Breast conservation therapy. Severe breast fibrosis after radiation therapy in patients with collagen vascular disease.

Two patients with collagen vascular disease (rheumatoid arthritis and scleroderma) had extremely poor cosmetic results after breast radiation therapy (RT). The patient with rheumatoid arthritis received 5251 cGy at 210 cGy per day, followed by a 1600 cGy iridium-192 implant boost. Between 8 and 11 months post-RT she had severe breast fibrosis, retraction, and pain that required a mastectomy for relief. The patient with scleroderma received 5040 cGy at 180 cGy per day without a boost. Between 1 and 4 months post-RT the systemic symptoms of scleroderma progressed and the breast became hard and retracted. Both rheumatoid arthritis and scleroderma are chronic systemic diseases characterized by severe inflammation and an autoimmune component. The presence of scleroderma at or before treatment should be considered a contraindication to breast RT, whereas the presence of active rheumatoid arthritis should be considered a relative contraindication. An autoimmune mechanism will be presented to explain both the fibrosis and the systemic progression of collagen vascular disease that was observed.     

Risk factors for development of dehydration in children aged under five who have acute watery diarrhoea: a case-control study

Objective: To identify risk factors for development of dehydration in under five year olds with acute watery diarrhoea.Design: Hospital based unmatched case-control study.Setting: Diarrhoea Treatment Unit, Government Medical College Hospital, Nagpur, India.Participants: The study included 387 cases of diarrhoea having severe or moderate dehydration and 387 controls suffering from diarrhoea with mild or no dehydration.Risk factors: The study included infancy, female sex, religion, residing in urban slums or rural area, under nutrition, cessation of breast feeding during diarrhoeal episode, fluid intake decreased/stopped during diarrhoea, ORS not received, home available fluids (HAF) not received, both ORS and HAF not received, non-washing of hands by mother before preparation of food, after defaecation, after disposal of faeces, history of measles in the previous six months, frequency of stools >8/d, frequency of vomiting more than twice per day and temperature more than 99°F, as risk factors for development of dehydration.Statistical analysis: Univariate analysis included OR, 95% CI for OR and Chi-square test. Multivariate analysis was carried out by unconditional multiple logistic regression (MLR).Results: This study identified the significance of infancy, religion, severe undernutrition, non-washing of hands by mother before preparation of food, frequency of stool >8/d, frequency of vomiting >2/d, history of measles in previous six months, withdrawal of breast feeding during diarrhoea, withdrawal of fluids during diarrhoea and not giving ORS, HAF or both during diarrhoea, in the outcome of development of moderate or severe dehydration.Conclusions: Timely intervention in the preventable risk factors included in this study may prevent the development of moderate or severe dehydration in the children suffering form acute watery diarrhoea.     

Extramembranous pregnancy: a case report.

A rare case of extramembranous pregnancy is reported. It was associated with intermittent loss of liquor and bloody discharge beginning at about the 25th week of gestation. An anencephalic infant was delivered alive from a breech presentation during the 31st week of gestation. The placenta was markedly circumvallate, with short, thick membranes which did not cover more than 10% of the infant. The course of the pregnancy and the examination of the infant and placenta are discussed, and the pertinent literature is reviewed.     

Allometric nucleo-cytoplasmic volume relations and rotation ellipsoid neuronal bodies of the cat nodosal and superior sympathetic ganglia

Using a Henning and Elias' plot, evidence was obtained for the rotation ellipsoid nature of the three-dimensional shape of neuronal bodies of the nodosal and cervical sympathetic ganglia of the cat. Nucleo-cytoplasmic volume relationships for both types of ganglia neurons obeyed the allometry formula. The allometry coefficient (ratio of logarithms of cytoplasmic and nuclear volumes) was found to be similar in the neurons of both ganglia, its value corresponding to 1.38–1.43.     

Cytophotometric and morphometric studies of postnatal rat hippocampal neurons and perineuronal gliocytes after electroconvulsive shock

Electroconvulsive shock was evoked by transcorneal electric current (50 Hz, 50 mA; 3 times by 0.2s with 10-min pauses) in 10-day and 20-day old rats. 2 hours after the end of the convulsions, the total cytoplasmic RNA and protein content per cell in CA3 hippocampal neurons has been shown cytospectrophotometrically to increase markedly in 10-day old rats without statistically significant changes in 20-day old animals. No changes in the RNA and protein content were found in perineuronal neuroglia cells in the CA3 hippocampus in both age groups of rats. Morphometric determinations revealed a pronounced augmentation of volumes of the hippocampal neuronal bodies, nuclei, and cytoplasm as well as of nucleo-cytoplasmic ratio in 10-day old rats under effect of electroconvulsive shock. In 20-day old rats, the shock led to less marked increase in volumes of the hippocampal neurons, with no changes in nucleo-cytoplasmic ratio.