Lymphangitis carcinomatosa complicating primary malignant peritoneal mesothelioma.

A patient with malignant peritoneal mesothelioma and a diffuse pulmonary infiltrate is described. Computed tomographic scanning suggested lymphangitis carcinomatosa. This was confirmed on transbronchial biopsy to be due to metastatic mesothelioma.     

Lipid profile studies in inner ear dysfunction

In the present paper fifty patients with symptoms of inner ear dysfunction, primarily deafness, vertigo or both, were subjected to a detailed history, pure tone audiometry and caloric tests. A detailed serum lipid analysis was done of all the patients. It was concluded that atherosclerotic disease of the labyrinthine vessels usually affects patients above forty years of age. It occurs bilaterally. Commonly both the cochlear and vestibular components are involved. Raised serum total cholesterol, L.D.L. cholesterol levels and hypertension, are more contributory as risk factors in its development.     

Measurement of capillary filtration coefficient in a solid tumor

The net transvascular filtration rate, JF (ml/min/100 g), in an isolated, RBC-free perfused R3230AC mammary adenocarcinoma tumor was measured using a gravimetric method whereby changes in tissue weight over time were monitored. From the gravimetric measurements of JF following changes in venous pressure, the capillary filtration coefficient (ml/min/mm Hg/100 g) was found to be 2.2 (range, 0.8-2.8), i.e., 10 to 1000 times higher than those found in several normal tissues and within the range of those reported for glomerular capillaries. These measurements of capillary filtration coefficient are consistent with elevated tumor interstitial fluid pressure, interstitial fluid flow, and peritumor edema.     

Corpectomy for multi-level cervical spondylosis and ossification of the posterior longitudinal ligament

The choice of a surgical approach for multi-level cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) is still a controversial issue. While most of the surgeons are still performing decompression by laminectomy some are doing multi-level anterior decompression. Few neurosurgeons are performing decompression by corpectomy. We have treated 26 patients by median cervical corpectomy during the last 4 years. These patients were followed up for a mean period of 25 months. Twenty one (80%) patients had a good outcome, 2 patients remained unchanged and 3 expired. Review of the literature and our experience indicates that patients with CSM and OPLL should be operated by median cervical corpectomy (anterior approach).     

Insulin dependent diabetes in children

We present our experience with twenty children with insulin dependent diabetes mellitus admitted during the past 2 1/2 years. Sixteen patients were admited with acute onset of ketoacidosis while four were having gradual onset. Active and symptomatic treatment was started in all diabetic ketoacidotic patients. One patient died during the acute stage. Eleven patients were followed for 3–6 months or more. Glycosylated hemoglobin was considered as a criteria for control. Three had good control, two fair and six poor control; six developed diabetic ketoacidosis and three developed hypoglycemia     

Non-familial juvenile polyposis with histological evidence of adenomatous transformation.

A 14-year-old male presented with abdominal pain, diarrhoea and a sensation of something prolapsing through the anus during defecation, and was found to have diffuse colonic polyposis. There was no evidence of mucocutaneous hyperpigmentation and family history was negative, suggesting a diagnosis of non-familial juvenile polyposis. Histological analysis of multiple endoscopic biopsies showed features typical of juvenile or retention type (hamartomatous) lesions: dilated cystic glands lined by mucocus-secreting epithelium and prominent, inflamed and congested lamina propria. However, admixed with these features, focal areas of atypical adenomatous changes were recognized. Even the intervening normal-looking colonic mucosa showed some dysplastic changes. These findings indicate that hamartomatous and atypical adenomatous epithelial changes can co exist in non-familial juvenile polyposis and the latter may confer a risk of malignant transformation in this otherwise non-neoplastic disease.