Neuropathy in hepatic disorders. A clinical, electrophysiological and histopathological appraisal.

The present study deals with 30 patients with cirrhosis of the liver and 12 patients with infective hepatitis who were studied clinically, neurophysiologically and histopathologically for the presence of neuropathy. Simultaneously, 13 healthy individuals were evaluated as controls. Clinical evidence of neuropathy was found in 63.3% of the patients with hepatic cirrhosis and in 16.6% of the patients with infective hepatitis. In hepatic cirrhosis, the conduction velocities were abnormal in 33.3% and histopathological demyelination was found in 80% of the patients. In infective hepatitis, on the other hand, altered nerve conduction velocities were found in 41.6% and segmental demyelination in 75% of the patients. Our data reveal that peripheral nerve involvement is seen both in chronic and acute liver disorders. The neuropathy in hepatic cirrhosis is unrelated to diabetes, alchoholism or portacaval shunt and may be due to unknown metabolic abnormality or to toxins. In infective hepatitis, the neuropathy may either be due to some acute metabolic derangement or may be purely viral in origin.

Carotid body tumour. Exicsion with resection of carotid arteries.

A case of carotid body tumour is reported and the salient features of its histopathology have been described. Its excision with resection of the carotid arteries can be safely undertaken if the tumour is of long duration, the angiography shows marked displacement of the carotid arteries and if the blood pressure is maintained during surgery by regulating the blood transfusion and lowering the head end of the patient, thereby preventing fatal brain hypoxia. The fact that it is a potentially malignant and radioresistant tumour, makes its excision with or without ligation of the carotid arteries almost imperative.

Tuberculosis of the tongue.

Involvement of the tongue by Mycobacterium tuberculosis occurs on rare occasions. Two interesting cases of tuberculosis of the tongue are reported and the mode of transfer of Mycobacterium tuberculosis to oral tissues is discussed. The need to consider tuberculosis as an etiological factor in indolent oral lesions is emphasised.

Pathological review of melanotic neuroectodermal tumour of infancy in India.

Melanotic neuroectodermal tumour of infancy (MNETI) is a rare occurrence. Review of literature indicated 14 cases of MNETI encountered in India. The reported cases were observed in infants below one year of age. Males were affected more than the females. Except for one in the orbit, all the lesions were located in the maxilla. Histologically, lesions have been reported to be classical and benign in nature. Morphology of the tumours have been presented and discussed.

Cervical cytologic profile of family planning acceptors aged around thirty years.

PIP: A prospective study is being conducted at the Post Partum Program Unit of the Department of Obstetrics and Gynecology, Banaras Hindu University Hospital, in order to screen the acceptors of various methods of family planning for cervical neoplasia. 100 patients were selected at random provided that the patient was over 28 years old and was herself or her partner using some method of contraception. Besides a detailed clinical history and physical examination, each patient was administered a Papanicolaou smear from both ecto- and endo cervix. IUDs were used by 41% of cases and 56% of cases had had a tubal ligation. 62% of cases had normal cervical cytologic smears, 26% had inflammatory smears, and 11% had dyskaryotic smears (moderate and severe 5.5% each). The detection rate of cervical malignancy was 1%. Three patients were called back and repeat smears confirmed earlier cytologic diagnosis. The authors, therefore, recommend opportunistic screening of women for cervical carcinoma at postpartum clinics. This is likely to contribute significantly toward early detection and treatment of cervical carcinoma, thereby reducing mortality and morbidity among women due to cervical malignancy.^ieng

Primary leiomyosarcoma of the vagina: a study of five cases.

The clinical and light and electron microscopic features of five cases of primary vaginal leiomyosarcoma, representing 2.9% of all vaginal malignancies registered at the Swedish Cancer Registry, are presented. The ages of the patients ranged from 31 to 69 years. The most common clinical presentation was an increasing mass and/or local tenderness. The tumor was located in the anterior wall in three cases and in the lateral wall in two. The size of the tumors ranged from 2 to over 10 cm. Four patients had tumors of high histologic malignancy grade and were all dead within 36 months. One patient had a tumor of low grade and is still alive 10 years after the initial excision. The ultrastructural observations of abundant myofilaments with focal elongated densities in primary paraffin-embedded material conform with the light microscopic diagnoses in all cases and indicate the usefulness and value of such material for electron microscopy in order to arrive at the diagnosis of leiomyosarcoma. The therapeutic and diagnostic aspects are discussed.

Delayed cutaneous hypersensitivity and blood lymphocyte count in advanced Hodgkin's and non-Hodgkin's lymphomas.

Cell-mediated immune status was assessed in twenty patients of advanced and active lymphoreticular malignancies and twenty control subjects of comparable age and sex distribution by delayed cutaneous hypersensitivity responses to recall and contact antigens and peripheral blood lymphocyte counts. The results show depressed cellular immunity in both Hodgkin's and non-Hodgkin's lymphoma patients. However, the severity of immunological dysfunction as shown by anergy to skin antigens and lymphocytopaenia is remarkably less than what has been mostly reported in the literature.

Immunological significance of lymphoreticular infiltration in gastrointestinal cancer.

The 60 patients of gastrointestinal cancer comprising this study were in the age range of 29--70 years with 39 males and 21 females. The primary sites of cancer were: gallbladder 19, colon 13, stomach 12, anorectum 8, and liver 8. The stage of tumor spread was localized in 32 and metastatic in 28 cases. Round cell infiltration scores were classified semiquantitatively from O-V. Cellular immunity as expressed by the blood lymphocyte count and DNCB reactivity was also studied. Round cell infiltration was dense in the localized group (P less than 0.0005). The mean lymphocyte counts in all the primary sites of gastrointestinal cancer were significantly higher in the localized group as compared to metastatic group. The DNCB reactivity showed anergy in six cases and poor response in the remaining 22 cases of metastatic group. There was a statistically significant correlation between lymphoreticular infiltration, peripheral blood lymphocyte count, and the DNCB reactivity. Diminished round cell infiltration, lymphopenia, and depressed DNCB response indicate an advanced stage of gastrointestinal cancer.

Primary rhabdomyosarcoma of the heart: a case report, with autopsy.

A case of rhabdomyosarcoma of the heart in a 45-year-old man is reported. The diagnosis was suspected because of refractory congestive cardiac failure, a bulge on the left cardiac border, and was confirmed histologically at necropsy.

Congenital midline fistula of the tongue.

A possibly unknown entity of congenital midline fistula of the tongue, hitherto not mentioned in the literature, is reported. The embryologic basis of it is explained and the role of the tuberculum impar in the development of the anterior two thirds of the tongue is discussed.

Hemangiopericytoma: report of three cases regarding role of radiation therapy.

The experience in treating three patients with hemangiopericytoma is reviewed. One patient was given irradiation alone, and the others were both treated with surgery and irradiation. Our experience reinforces reports of the usefulness of irradiation in treating this neoplasm and its metastases.