Bilateral transplantation of allogenic adult human bone marrow-derived mesenchymal stem cells into the subventricular zone of Parkinson's disease: a pilot clinical study.

The progress of PD and its related disorders cannot be prevented with the medications available. In this study, we recruited 8 PD and 4 PD plus patients between 5 to 15 years after diagnosis. All patients received BM-MSCs bilaterally into the SVZ and were followed up for 12 months. PD patients after therapy reported a mean improvement of 17.92% during "on" and 31.21% during "off" period on the UPDRS scoring system. None of the patients increased their medication during the follow-up period. Subjectively, the patients reported clarity in speech, reduction in tremors, rigidity, and freezing attacks. The results correlated with the duration of the disease. Those patients transplanted in the early stages of the disease (less than 5 years) showed more improvement and no further disease progression than the later stages (11-15 years). However, the PD plus patients did not show any change in their clinical status after stem cell transplantation. This study demonstrates the safety of adult allogenic human BM-MSCs transplanted into the SVZ of the brain and its efficacy in early-stage PD patients.

Primary osteogenic sarcoma of the tongue.

A 56-year-old man presented with the difficulty of swallowing and respiratory distress due to a large tumour arising from the tongue and occupying the entire oral cavity. Histological examination revealed it to be an extraskeletal osteogenic sarcoma. The tumour was excised. After six weeks, he came back with massive local recurrence and bleeding from the tumour, but died despite chemotherapy. Review of the literature revealed only four other such cases of this rare tumour. A brief review of these four cases is also made.

Orbital malignancy in Papua New Guinea: a 21 year review.

BACKGROUND: Information about orbital malignancies in Papua New Guinea (PNG) is limited to reports published 20 years ago. The present retrospective study was performed to establish the pattern of malignant orbital lesions occurring in PNG and to see whether the pattern is any different from that reported in the earlier series and in other countries. Papua New Guinea is special in that it has a large and relatively homogenous population unaffected,to a large extent, by contact with the'outside world'. METHODS: The records of 176 proven cases of orbital malignancy treated between 1975 and 1996 were studied with respect to type of tumour, age, gender; mode of presentation and, where possible, treatment and its outcome. RESULTS: Orbital tumours were found to be uncommon relative to other malignancies. The most common orbital tumour encountered in the present study was orbital extension of retinoblastoma (40.3%). These tumours were all unilateral and were associated with a very high mortality. No bilateral or familial cases were seen. Squamous cell carcinomas were the second most common tumours (25.6%) and were seen in young adults (average age 36.6 years). Basal cell carcinomas (9.1%) occurred later (average age 54 years) and were more common in the lighter-skinned Southern Highlanders and expatriates. The other malignancies seen included lacrimal gland tumours (3.4%), malignant melanomas (4.5%), lymphomas (3.4%), rhabdomyosarcomas (1.7%), meibomian cell carcinomas (1.7%) and soft tissue sarcomas. CONCLUSIONS: Most patients presented late and the mortality rate was high. This could also reflect the relative paucity of ophthalmic and oncological services in the country as well as psychosocial attitudes to disease. Many patients live far from medical services and may be treated by traditional healers before coming to a hospital.

Malignant tumours of the nasal cavity and the paranasal sinuses in a Melanesian population.

Malignant tumours of the nasal cavity and paranasal sinuses are usually associated with poor prognosis. From 1986 to 1995, 50 such tumours were managed in Papua New Guinea. Twenty-nine of these arose in the maxillary sinus, 15 in the nasal cavity, four in the ethmoid sinus and two in the frontal sinus. Males were more frequently affected than females. No specific carcinogenic factor was apparent in these patients who were uniformly distributed all over the country. Advanced local disease with multiple symptoms and signs was common during presentation. Systemic and neck node metastases were infrequent. Histopathologically, squamous cell carcinoma was the commonest type of tumour. Satisfactory results were obtained by combination therapy consisting of surgery, irradiation, and systemic chemotherapeutics agents. Better health consciousness and health care delivery system are essential for early diagnosis, regular posttreatment follow-up and improved survival of these patients.

