Variability in the proliferative potential of human gliomas

One hundred forty-three patients with gliomas of astrocytic origin (61 with glioblastomas multiforme (GM) and 82 with astrocytomas) received an intravenous infusion of bromodeoxyuridine (BUdR), 150–200 mg/m² at the time of surgery, to label tumor cells undergoing DNA synthesis. BUdR-labeled cells were identified by the indirect immunoperoxidase method using anti-BUdR monoclonal antibodies. The percentage of BUdR-labeled cells, or BUdR labeling index (LI), was calculated by microscopic examination of selected viable areas of the tissue sections. The GMs had a median LI of 7.5%, and three quarters of these tumors had LIs greater than 5%. Highly anaplastic astrocytomas (HAAs) and moderately anaplastic astrocytomas (MoAAs) had median Lls of 2.3% and less than 1%, respectively. Among the HAAs, the Ll was 1% to 5% in 56% of tumors, greater than 5% in 26%, and less than 1% in 18%. More than 60% of MoAAs had LIs less than 1%, which agrees with the slow clinical progression of this type of tumor, and the remainder had LIs of 1.4% to 9.3%. These results show that histopathologically similar tumors may have different proliferative potentials. Measuring the proliferative potential of individual gliomas is therefore crucial for predicting the prognosis more accurately and for devising more tumor-specific treatment regimens for individual patients.     

An unusual complication of the pectoralis major myocutaneous flap

The development of myocutaneous flaps has been a major advance in reconstructive surgery of the head and neck. The pectoralis major myocutaneous flap has proven to be the most reliable and versatile for use in this area. There have been several reports of its advantages with few complications noted. This article reports two patients who developed osteomyelitis of the rib in the donor area of the pectoralis major myocutaneous flap. The etiology of this potentially serious complication is discussed and the management is outlined.     

Orphan airlift. Enteric pathogens isolated from Vietnamese children immigrating to the United States.

Isolation studies for bacterial and parasitic agents were carried out on stool specimens from Vietnamese infants at the time of their mass airlift to the United States. One or more bacterial pathogens were found in 49% of the 367 stool specimens cultured. The isolates included enteropathogenic Escherichia coli (161), Shigella (16), Salmonella (15), but no Salmonella typhi or Vibrio cholerae. Parasites identified in 88 stool specimens included Giardia lamblia (10), Ascaris lumbricoides (7), and Entamoeba histolytica (1). Transmission of agents to volunteers probably occurred, because 48% of 272 adults questioned had diarrhea shortly after caring for the children, and stool cultures from these adults resulted in the isolation of E coli (105), Salmonella (1), and Shigella (3).     

Tooth contacts and stability before and after occlusal adjustment.

A study was undertaken to analyze the possible relationship between the number and type of tooth contacts before, immediately after and 16 weeks after occlusal adjustment and their influence upon occlusal stability. The data collected from 10 adult subjects who required an occlusal adjustment indicated the following: 1. Six of the ten subjects had no clinically perceptible "slide from centric relation" 6 weeks after occlusal adjustment, and the number of teeth and number of contacts were virtually the same immediately after 6 weeks after occlusal adjustment. 2. The remaining four subjects, whose occlusions had relapsed after adjustment, had one dental arch that included a missing tooth. It would seem that dental arches interrupted with extraction spaces do not remain stable with occlusal adjustment alone. 3. The type of tooth contacts that are the most stable are those of a cup against a flat plane (e.g., bottom of a fossa or marginal ridge) or those of a combination of a cup against a flat plane and one or more inclined planes.     

Risk factors for HIV-1 infection in a British population: lessons from a London sexually transmitted diseases clinic

Between September 1985 and June 1988, 6923 people (4550 men and 2373 women) were tested for HIV-1 antibodies at a sexually transmitted disease clinic, London, UK. Of the 6923 individuals tested, 558 (8%) were seropositive, of whom 523 (94%) were men and 35 (6%) women. Of the seropositives, 84% were homosexual or bisexual men, 5% were intravenous drug users, 4% were heterosexual contacts of HIV seropositives, 4% had multiple risk factors, 2% were heterosexual contacts of central African partners and 1% were heterosexuals with no other risk factors. This prevalence pattern conforms to that observed in other industrialized nations. For the women, heterosexual intercourse with an HIV-infected partner, intravenous drug use and heterosexual contact with a partner from central Africa were the main risk factors for infection. The important risk factors among the men were heterosexual contact with an HIV-seropositive partner, being homosexual or bisexual, intravenous drug use and heterosexual contact with a resident from central Africa. heterosexual and homosexual transmission were implicated as the main routes for viral spread in this British population.     

Histoplasmosis of the larynx

Granulomatous diseases caused by infectious agents are being seen more frequently than before. Infection with Histoplasma capsulatum is one such granulomatous disease. This condition may have protean manifestations, with involvement of the larynx of particular interest to the Otolaryngologist. Histoplasmosis of the larynx may present difficult diagnostic problems and may closely mimic carcinoma. A case of histoplasmosis of the larynx treated at the University of Cincinnati Medical Center is presented and used to highlight the mode of presentation and the management of this particular disease. The clinical presentation of histoplasmosis is discussed with emphasis on involvement of the upper aerodigestive tract. The diagnostic tests of practical value are outlined. Amphotericin B is the treatment for this disease entity.