Peripheral and central giant cell granulomas of the jaws: a demographic study

OBJECTIVE: This study aimed to assess the demographic characteristics of peripheral giant cell granulomas (PGCGs) and central giant cell granulomas (CGCGs) in patients treated at our centers. STUDY DESIGN: This 12-year retrospective study was based on existing data. Files of patients from 1993-2004 with a definite diagnosis of PGCGs and CGCGs from the oral pathology departments of our universities were assessed. Information regarding age distribution, gender, the jaw involved, the presenting area of the lesion, surgical treatment, and recurrence was documented. RESULTS: During the study period, 204 patients with CGCGs were treated. The patients with CGCGs varied in age from 5 to 72 years, and the mean age patients was 23.72 years. Among these, 127 cases (62.87%) occurred in the second and third decades of life. One hundred thirty cases (63.75%) occurred in females and 74 (36.25%) in males. Ninety cases (44.1%) presented in posterior parts of the jaws. One hundred forty-four cases (70.58%) appeared in the mandible. Peripheral GCGs presented in 575 patients, who varied in age from 2 to 85 years with a mean age of 31.02 years. Among these, 297 cases (51.65%) occurred in females and 278 (48.34%) in males. Four hundred sixty-seven cases (81.2%) occurred in the first five decades of life, and 352 cases (61.21%) appeared in the mandible. CONCLUSIONS: Giant cell granulomas comprised 9.29% of oral lesions. Peripheral GCG lesions occurred more than 2 times more frequently than CGCGs. Central GCGs occurred about 2 times more frequently in females, whereas PGCGs had an equal prevalence in both genders (P < .05). The mean age for patients with CGCGs was less than patients with PGCGs (P < .05). Central GCGs involved the mandible approximately 2 times more frequently than the maxilla (P < .05). However, when presenting in the maxilla, CGCGs most frequently presented in the area anterior to the canines (P < .05). Peripheral GCGs involved the mandible approximately 1.5 times more frequently than the maxilla (P < .05). Thorough curettage was the main treatment modality used. There were 9 cases (4.41%) of recurrence of CGCGs and 8 cases (1.39%) of recurrence of PGCGs documented during the follow-up period (ranging from 1-12 years).     

INVESTIGATION OF BREAST LUMPS: AN EVALUATION

70 patients with 72 palpable breast lumps were assessed by Physical Examination (PE), Mammography (MG), Ultrasound Scan (USS) and Fine Needle Aspiration Cytology (FNAC). The individual and collective value of these investigations have been assessed and a cost effective algorithm suggested.KEY WORDS: FNAC, Mammography, Palpable breast lump, Physical examination     

The effects of preterm birth on visual development

Children born very preterm are at a greater risk of abnormal visual and neurological development when compared to children born at full term. Preterm birth is associated with retinopathy of prematurity (a proliferative retinal vascular disease) and can also affect the development of brain structures associated with post‐retinal processing of visual information. Visual deficits common in children born preterm, such as reduced visual acuity, strabismus, abnormal stereopsis and refractive error, are likely to be detected through childhood vision screening programs, ophthalmological follow‐up or optometric care. However, routine screening may not detect other vision problems, such as reduced visual fields, impaired contrast sensitivity and deficits in cortical visual processing, that may occur in children born preterm. For example, visual functions associated with the dorsal visual processing stream, such as global motion perception and visuomotor integration, may be impaired by preterm birth. These impairments can continue into adolescence and adulthood and may contribute to the difficulties in learning (particularly reading and mathematics), attention, behaviour and cognition that some children born preterm experience. Improvements in understanding the mechanisms by which preterm birth affects vision will inform future screening and interventions for children born preterm.     

HORMONAL MARKERS IN THE STUDY OF PITUITARY ADENOMAS

Twenty pituitary adenomas were studied using light microscopy, immunohistochemistry and electron microscopy. Based on clinical manifestations of hormonal hypersecretion they were divided into two groups, i.e. group-I (12 patients) with no endocrine dysfunction and group-II (8 patients) with endocrine dysfunction. Group-I could be further sub-divided into two groups based on IHC : group LA in which no hormone could be localised in the tissue (null cell adenomas) and group IB where hormones could be localised in the tissue (1). Tumours in group II, with light microscopy, were acidophil (n=5), basophil (n=1) or mixed (n=2) adenomas. Eight of these 20 cases were plurihormonal. Growth hormone, and prolactin were the commonest combination. This study has helped in the reclassification of the pituitary adenomas according to the hormone they produce.KEY WORDS: Pituitary neoplasms, Diagnosis, Immunohistochemistry, Electron microscopy     

Cervical neural foramina: correlative anatomic and MR imaging study

Accurate diagnosis of diseases affecting the cervical neural foramina with magnetic resonance (MR) imaging requires an appreciation of the normal anatomic appearance of the foramen. The MR appearance of the foramen was studied in cadavers and healthy volunteers and was correlated with cadaver cryomicrotome sections. With gradient-echo techniques, foraminal soft tissues are highlighted relative to adjacent bone, making gradient-echo images valuable for evaluating the overall size and contents of the neural foramina. Intravenously administered gadolinium DTPA produces enhancement of all foraminal soft tissues, including the dorsal root ganglion. The nerve roots do not enhance with Gd-DTPA. Gradient-echo pulse sequences and intravenous use of Gd-DTPA represent promising techniques for the evaluation of the cervical foramina.