Safety and efficacy of unguided trans thoracic fine needle aspiration biopsy (FNAB) in outdoor patients

We studied the safety and efficacy of unguided transthoracic fine needle aspiration biopsy (FNAB) in peripheral lung lesions in an outpatient setting in 62 patients. The diagnostic yield of unguided aspiration was 67.7 per cent. Smaller lesions usually required guided FNAB. Specific tissue diagnosis was obtained in all cases aspirated successfully. Complications were seen in 7 patients (pneumothorax in 4 and haemoptysis in 3 patients). With careful patient selection, unguided FNAB can be an effective out-patient procedure for diagnosing lung lesion beyond the reach of the fiberoptic bronchoscope.

Light & electron microscopy of proliferating oval cells during early chemical hepatocarcinogenesis

Early hepatic changes were studied in male albino rats (70) of Sprague Dawley strain fed a choline devoid diet containing 0.05 per cent w/w AAF (2-acetylaminofluorene) for 12 days. Proliferating periductal and ductal cells appeared in the portal area on days 1 and 3 respectively in the experimental group. On day 7, these cells infiltrated within the sinusoids of adjacent lobules up to the first one or two layers of hepatocytes. Subsequently, these cells extended up to the midzonal region on day 21 and by day 24 the entire lobule was infiltrated. Formation of duct like structures by the proliferating cells was seen on day 21. Ultrastructurally both periductal and ductal cells showed only a few organelles. Periductal and ductal cells are the earliest cells to appear in the portal area in chemically induced hepatocarcinogenesis. Its undifferentiated ultrastructure, may suggest the stem cell nature of these cells.

Role of serial pleural biopsies in the diagnosis of pleural effusions

One hundred fifty-five cases of pleural effusion underwent a percutaneous pleural biopsy by the Cope needle. In the face of an inconclusive result in the first attempt, biopsy was repeated for upto three times. Diagnostic yields of biopsy in tuberculous and malignant effusion were 93.5 per cent and 66.7 per cent, respectively. When combined with pleural fluid cytology, a definite diagnosis of malignancy could be established in 80.95 per cent cases. Serial pleural biopsies significantly increased the diagnostic yield.

Multiple glomangiomas of lower limb

A young man with multiple painful nodules on the left lower limb is presented. Histology of one of the nodules proved the diagnosis of glomangioma.

Fibrebronchoscopy in pulmonary sarcoidosis--an Indian experience

Twenty-four patients suspected to have sarcoidosis were subjected to fibrebronchoscopy. Histopathological support for the diagnosis was ultimately obtained in 20 patients. Fibrebronchoscopy provided the diagnosis in 17 patients, while histopathological confirmation was obtained from extrapulmonary biopsy sites in 3 patients. Transbronchial lung biopsy, attempted without fluoroscopic guidance, revealed non-caseating granulomata in 15 patients. The only complication encountered was a small pneumothorax, not requiring intervention, in one patient. Lack of fluoroscopic guidance did not compromise the diagnostic yield or increase the complication rate of the procedure. Bronchial biopsy confirmed the diagnosis in 2 patients with a non-specific lung biopsy. It was positive in 6 of 8 patients with an abnormal appearing mucosa and in 5 of 12 patients with a normal bronchial tree. Random bronchial biopsy in all patients, irrespective of mucosal changes, made an important contribution to the yield of fibrebronchoscopy. Fibrebronchoscopy confirmed the diagnosis of tuberculosis in 2 patients with an atypical radiological picture, thereby differentiating the two conditions which occasionally mimic each other.

Morphological changes in the liver on chronic administration of small doses of paracetamol in albino rats

30 male albino rats of Wistar strain were used to study the effect of repeated administration of small doses of paracetamol over a period of 24 weeks. The animals were administered 0.3 g of paracetamol orally admixed in the diet, after an overnight fast. Three animals from the test group and one control were sacrificed at the end of 4, 8, 12, 16, 20 and 24 weeks, under ether anaesthesia. Liver cell necrosis was not seen at any stage of the experiment. Fatty change was focal at 4 to 8 weeks and diffuse at 12 to 24 weeks. Chronic administration of paracetamol admixed in the diet showed less extensive changes comprising of focal ballooning degeneration. Ultrastructural changes involved mitochondria and RER. Fibrosis was not seen.

Cytomorphologic features of the rare epithelial-myoepithelial carcinoma of the salivary gland

The cytomorphologic features of an epithelial-myoepithelial carcinoma arising in the submandibular gland are reported. The aspiration smears were cellular, with two cell types present: dark cells showing attempted gland formation and clear cells with vacuolization. The clear cells frequently formed globular masses and had indistinct cytoplasmic membranes. These globular masses of clear cells were usually adjacent to the fragments of dark cells. A striking feature was the presence of numerous naked nuclei.

Fine needle aspiration cytology in the diagnosis of bone tumors

Two hundred and forty osteolytic lesions were biopsied by means of a fine needle. The procedure yielded adequate material in 92 percent of the cases. A definitive diagnosis with correct cell typing was provided in 89 per cent of the adequate samples. Processing of the aspirated clot in addition, in 142 cases, provided fragments of tumour tissue in its histological milieu, a feature lost in cytologic smears. FNAC can be effectively used in the screening of various musculo-skeletal mass lesions and their management.

