Low-grade immature teratomas with peritoneal gliomatosis; a case report

Immature teratomas with peritoneal gliomatosis are rare. Eight cases have been registered by the Dutch Ovarian Tumor Committee and one patient, presented in this paper, was treated recently. The follow-up in these cases indicates a good prognosis, even in grade 2 teratomas. Peritoneal implants do not influence adversely the prognosis when they are composed of mature glial tissue. A conservative approach seems to be justified.     

Radiation therapy in the management of medically inoperable carcinoma of the lung: results and implications for future treatment strategies.

Surgery is the treatment of choice for resectable non-small cell lung carcinoma. For patients who are medically unable to tolerate a surgical resection or who refuse surgery, radiation therapy is an acceptable alternative. We reviewed the records of 152 patients with medically inoperable non-small cell lung carcinoma treated at our institution between 1982 and 1990. Patients with metastatic disease, mediastinal lymph node involvement or unresectable tumors were excluded. The actuarial overall survival at 2 and 5 years was 40% and 10%, respectively. The disease-free survival at 2 and 5 years was 31% and 15%. The disease-free survival for patients with T1 tumors was 55% at 2 years, versus 20 and 25% for T2 and T3 lesions, respectively (p = .0006). Increasing tumor dose was also associated with increasing disease-free survival (p = .0143). Overall, 66% percent of the patients were considered to have failed. Of these, 70% showed a component of local failure and 45% failed distantly. Patients with T1 tumors experienced a lower probability of failing locally or distantly than did patients with T2 or T3 tumors. A reduced risk of local and distant failure was seen for patients treated to doses of greater than 65 Gray, especially for T1 tumors. We conclude that radical radiation therapy is an effective treatment for small tumors when treated to doses of 65 Gray or more. Since local failure is the prominent pattern of relapse in patients with large tumors, new therapeutic strategies should be considered for this patient group.     

The forked flap repair for hypospadias

Context:

Despite the abundance of techniques for the repair of Hypospadias, its problems still persist and a satisfactory design to correct the penile curvature with the formation of neourethra from the native urethral tissue or genital or extragenital tissues, with minimal postoperative complications has yet to evolve.

Aim:

Persisting with such an endeavor, a new technique for the repair of distal and midpenile hypospadias is described.

Materials and Methods:

The study has been done in 70 cases over the past 11 years. The “Forked-Flap” repair is a single stage method for the repair of such Hypospadias with chordee. It takes advantage of the rich vascular communication at the corona and capitalizes on the established reliability of the meatal based flip–flap. The repair achieves straightening of the curvature of the penis by complete excision of chordee tissue from the ventral surface of the penis beneath the urethral plate. The urethra is reconstructed using the native plate with forked flap extensions and genital tissue relying on the concept of meatal based flaps. Water proofing by dartos tissue and reinforcement by Nesbit''s prepucial tissue transfer completes the one stage procedure.

Statistical Analysis:

An analysis of 70 cases of this single stage technique of repair of penile hypospadias with chordee, operated at 3 to 5 years of age over the past 11 years is presented.

Results and Conclusion:

The Forked Flap gives comparable and replicable results; except for a urethrocutaneous fistula rate of 4% no other complications were observed.KEY WORDS: Chordee, fistula, forked flap, hypospadias, urethral plate     

Effect of Ethanolic Extract of Pedalium murex on Growth and Haemato-Immunological Parameters of Labeo rohita

To evaluate the dietary effect of ethanolic extract of Pedalium murex (Bada Gokshru) on growth and haemato-immunological parameters of an Indian major carp, Labeo rohita fingerlings, a 45 days study was conducted. Fishes were fed with diets containing six graded levels (0.0, 0.1, 0.3, 0.7, 1.1 and 1.5 g/100 g diet) of ethanolic extract of P. murex. There was significant variation (p < 0.05) in growth parameters [i.e. net weight gain and specific growth rate (SGR)] and food conversion ratio. The highest weight gain and SGR were recorded as 0.1 g/100 g with P. murex supplemented diet. However, the inclusion of higher levels (1.5 g/100 g diet) of P. murex did not show any significant increase in the growth of fish. Further, the haematological parameters such as packed cell volume, haemoglobin concentration and red blood cells were not significantly different in P. murex supplemented diets as compared to control. A significant (p < 0.05) proliferation of the white blood cells, improvement in respiratory burst activity and lysozyme, lower level of the blood glucose at dietary level of 0.1 g/100 g were observed. The results of present study explain the role of ethanolic extract of P. murex in growth and immune defence mechanism of fish.     

A phase II randomized double blinded trial evaluating the efficacy of curcumin with pre-operative chemoradiation for rectal cancer

BackgroundIn vivo studies demonstrate that curcumin increases radioresponse of colorectal cancers. To demonstrate efficacy in humans, we performed a randomized double-blind study of locally advanced rectal cancer (LARC) patients receiving pre-operative chemoradiation therapy (CRT) ± curcumin. We used pathologic complete response (pCR) rate as a surrogate for clinical outcome.MethodsFrom 2008–2010, LARC patients were randomized to placebo/curcumin in a 1:2 ratio. Patients received CRT [50.4 gray in 28 fractions; capecitabine (825 mg/m² twice daily)] followed by surgery. Curcumin (4 grams orally, twice daily) or placebo was given throughout CRT and 6 weeks afterward. Toxicity was monitored weekly. Blood samples taken pre- and 1-hour post-ingestion and tissue biopsies (both collected at CRT week 2) were analyzed for pharmacokinetics. The primary outcome was surgical pCR rate.ResultsOf 22 enrolled patients, 15 received curcumin. Median age was 61 years and the majority were male (n=13; 59%). The median serum curcumin concentrations before (3.04 ng/mL; range, 1.24–18.88 ng/mL) and 1 hour after (3.32 ng/mL; range, 0.84–5.36 ng/mL) curcumin intake did not differ significantly (P=0.33). Serum curcumin concentrations both increased and decreased 1-hour post-administration (range as percentage of baseline: 8.8–258.1%). Twelve curcumin patient tissue biopsies had median curcumin concentration of 33.7 ng/mg tissue (range, 0.1–4,765.7 ng/mg). Two placebo and 1 curcumin patient achieved pCRs (P=0.18). One grade 3 toxicity (infection) was experienced.ConclusionsThe addition of curcumin to CRT did not increase pCR rates for LARC patients. The unpredictable bioavailability of curcumin contributes to continued uncertainties regarding curcumin efficacy.Trial RegistrationClinicalTrials.gov identifier: {"type":"clinical-trial","attrs":{"text":"NCT00745134","term_id":"NCT00745134"}}NCT00745134.     

Migrating foreign body in bronchus

Bronchial foreign bodies are often clinically encountered especially in small children. We report a case of an unusual foreign body in an adult bronchus showing migratory movements.     

Giant cell tumour of the sternum

A patient with histopathologically benign but clinically malignant giant cell tumour of the sternum underwent total strnectomy. The chest wall defect was repaired by mobilising pectoralis major muscles on either side without any respiratory embarrassment.     

Ultrasound detection of antenatal meconium

A new method for antenatal diagnosis of the presence of meconium in the amniotic cavity is reported. Ultrasonographic placental grading is a routine procedure in the monitoring of high-risk pregnancy. During serial scans of 58 patients, it was noted that in 11 cases placental grading was impossible after a certain period. At delivery, thick meconium was noted in all these cases.