Benign Tumours of Nasopharynx—Revisited

Benign tumours of nasopharynx are extremely rare; seen predominantly in children and young adults. Patients usually present with seemingly innocuous symptoms and an error in judgement can be catastrophic. This is a retrospective analysis of patients diagnosed to have benign tumours of nasopharynx by histopathological examination in our tertiary care referral centre. The period of study is from September 2009 to August 2010. Eight patients with complete clinical data were identified and included in the study. All the patients were males with a mean age of 21.37 years (range 10–43). Following surgical excision patients were followed up for a mean period of 6.5 months (range 3–14). The Clinical profile, investigation modalities, treatment options are being analysed here.     

Confrontation naming and semantic relatedness judgements in Spanish/English bilinguals

Background: The results of many current studies on naming in bilingualism have provided converging evidence for a semantic representation common to both languages within a bilingual individual. However, the interaction between lexical access and semantic representation in bilinguals is relatively unclear. Aims: To further understand this relationship in normal bilingual individuals, we asked the following questions: (1) Is there homogeneity in naming accuracy for both languages across subjects? We predicted that naming accuracy would differ across subjects based on their proficiency levels in each language. (2) After separating subjects into groups based on their proficiency levels (balanced, Spanish dominant, English dominant), is there a difference in their mean ratings of the semantic similarity of word pairs across proficiency groups? According to the mixed model (De Groot, Dannenburg, & van Hell, 1994), it was predicted that similar mean ratings would be observed across all groups. Methods & Procedures: A total of 23 Spanish/English bilinguals (average age = 35.5 years) completed a confrontation naming task and a semantic relatedness questionnaire in both languages. The same set of stimuli, controlled for various factors, was used for each task in both languages and counterbalanced by language across two sessions. Based on naming performances, participants were assigned to the balanced bilingual (N = 10), English dominant (N = 10), or Spanish dominant (N = 3) group (Kohnert, Hernandez, & Bates, 1998). Outcomes & Results: Overall English mean correct was 94.29%; Spanish was 88.19%. Significant differences in naming were seen between groups, F(2, 85) = 4.3, p =. 01, and within the language dominant groups across subjects (p <. 05) and items (p <. 05). On the semantic relatedness task, no significant difference was observed between the ratings of word pairs in each language across participants or items in any group. Conclusions: Despite differences in lexical access, participants in all proficiency groups rated word pairs similarly, indicating a shared semantic representation for both languages. The mixed model (de Groot et al., 1994) can explain the findings for all groups. Results of this study have clinical implications for bilingual aphasic patients. It is imperative to ascertain a patient's pre‐morbid language use prior to brain damage in order to gauge pre‐morbid proficiencies. Treatment should consider proficiency levels in both languages, with consideration that the strength of connections between each lexicon and from each lexicon to semantic memory may differ.     

Platelet Functions in Cardiopulmonary Bypass Surgery

Background

Haemorrhage after Cardio Pulmonary Bypass (CPB) Surgery is a well recognised complication that leads to significant morbidity and mortality. The incidence varies between 5-25% depending upon the clinical situation. Several factors are implicated as causative but none have been precisely proved.

Methods

Our study was an attempt to evaluate the haemostatic defect with particular reference to platelet function abnormalities during cardio pulmonary bypass surgery, in order to reduce the morbidity and mortality associated with post CPB haemorrhage. Flow cytometric evaluation of different platelet glycoproteins like GPIb/IX, GPIIb/IIIa and GMP-140 was done.

Results

The marker expression showed deregulation during surgery which returned to base after bypass was terminated. In contrast, the cases with bleeding showed significant variation. P-Selectin (GMP 140) expression decreased progressively till 3^rd post-operative day showing lack of activation of platelets in cases of severe bleeding.

Conclusion

Longer duration of CPB initiates plasmin generation through heparin, which raises the PAI-1-tPA complex and thereby down regulating the functions of platelets. This suggests a link between duration of CPB, bleeding, platelet dysfunction and fibrinolysis. Hence serial estimations of the levels of GMP-140 and tPA can predict severe bleeding.Key Words: CardioPulmonary Bypass, Platelet dysfunction, flowcytometry, platelet glycoproteins, haemorrhage     

Intracranial Ewing sarcoma

The occurrence of primary extraosseous Ewing sarcoma (EES) of the central nervous system (CNS) has only rarely been reported in the literature. It is important to distinguish this entity from the more common central primitive neuroectodermal tumor (PNET) of brain, since the management of these tumors is different from that of EES. We present the clinical, radiologic, and pathologic features of two cases of EES occurring in the brain. The diagnosis was further confirmed by detection of a rearrangement of the FLI1 and/or EWS gene loci in tumors from both patients using fluorescent in situ hybridization (FISH). Although rare, the possibility of EES should be considered particularly when tumors that arise near the meningeal surface of the brain and have the pathologic appearance of a PNET. Demonstration of t(11;22)(q24;q12) by molecular analysis essentially confirms the diagnosis and enables the oncologist to choose appropriate therapy.     

