Bone marrow examination in geriatric patients-An institutional experience from the north Himalayan region of India.

BACKGROUND: The surge of the geriatric population has led to design research studies related to health problems in this age group worldwide. Bone marrow examination which is an important diagnostic tool for various diseases may vary in geriatric population in comparison to younger groups. The present study was, therefore, conducted to study the indications and morphological features of bone marrow examination in geriatric population in north Himalayan region of India. It was also intended to study if there is any variation in these findings from elderly populations in other parts of the world. MATERIAL AND METHODS: Study was conducted in an institute situated in north Himalayan Uttarakhand state of India over a period of two years including patients above 60 years of age who underwent bone marrow examination. RESULTS: Total 156 cases underwent bone marrow examination with most common indication being suspicion of lymphoma (18.5%) followed by cytopenia (17.3%). Nutritional anaemia was most common pathological diagnosis in 16.6% cases. Diagnostic discordance between aspirate and biopsy was observed in 5.7% of total cases with non-Hodgkin's lymphoma (NHL) being the most common misdiagnosis on aspirate. CONCLUSION: Nutritional anaemia particularly iron deficiency anaemia is the most common diagnosis of bone marrow examination indicating the importance of nutritional therapy in the elderly population of this region. Bone marrow biopsy proves to be an important adjunct to aspiration in precise diagnosis with minimal complications. The awareness of bone marrow findings would not only be helpful to clinicians and pathologists but also provide valuable information to the policymakers to improve the quality of health in the geriatric population of this area.

Evaluation of magnesium levels in blood and saliva of oral squamous cell carcinoma and potentially malignant disorders by xylidyl blue method.

BACKGROUND: Cancer is Latinized from Greek word 'karkinos' meaning crab, denoting how carcinoma extends its claws like a crab into adjacent tissues. It has been well established by researchers that virtually all oral cancer are preceded by visible clinical changes in the oral mucosa usually in the form of white or red patch (two-step process of cancer development). Mg is an essential mineral that is needed for a broad variety of physiological functions. Imbalances in Mg metabolism are common and are associated with different pathological conditions. The purpose of this study was to evaluate and compare the magnesium concentration in blood serum and saliva of oral squamous cell carcinoma, potentially malignant disorders and healthy subjects to serve as a positive marker or indicator in the process of carcinogenesis. MATERIALS AND METHODS: The study includes 17 precancerous (OSMF + Leukoplakia) patients, 17 OSCC and 17 control group. Blood and saliva was collected; serum and saliva was extracted from both the groups and was biochemically evaluated for magnesium levels. Statistical analysis was performed using ANOVA. RESULTS: The Salivary magnesium Mean ± SD of Healthy group is higher 1.6681 ± 0.0207 mmol mg/l followed by Potentially Malignant Disorder group 1.5532 ± 0.0283 and Oral Squamous Cell Carcinoma 0.5979 ± 0.0659. The mean values differ significantly between 3 groups (P < 0.001) The Serum magnesium Mean ± SD of Healthy group is higher 1.9188 ± 0.0550 mmol mg/l followed by Potentially Malignant Disorder group 1.6951 ± 0.0949 and Oral Squamous Cell Carcinoma 0.7329 ± 0.1561. The mean values differ significantly between 3 groups (P < 0.001) The study revealed decreased serum and salivary magnesium in oral precancerous patients and an Oral Squamous cell carcinoma patients compared to healthy individuals. CONCLUSION: The magnesium concentration was low in both blood plasma and saliva of oral squamous cell carcinoma as compared to potentially malignant disorders and healthy subjects. Thus the magnesium ion concentration in blood plasma and saliva could be considerd as tumor marker, playing an important role in carcinogenesis.

Increased level of exogenous zinc induces cytotoxicity and up-regulates the expression of the ZnT-1 zinc transporter gene in pancreatic cancer cells.

A balance between zinc uptake by ZIP (SLC39) and efflux of zinc from the cytoplasm into subcellular organelles and out of the cell by ZnT (SLC30) transporters is crucial for zinc homeostasis. It is not clear whether normal and cancerous pancreatic cells respond differently to increased extracellular zinc concentrations. Use of flow cytometry-based methods revealed that treatment with as little as 0.01 mM zinc induced significant cytotoxicity in two human ductal adenocarcinoma cell lines. In contrast, normal human pancreatic islet cells tolerated as high as 0.5 mM zinc. Insulinoma cell lines of mouse and rat origin also succumbed to high concentrations of zinc. Exposure to elevated zinc concentrations enhanced the numbers of carcinoma but not primary islet cells staining with the cell-permeable zinc-specific fluorescent dye, FluoZin-3, indicating increased zinc influx in transformed cells. Mitochondrial membrane depolarization, superoxide generation, decreased antioxidant thiols, intracellular acidosis and activation of intracellular caspases characterized zinc-induced carcinoma cell death. Only the antioxidant glutathione but not inhibitors of enzymes implicated in apoptosis or necrosis prevented zinc-induced cytotoxicity in insulinoma cells. Immunoblotting revealed that zinc treatment increased the ubiquitination of proteins in cancer cells. Importantly, zinc treatment up-regulated the expression of ZnT-1 gene in a rat insulinoma cell line and in two human ductal adenocarcinoma cell lines. These results indicate that the exposure of pancreatic cancer cells to elevated extracellular zinc concentrations can lead to cytotoxic cell death characterized by increased protein ubiquitination and up-regulation of the zinc transporter ZnT-1 gene expression.

Fibroblastic variant of osteosarcoma: a challenge in diagnosis & management.

Osteosarcoma of the jaws is a relative rare malignant bone tumor. Like, its counterpart in the long bones, osteosarcoma affecting the head and neck region shows distinct yet diverse clinical, histologic and prognostic characteristics. Its diagnosis is a challenge to histopathologists and is especially important in early stages to improve its prognosis. In the initial phase, it may present as nondescript swelling with an indolent growth rate, only to become overtly aggressive and malignant towards the later phase of the disease. This article reports on a case of an advanced osteosarcoma of the maxilla in a 42 year old woman who came for the evaluation of a swelling. The case was submitted for surgical intervention and was followed by one recurrence till the time of reporting. This case illustrates that immunohistochemical staining of Vimentin, S-100 and CD 68 markers are useful to confirm the histologic diagnosis of osteosarcoma, along with radiographic evaluation using CT scan and 3D imaging.