role to play in the management of these tumours in future as most of the sinonasal lymphomas are of poorly differentiated variety or of unfavourable histology.     

Role of combined therapy in advanced carcinoma of the larynx and hypopharynx

The present prospective preliminary study is based on treatment of stage III and IV cancers of the larynx and hypopharynx with a planned combined regimen of radiotherapy and radical surgery. There is a reduction in the failure rate in these cases as compared to those treated in this centre with a single modality of therapy like radiotherapy or surgery alone. 69% of the patients thus treated are surviving disease-free for follow ups varying 18–30 months with a median follow up of 24 months following combined treatment.     

Tubal factor infertility: an association with prior chlamydial infection and asymptomatic salpingitis

In 265 Canadian women, with and without tubal factor infertility (TFI), we compared Chlamydia trachomatis cultures of endocervical swabs, endotubal swabs and biopsies, serology, and past history. A history of pelvic inflammatory disease (PID) was absent in 69.2% of TFI women, despite visual evidence of tubal damage. C. trachomatis was not isolated in any of 52 patients with TFI (TFI group), 114 having tubal ligation (STER group), or 99 patients having hysterectomy (HYST group). However, chlamydial antigen was detected with an immunochemical method in 1 of 16 tubal biopsy specimens from TFI women. The prevalence of chlamydial IgM or IgG antibody in serum was significantly higher (P less than 0.0001) in the TFI group (79.1%) than in the other two groups (relative odds, 6.3; 95% confidence interval: 2.5, 16.8). In seropositive (IgG or IgM) subjects, there was a significant (P = 0.003) and strong (relative odds, 5.1; 95% confidence interval: 1.5, 18.1) association between chlamydial IgA antibody and TFI. In women with TFI, there was no significant association between IgM or IgG seropositivity (P = 0.56). or IgA seropositivity (P = 0.53), and a negative history for PID. These findings are consistent with the hypothesis that C. trachomatis is a major cause of TFI following PID, which may or may not be asymptomatic.     

Prognostic factors influencing the outcome of thalamic glioma

Retrospective analysis of 27 patients of thalamic glioma including adults and children treated over a period of 7 years from 1991-1997 was done. The study group included 19 males and 8 females; 9 patients were less than 15 years and 18 patients more than 15 years of age at the time of diagnosis. The commonest symptoms were headache and vomiting. 12 patients underwent VP shunt as an initial procedure and 7 underwent total or partial surgical resection. Confirmed histopathological examination was possible in 16 patients; while 12 had low grade astrocytoma, 4 cases had high grade histology. All patients were treated with radiotherapy to a total dose of 50-60 Gy in 25-30 fractions. Median follow up was 9.63 months. The disease free survival in these patients was 28% at 2 years. Prognostic factors which included age, sex, duration of symptoms, surgical procedures, histology and radiotherapy dose were evaluated for significance. A subtotal resection conferred a better prognosis.     

Fibrosarcoma associated with a benign cystic teratoma of the ovary.

OBJECTIVE: A case of ovarian fibrosarcoma associated with a benign cystic teratoma is described. METHODS: A 32-year-old patient with an ovarian tumor detected by routine gynecological examination was referred to our hospital. In addition to histopathological examination of the resected tumor, immunohistochemical studies as well as a cytogenetic analysis by comparative genomic hybridization were carried out. RESULTS: The 7-cm-sized tumor consisted of two different components: a fibrosarcoma and a benign cystic teratoma. The teratoma contained elements of all three germ layers and lacked any focus of immature teratoma. A fibrosarcoma was immediately connected to the teratoma. The sarcoma cells showed eight mitoses per 10 high-power fields on average and exhibited immunohistochemical reactivity for vimentin only. Cytogenetic analysis of the fibrosarcoma using comparative genomic hybridization revealed imbalances of chromosomes 9, 12, and 16. After a 1-year follow-up, there were no signs of tumor recurrence or systemic disease. CONCLUSION: To the authors' knowledge, this is the second report of an association of ovarian fibrosarcoma and benign cystic teratoma, and the first including a cytogenetic analysis.     

Bestimmung des Ureter-Zervixabstandes vor kombinierter laparoskopisch-vaginaler Hysterektomie mit dem EndoGIA™30

Schlu?folgerung Bei Beachtung der Indikationsstellung (HE bei Nullparit?t mit enger Vagina bzw. immobilem Uterus mit zu erwartenden Verwachsungen) und vorheriger Sicherung des Ureter-Zervixabstandes, stellt dieses Verfahren durch seine minimale Invasivit?t eine Bereicherung der traditionellen Operationstechniken dar, welches nicht als Konkurrenzmethode zur abdominalen Uterusexstirpation zu sehen ist, sondern als ein Mittel, die Indikation zur vaginalen Operation zu erweitern und die Sicherheit dieses Eingriffes zu erh?hen.     

Trophoblast invasion in pre-eclampsia

It is generally accepted that insufficient invasion of trophoblast cells into the myometrial portions of the spiral arteries is thought to play a crucial role in the development of preeclampsia. As a consequence, uteroplacental vessels fail to undergo adaptive changes which are imperative to provide a sufficient blood supply to the placenta. Consecutive placental hypoxia is supposed to cause secretion/shedding of still unidentified placental metabolites resulting in different forms of pregnancy-induced hypertension. This review presents published data concerning the causes of insufficient trophoblast invasion in preeclampsia. Expression of HLA-G by extravillous trophoblast cells seems to be altered, resulting in activation of the maternal immune system. The pattern of integrin expression as well as the secretion of proteases is reported to be disturbed, which could lead to a reduced invasive potential of the trophoblast cells. Recent data indicate a pathophysiological role of NK-cells and macrophages in the altered trophoblast invasion. Also angiotensinogen Thr235 polymorphism seems to alter early physiologic changes in spiral arteries. In summary, preeclampsia seems to be induced by a multifactorial disturbance of trophoblast invasiveness which is characterized by reduced invasiveness of the trophoblast cells themselves and by an activated maternal immune response blocking the invasion by the semiallogenic trophoblast.