A study of the correlation of prostatic pathology and serum prostate-specific antigen (PSA) levels: a perspective from Papua New Guinea.

A review of serum prostate-specific antigen (PSA) values from January 1994 to May 1997 and their correlation with the histopathology of prostate specimens was carried out in the Department of Pathology, Port Moresby General Hospital. The study has shown that this biochemical investigation has not been properly used for the maximum benefit of the patient population. Remedial measures are suggested to improve the sensitivity and specificity of PSA in a setting with limited resources.

Intracranial juvenile nasopharyngeal angiofibroma.

Eight cases of intracranial extensions of juvenile nasopharyngeal angiofibromas (JNA) are presented. These form 33% of the cases of JNA treated during a 5-year period (1988-93). A high incidence of visual complications in this stage of tumour is observed and the basis of this is discussed. Death results from serious complications of severe haemorrhage and cerebro-spinal fluid leak. The intradural intracranial extensions of the tumour warrant careful approach in terms of surgery, because of their greater risk for complications during the dissection.

Sclerosing stromal tumour of the ovary.

Two cases of sclerosing stromal tumour of the ovary in young Melanesian females are described and the differential diagnosis is discussed. Sclerosing stromal tumour of the ovary is a rare benign tumour of ovarian stromal origin which is associated with endocrine activity in a few cases. One of the patients presented with signs of precocious puberty and the tumour in this patient was considered as a functioning lesion.

Basics of molecular biology and its applications: I. Molecular biology in medicine: basic concepts.

Medicine has, in recent years, incorporated wave after wave of new scientific discoveries and technologies. Molecular medicine is one of these technologies and shows a dramatic example of the impact of advances in basic science. Advances in molecular biology have revolutionized daily clinical practice, particularly in developed countries, such that practitioners who received their medical education decades ago now need to adapt to this new discipline. While molecular medicine may not be a priority health issue in developing countries such as Papua New Guinea, it is equally important to ensure that the basic principles of knowledge and understanding of what goes on in that field form part of today's teaching of all practitioners of medicine and allied health workers. The three papers in this series aim to present molecular biology and its medical applications in as simple and lucid a manner as possible so that its scientific basis and principles as well as its potential for diagnosis and management of diseases are well appreciated.

Hydrometrocolpos and segmental colonic dilatation in a girl with megacystis-microcolon-intestinal hypoperistalsis syndrome.

OBJECTIVE: To report a case of a newborn female infant noted to have features of the megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) with the additional features of hydrometrocolpos and segmental colonic dilatation and review the literature. METHODOLOGY: The details of the case were collated and compared with the previous published experience with this condition. RESULTS: Thus far there have been 58 previous cases of MMIHS described, only four of which have had colonic dilatation. A number of concurrent anomalies have been described, but not the hydrometrocolpos or dysmorphic features seen in this patient. CONCLUSION: This case appears to be MMIHS with additional features not previously recorded.

Liver disease in Papua New Guinea 1981 to 1988, twenty years after the first surveys were done.

Twenty years after the first surveys of liver disease were done cirrhosis and hepatocellular carcinoma were still found to be the most important liver diseases in Papua New Guinea. Hepatitis B virus appears to be the main cause of both these conditions. Data from a number of different sources suggest a prevalence of hepatitis B positivity of about 17%. The most significant new finding was grade 3 iron deposition in 8 patients. This raises the question as to whether iron storage disease may now contribute to the spectrum of liver disease in Papua New Guinea. Many biopsies in the 1960s and 1980s were interpreted as nonspecific hepatitis; in the light of recent observations, at least some of these may have been due to hepatitis C infection.

The spectrum of cancer in Papua New Guinea. An analysis based on the Cancer Registry 1979-1988.