Krabbe disease treated with hematopoietic stem cell transplantation: serial assessment of anisotropy measurements--initial experience

PURPOSE: To prospectively compare diffusion-tensor magnetic resonance (MR) imaging anisotropy measurements of white matter (WM) regions in early and late treatment groups of Krabbe disease patients treated with stem cell transplantation. MATERIALS AND METHODS: The study was approved by the Institutional Review Board and was compliant with Health Insurance Portability and Accountability Act; informed consent was obtained from the families of all patients. Patients with early-onset Krabbe disease (four girls and three boys) underwent diffusion-tensor MR imaging before and after stem cell transplantation. Fractional anisotropy (FA) values from serial studies were compared in patients who underwent transplantation at less than 1 month (early group, two girls and one boy) and those who underwent transplantation at 5-8 months (late group, two girls and two boys). FA values were measured in the genu and splenium of the corpus callosum, the frontal WM, and the internal capsule; were compared with those of five age-matched children in the comparison group (normal MR images and no proved neurologic disease); and were expressed as a ratio. Images obtained after transplantation were evaluated at approximately 1 (n = 7), 2 (n = 6), 3 (n = 1), and 4 (n = 1) years. RESULTS: Before transplantation, mean FA ratios in the early group for all four WM regions ranged between 97% and 117%. At 1 year, mean FA ratios at all locations were either 92% or 93%. At 2 years after transplantation, mean FA ratios were between 83% and 92%. In one patient imaged at 3 years, the mean FA ratio was 97%; in another patient imaged at 4 years, the mean FA ratio was 77%. Before transplantation, mean FA ratios in the late group ranged between 55% and 74%. Mean FA ratios were between 37% and 50% at 1 year after transplantation and between 36% and 39% at 2 years. CONCLUSION: All patients had decreases in FA ratios over time. The early group had higher initial FA ratios and lower subsequent decreases, which may indicate amelioration of the dysmyelinating process.     

Resistance of Mycobacterium tuberculosis to the first line anti tubercular drugs--a twenty year review

Tuberculosis and more so the multi drug resistant variety has been thrust into the forefront as a serious and life threatening illness in recent years. The advent of AIDS contributes to this substantially, especially in the developed world where it had become practically non- existent. We reviewed our data over the past 20 years with a view to determine when drug resistance began to manifest in the strains.     

Stage IV Primitive-Appearing Sinus and Orbital Rhabdomyosarcoma Presenting in a 68-year-old Female Previously Treated for Breast Cancer

A 68-year-old female who had undergone treatment several years previously for breast cancer presented with diplopia and unilateral proptosis and exposure keratopathy related to biopsy-proven rhabdomyosarcoma of the sinus and orbit. Further evaluation revealed multiple metastatic lesions felt to have originated from the primary sinus and orbital tumor. Histopathologic examination showed primitive-appearing rhabdomyosarcoma with some features suggestive of the alveolar subtype. Orbital or sinus rhabdomyosarcoma is seen almost exclusively in the pediatric population, but may very rarely occur in adults. There are several genetic mutations that appear to play a role in both rhabdomyosarcoma and certain breast tumors. There is also increasing evidence that even low doses of radiation may contribute to the future development of cancer, particularly in susceptible individuals. In our patient with atypical demographics for rhabdomyosarcoma, the previous neoplasm and treatment thereof may have predisposed to the development of this rare tumor.     

Social cognitive variables as correlates of physical activity in persons with multiple sclerosis: findings from a longitudinal, observational study

There is a lack of data regarding the associations among changes in social cognitive variables and physical activity over time in persons with multiple sclerosis (MS). To that end, the current study adopted a panel design and analysis for examining hypothesized relationships among changes in social cognitive variables and physical activity over time in persons with MS, and this is necessary for designing effective behavioral interventions. On two occasions separated by an 18-month period, persons (N = 218) with relapsing-remitting MS (RRMS), who were initially recruited by telephone for a cross-sectional study, completed a battery of questionnaires that assessed social cognitive variables and physical activity. Those study materials were delivered and returned via the United State Postal Service. The 18-month changes in self-efficacy (path coefficient = .25, p < .01) and goal setting (path coefficient = .26, p < .01) had direct effects on residual change in physical activity. The change in self-efficacy further had an indirect effect on residual change in physical activity that was accounted for by change in goal setting (path coefficient = .05, p < .05). This longitudinal study suggests that self-efficacy and goal setting represent plausible targets for changing physical activity behavior in persons with RRMS.     

Mechanistic basis for the chemopreventive effects of black raspberries at a late stage of rat esophageal carcinogenesis

The present study used a postinitiation protocol to investigate molecular mechanisms by which black raspberries (BRBs) influence the late stages of N-nitrosomethylbenzylamine (NMBA)-induced esophageal tumorigenesis in rats. F344 rats were injected with NMBA and then fed either control diet or a diet containing 5% BRB powder. Control rats were injected with DMSO/water (20:80), the vehicle for NMBA. Esophagi from control, NMBA- and NMBA?+?BRB-treated rats were collected at 35 wk for histopathological, molecular, and immunohistochemical analyses. Treatment with 5% BRBs reduced the number of dysplastic lesions and the number and size of esophageal papillomas in NMBA-treated rats. When compared to esophagi from control rats, NMBA treatment led to the differential expression of 4807 genes in preneoplastic esophagus (PE) and 17?846 genes in esophageal papillomas. Dietary BRBs modulated 626 of the 4807 differentially expressed genes in PE and 625 of the 17?846 differentially expressed genes in esophageal papillomas towards normal levels of expression. In both PE and in papillomas, BRBs modulated the mRNA expression of genes associated with carbohydrate and lipid metabolism, cell proliferation and death, and inflammation. In these same tissues, BRBs modulated the expression of proteins associated with proliferation, apoptosis, inflammation, angiogenesis, and both cyclooxygenase and lipoxygenase pathways of arachidonic acid metabolism. Interestingly, matrix metalloproteinases involved in tissue invasion and metastasis, and proteins associated with cell-cell adhesion, were also modulated by BRBs. This is the first report of the effects of berries on the expression of genes associated with the late stages of rat esophageal carcinogenesis.