Comparison of ThinPrep versus conventional smear cytopreparatory techniques for fine-needle aspiration specimens of head and neck masses.

OBJECTIVES: Diagnostic accuracy of the ThinPrep process (Cytyc, Boxborough, MA) was compared with that of conventional (smear) cytopreparation for fine-needle aspiration (FNA) of head and neck masses. METHODS: In a prospective, randomized, single-blinded study, 209 patients served as their own controls and underwent 236 FNAs using ThinPrep and conventional (smear) cytopreparatory techniques. RESULTS: ThinPrep produced less air-drying artifact and less mechanical distortion than the conventional method. The conventional technique was diagnostic in 63% of samples; the ThinPrep technique was diagnostic in 55% of samples. When all results were combined, pathologists subjectively preferred the conventional technique but accepted use of ThinPrep as the only cytopreparatory technique for most head and neck masses. CONCLUSIONS: For adequately experienced cytopathologists, ThinPrep is acceptable for FNA of salivary masses, neck cysts, metastatic lymph nodes, and thyroid lesions. Conventional smear technique should be used for FNA of nonmetastatic lymphoid lesions. Use of ThinPrep can complement use of the conventional (smear) cytopreparatory technique when aspirate is nondiagnostic or bloody, when the patient has a blood-borne infectious disease, when the clinician is inexperienced, or when aspirate has entered the syringe.     

Role of levamisole immunotherapy as an adjuvant to radiotherapy in oral cancer. II. Lymphocyte subpopulations

The effect of radiotherapy and adjuvant levamisole immunotherapy on the lymphocyte subpopulations was investigated. Comparisons were made between the groups receiving levamisole, those receiving placebo and normal healthy controls. Results of a thirty-month follow-up are reported. Radiotherapy caused leukopenia and lymphopenia affecting all the subsets (T, B, TG, and TM), T lymphocytes were affected to a greater extent. This study demonstrates that levamisole does hasten the restoration of T lymphocytes, with the TM lymphocytes showing a faster repopulation in comparison to the TG lymphocytes.     

Human papilloma virus infection in Indian nasopharyngeal carcinomas in relation to the histology of tumour

Nasopharyngeal carcinoma (NPC) is a rare malignancy world-wide. It shows an increasing trend in the southern parts of India. Genetic alterations brought about by environmental factors, HPV and EBV are thought to be crucial for NPC carcinogenesis. This study reports for the first time the incidence of HPV infection in NPC in Southern India. Detection of HPV was carried out in 36 NPC and 10 adenoid lesions by immunohistochemical analysis. 38.8% of NPC were positive for HPV with higher positivity in WHO Type I and WHO Type II cancers. One among 10 adenoid lesions also showed presence of HPV. The patients belonged to low socio-economic status and had exposure to either tobacco or alcohol alone or in combination or kitchen smoke.     

Isolated pure lipoma of the uterus--a case report

Lipoma primary to uterus is a rare entity among uterine fatty tumors. These create preoperative diagnostic confusion and their histogenesis is still unclear. Only a few cases of pure lipoma of uterus have been reported in the last few decades. A case of isolated pure lipoma primary to uterus diagnosed postoperatively by pathological examination is presented.     

Association of IL4 gene polymorphisms with asthma in North Indians

BACKGROUND: Asthma is a complex airway disorder, and a number of genetic loci have been found to be associated with asthma. The 5q31-33 region is one of the most important loci linked to asthma and atopic disorders. However, association studies with candidate genes in this region, such as IL4, were inconclusive, as both positive and negative results were obtained in several populations studied. The aim of our case-control study was to determine the association between IL4 and asthma in North Indians. PATIENTS AND METHODS: Polymorphisms in the promoter and a dinucleotide repeat in the 2nd intron in IL4 were genotyped by sequencing and GeneScan analysis, respectively, in ethnically matched, unrelated patients (n = 171) and controls (n = 128), following the guidelines of the American Thoracic Society. RESULTS: The proximal promoter region of the IL4 gene was found to be invariant. Previously reported polymorphisms, -590 C/T and +33 C/T, were found to be absent in our population. The chi2 test using only large expected cell counts (more than 5% of the sample size) showed a significant association between allele size and disease status (chi2 = 38.08, d.f. = 6, p < 0.05). In addition, a significant difference was observed for the allele and genotype frequencies (p < 0.0005 and p = 0.0009, respectively) in the patient and the control groups using the Fisher-Freeman-Halton test. CONCLUSION: Our studies indicate that the promoter of the IL4 gene is invariant in our population. The case-control studies on the CA repeat polymorphism in the 2nd intron of the IL4 gene have shown interesting results and indicate the need for further family-based studies.     

Expression of epidermal growth factor and its receptor in gestational trophoblastic diseases

Gestational trophoblastic diseases (GTD) is an abnormal condition of the placenta, the incidence of which is very high in the State of Kerala, India. Placentae of normal (50) and molar pregnancy (122) including 52 showing persistent disease were used for the study. EGFR and EGF expression was analyzed by immunohistochemistry using monoclonal antibodies. EGF receptors were quantitated using the I-125 EGF-binding assay and that of EGF was quantitated using isotope labelled antibody to EGF. Tumours with histological diagnosis of invasive moles and choriocarcinoma showed very strong binding of both EGF and EGFR. The present observations also suggest the possibility of presence of mutated EGF receptors in persistent trophoblastic disease.     

Comparative study of efficacy and tolerability of flupirtine versus tramadol in non-steroidal anti-inflammatory drug intolerant mechanical low back pain

BackgroundMechanical low back pain (MLBP) is a commonly encountered entity in clinical practice. Pain relief and restoration of functional capacity are management goals.Aims and objectivesTo compare the efficacy and tolerability of flupirtine, a selective neuronal potassium channel-opener (SNEPCO), with tramadol, a widely-used opioid analgesic, in MLBP.MethodsThis randomized, single-blinded, intention to treat (ITT) trial started with 240 non-steroidal anti-inflammatory drug (NSAID) intolerant patients who were prescribed either tablet flupirtine (100 mg twice daily) or capsule tramadol (50 mg twice daily), for 4 weeks. Follow-up was done on days 14, 28 and 4 weeks after treatment completion. Assessment of improvements in Indian Health Assessment Questionnaire Disability Index (Indian HAQ-DI), Visual Analogue Scale (VAS), Numerical Rating Scale (NRS) and measurement of Pain Relief Rate (PRR) were performed. Adverse events were recorded.ResultsOne hundred and seven patients receiving flupirtine and 103 receiving tramadol were analyzed on an ITT basis. Scores in Indian HAQ-DI, VAS and NRS improved significantly in both groups in the last visit, but more so with flupirtine. PRR was reasonably higher with flupirtine, [59 (55.14%)] patients experiencing significant to complete pain relief at the end of the study, compared to tramadol [41 (39.81%)]. Adverse effects were less with flupirtine [26 (24.30%) versus 41 (39.81%), p < 0.05], minimizing drop-outs.ConclusionFlupirtine has better sustained efficacy and tolerability than tramadol in MLBP.