Malignant tumors registered with the Tumour Registry of Papua New Guinea (PNG) from 1958-1988 were analyzed with emphasis on the variation of incidence with time and different regions. Cancer incidence was generally low in PNG. During this period, carcinoma of oral cavity, cervix, breast, and skin, hepatoma, and lymphoma were the most common types of malignant lesions detected. The incidence of carcinoma of the oral cavity has increased. Currently, it is more common in the Highlands region and is associated with the spread of betel nut chewing. A threefold increase in cervical carcinoma registration was observed nationally, with a sixfold increase in the Highlands region; this was attributed both to social changes and improved registration. The incidence of breast cancer has doubled, in keeping with better registration, but there is little interregional variation. The decline in registrations of hepatocellular carcinoma is artifactual. PNG is a high-incidence area for Burkitt lymphoma, but Hodgkin disease is rare. Both Burkitt and other non-Hodgkin lymphomas are uncommon in the Highlands. A decline in the incidence of squamous carcinoma of skin was observed that was associated with improved control of tropical ulcers. The incidence of stomach cancer is falling. The registered cancer incidence in PNG is low, even when compared with that in native people from other Pacific nations, such as Fijians and New Caledonian Melanesians. Preventive measures have been hitherto ineffective, with the exception of squamous carcinoma of skin.

Benign breast disease in Papua New Guinea.

In this study 302 biopsy-confirmed benign breast lesions in Papua New Guinean (Melanesian) women during a ten-year period were reviewed. Inflammatory breast disease was the most frequent type. Chronic mastitis, chronic suppurative mastitis and abscesses formed 32% of benign breast lesions and 71% of the group of mastitides. 10 cases of tuberculous mastitis were recorded. Fibrocystic disease was observed at a lower age (31.9 +/- 8.2 years) than has been reported from Black United States and West Indian populations. The high frequency of mastitis is an important finding. This is most likely to be associated with lactation. Proper hygiene during breastfeeding and the judicious use of antibiotics should reduce this high frequency. Education of women about these matters should form part of health education programs in Papua New Guinea.

A rare case of endodermal sinus tumour of the vagina in an infant.

A rare case of endodermal sinus tumour (EST) of the vagina in a 1 year 5 months old Papua New Guinean female is described and the literature on vaginal ESTs in childhood is briefly reviewed.

Nasal cartilaginous tumour.

A cartilaginous tumour of nasal region in a 6-year-old child is described. The problems of histological interpretation and treatment are discussed.

Comparative in situ hybridisation study of juvenile laryngeal papillomatosis in Papua New Guinea and Australia.

A comparative study of cases of juvenile laryngeal papillomatosis from Papua New Guinea (n = 3) and Brisbane, Australia (n = 9) was carried out. In situ hybridisation reactions for human papillomavirus (HPV) types 6 and 11 occurred in 11 cases. All three cases from Papua New Guinea and eight from Australia gave positive signals. A negative reaction was observed in one Australian case. The intensity of the reaction was strong in seven cases, moderate in one, and weak in three. An equivocal reaction was also noted with probes for types 16 and 18, and types 31, 33, and 35 in two cases from Australia and one from Papua New Guinea. It is concluded that as similar staining patterns and intensities occurred in cases from both areas, the aetiology is the same. The equivocal reactions noted in three cases were probably due to cross hybridisation rather than multiple infection.

Tumoral calcinosis: a study of cases from Papua New Guinea.

Forty-eight cases of tumoral calcinosis were recorded in surgical pathology material, Port Moresby General Hospital, Papua New Guinea during the period from 1981 to 1985. The lesions were most common in the fifth decade of life and the female to male ratio was 2:1. The hip region and the greater trochanter were the common sites involved and this observation supports the possible aetiological relationship of tumoral calcinosis to trauma resulting in pressure ischaemia. In this series, from a country in which the condition is well known, only 35.8% were correctly diagnosed preoperatively. With a knowledge of its clinicopathological features, it should be possible for most cases to be diagnosed preoperatively.