Paraffin-embedding lithography and micro-dissected tissue micro-arrays: tools for biological and pharmacological analysis of ex vivo solid tumors.

There is an urgent need and strong clinical and pharmaceutical interest in developing assays that allow for the direct testing of therapeutic agents on primary tissues. Current technologies fail to provide the required sample longevity, throughput, and integration with standard clinically proven assays to make the approach viable. Here we report a microfluidic micro-histological platform that enables ex vivo culture of a large array of prostate and ovarian cancer micro-dissected tissue (MDT) followed by direct on-chip fixation and paraffination, a process we term paraffin-embedding lithography (PEL). The result is a high density MDT-Micro Array (MDTMA) compatible with standard clinical histopathology that can be used to analyse ex vivo tumor response or resistance to therapeutic agents. The cellular morphology and tissue architecture are preserved in MDTs throughout the 15 day culture period. We also demonstrate how this methodology can be used to study molecular pathways involved in cancer by performing in-depth characterization of biological and pharmacological mechanisms such as p65 nuclear translocation via TNF stimuli, and to predict the treatment outcome in the clinic via MDT response to taxane-based therapies.

Pseudocyst of pinna: a recurrence-free approach.

OBJECTIVE: The aims of the article were to study the epidemiological profile of pseudocyst of pinna in non-Chinese population, to propose a hormonal basis of pseudocyst formation, and to compare 2 commonly used treatment modalities of incision drainage with compression and deroofing with compression, so as to ascertain the definitive treatment of this frequently recurring condition. MATERIAL AND METHODS: Twenty-nine patients were diagnosed with pseudocyst of the auricle between June 2005 and December 2006 in a medical college hospital. All the patients were initially subjected to aspiration with contour dressing. Of the 29 patients, 28 showed recurrence with in 1 week. These 28 patients were divided into 2 groups--13 patients underwent incision and drainage with curettage followed by buttoning, whereas 15 underwent surgical deroofing of the cyst along with buttoning. RESULTS: All the 29 patients were males with a mean age of 32.6 +/- 4.3 years. Sixteen (55.17%) patients had a right-sided lesion, whereas 13 (44.82%) patients had a left-sided lesion. No case of bilateral pseudocyst was seen. The pseudocyst was most commonly located in the concha. After aspiration with contour dressing, 28 (96.55%) patients showed recurrence within 1 week. Of the 13 patients who underwent incision drainage with buttoning, 5 (38.46%) showed recurrence. Of the 13 patients who underwent incision drainage, 3 (23.07%) showed permanent thickening of the auricular cartilage. The 5 cases that recurred then underwent deroofing with buttoning along with 15 patients. Thus, a total of 20 patients underwent surgical deroofing. No recurrence was seen with this technique. The patients were followed up for 1 month. No complication was noted, and the results were cosmetically acceptable. CONCLUSION: Pseudocyst of the pinna is an uncommon condition of the auricle presenting as a painless swelling in young adult males. The epidemiological profile of this condition is similar in Chinese and non-Chinese (Indian) population. A hormonal influence modulating the inflammatory process explains the marked male predominance of this condition. Surgical deroofing followed by buttoning is the definitive treatment of this entity as it is associated with no recurrence and gives a cosmetically acceptable result.

Clinicopathological profile of cervicofacial masses in pediatric patients.

Four hundred pediatric patients (0-12 years of age) who presented with cervicofacial masses were evaluated clinically and pathologically. Infl ammatory lesions were the commonest (48%) followed by congenital and developmental malformations (26%). In infl ammatory lesions, reactive lymphadenopathy was the commonest (16%) followed by tubercular lymphadenitis (11.5%). In congenital and developmental malformations hemangiomas were the commonest (12%) followed by TG cyst (6.5%). Cystic lesions (non-developmental) constituted 19%, benign neoplastic lesions 7% and malignant neoplastic lesions 2% of the cases. Males predominated the series (53.5%) and commonest age group involved was 10-12 years (20.5%). FNAB was performed in 93% of cases and HPE was available in 51.5% of cases. Sensitivity of FNAB in our series was 87.4%.

CT scan evaluation of the anatomical variations of the ostiomeatal complex.

INTRODUCTION: Functional endoscopic sinus surgery (FESS) has revolutionized the approach and treatment of chronic rhinosinusitis. Certain anatomical variations are thought to be predisposing factors for the development of sinus disease and it is necessary, for the surgeon to be aware of these variations, especially if the patient is a candidate for FESS. OBJECTIVE: The aim of the present study was to identify the various anatomical variations of the ostiomeatal complex in patients of chronic rhinosinusitis who underwent FESS. MATERIALS AND METHODS: A total of 150 patients of chronic rhinosinusitis (medical treatment failures) who were subjected to FESS were CT scanned preoperatively to find any bony anatomic variation and the extent of mucosal disease. RESULTS: Concha bullosa was the commonest anatomic variation and was seen in 45 (30%) patients. The other anatomic variations noted included: paradoxical middle turbinate in 9.33% patients, uncinate process variations in 25% patients, agger nasi cells in 9.33%, Haller cells in 8.66% and posterior septal deviations in 25.33% patients. The mucosal disease was most commonly seen in anterior ethmoids (87.33% ), followed by maxillary sinus ostial area (70%), maxillary sinus disease (65.33%), posterior ethmoidal disease (38%), frontal sinus disease (15%) and sphenoid sinus mucosal disease (8.66%) patients. CONCLUSION: A thorough preoperative CT evaluation of the patients undergoing FESS is necessary to detect various anatomical variations in the ostiomeatal complex.

Successful treatment of niclosamide- and praziquantel-resistant beef tapeworm infection with nitazoxanide.

BACKGROUND: Beef tapeworm (Taenia saginata) infection is acquired by eating inadequately cooked beef that contains the larvae or cysticerci of T. saginata. Niclosamide and praziquantel have proved effective for its treatment but treatment failures are well known. We report herein the results of nitazoxanide therapy. METHODS: A prospective study was conducted in 18 children and 34 adults to assess the efficacy and safety of nitazoxanide in the treatment of niclosamide- and praziquantel-resistant T. saginata infection. Nitazoxanide was administered twice daily for 3 days in 500-mg doses for those aged over 14 years and at 20mg/kg body weight/day in children aged 5-14 years. Post-treatment follow-up was undertaken at 1, 2, 4, 8, and 12 weeks for fecal samples for proglottides, and to check the presence, number, and viability of Taenia eggs. RESULTS: Nitazoxanide cured 51 of 52 (98.1%) patients. Mild side effects occurred in seven patients, which resolved spontaneously. There were no abnormalities in laboratory parameters. CONCLUSIONS: Nitazoxanide is a safe, effective, inexpensive, and well-tolerated drug for the treatment of niclosamide- and praziquantel-resistant beef tapeworm infection.