Synergistic promoter effect of diethylstilbesterol & phenobarbitone in diethylnitrosamine induced hepatic neoplasia in rats

An experimental model was designed to study the role of both diethylstilbesterol (DES) and phenobarbitone (PB) singly or in combination, in diethylnitrosamine (DEN) induced hepatic neoplasia. Experimental and control rats were injected DEN (200 mg/kg) or saline, ip. Acute morphological changes were studied at days 1, 2 and 3; and at weekly intervals for 3 wk. Four weeks after DEN pretreatment the experimental and control rats were randomized into various groups and fed DES (T1), PB (T2) or a combination of both DES and PB (T3). Five rats from each experimental group were sacrificed at 10, 20 and 30 wk. Group T3 showed gross nodules with a mean nodule score of 20.5 mm at 20 wk. Nodule score in T1, T2 and T3 at 30 wk were 7, 9 and 34.5 mm respectively. The sequential morphological lesions encountered were clear cell and acidophilic foci; acidophilic, basophilic and mixed nodules. Haemorrhage within the nodules was frequent when DES was administered either alone or in combination with PB. Oval cell proliferation and cholangiocellular lesions were produced in all experimental groups. Foci and nodules generally showed loss of glucose-6 phosphatase, adenosine triphosphatase and invariable presence of gamma-glutamyl transpeptidase and glycogen. A combination of DES and PB as promoter yielded earliest and highest nodule score. This suggests that DES and PB acted synergestically as promoters or that PB caused enzyme induction thereby enhanced the promotive effect of DES.

A study of emergency psychiatric referrals in a government hospital

The socio-demographic and clinical characteristics of psychiatric referrals in emergency O. P. D. of a teaching general hospital were studied from January 1986 to December 1987. The referral rate was 1.5%. The source, reason and purpose of referrals were studied. Hysterical fits, altered sensorium and excitements together constituted three fourth of all emergency referrals. The diagnosis of neurosis was made in one third of the patients and about one fourth of all patients were labelled as suffering from hysterical neurosis (fits being the most common presentation).

Protein p126: a parasitophorous vacuole antigen associated with the release of Plasmodium falciparum merozoites

The p126 protein is synthesized by P. falciparum between the 32nd and the 36th hour of the erythrocytic cycle, and is localized in the parasitophorous vacuole. It is processed when schizonts rupture and the major fragments (50, 47 and 18 kDa), which are released into culture supernatant, have been characterized using monoclonal antibodies. The 47 kDa fragment has been mapped at the N-terminus of the molecule. The portion of the protein p126 gene coding for this fragment contains 3 introns and is characterized by a sequence coding for 6 repeats of 8 aminoacids and by repeats of TCA/T-AGT coding for a polyserine sequence of 37 serines in a row for the FCR-3 strain. The 50 kDa fragment is also found in culture supernatant when merozoites are released from mature schizonts. The incubation of mature schizonts with leupeptin inhibits the release of merozoites and, in this case, a 56 kDa intermediate product is found. In those conditions, merozoites were observed free in the erythrocyte cytoplasm, the membrane of the parasitophorous vacuole being destroyed. The 50 kDa fragment can be obtained from the 56 kDa fragment by treatment with trypsin (a protease inhibited by leupeptin). Our results suggest that the processing of the 56 kDa fragment: 1) is protease-dependent, and could depend on a trypsin-like activity; 2) cannot occur after the release of merozoites because of the protease inhibitors contained in the serum; 3) does not occur before the release of merozoites, since no processed products of the protein p126 are observed in unruptured schizonts.(ABSTRACT TRUNCATED AT 250 WORDS)

The stereoselectivity of four hepatic glutathione S-transferases purified from a marine elasmobranch (Raja erinacea) with several K-region polycyclic arene oxide substrates

Product analysis by HPLC demonstrated that three hepatic cytosolic glutathione S-transferases of little skate (E-2, E-3 and E-4) were highly stereoselective, if not stereospecific, for thiol reaction at the R-configured oxirane carbons of four K-region arene oxides; pyrene 4,5-oxide, (+/-)-benz[a]anthracene 5,6-oxide, (+/-)-benzo[a]pyrene 4,5-oxide and phenanthrene 9,10-oxide. A fourth transferase, E-5, exhibited no stereopreference with pyrene 4,5-oxide or phenanthrene 9,10-oxide. Immunological and electrophoretic evidence has shown that the three enzymes exhibiting stereospecificity have a common subunit which is absent from enzyme E-5. The high stereoselectivity of the three enzymes E-2, E-3, and E-4 was accompanied by effective catalysis of the reaction of GSH with these K-region epoxides; for example, the calculated turnover number for E-4 with benzo[a]pyrene 4,5-oxide was 550.

Immunochemical analysis of a major antigen of Plasmodium falciparum (P126) among ten geographic isolates

Protein P126, a parasitophorous vacuole major antigen of Plasmodium falciparum and precursor of 3 major exoantigens (50, 47, and 18 Kd in strain FCR-3) has been studied in 10 culture-adapted isolates originating from various endemic areas. Two monoclonal antibodies (specific for 50 and 47 Kd exoantigens, respectively) were used to immunoprecipitate culture supernatants and parasitized erythrocytes in each case. It was observed that all the parasite isolates reacted with both monoclonal antibodies, indicating the ubiquity of the epitopes analyzed. Further, two of the exoantigens (the 50 and 18 Kd of FCR-3) were found to have a stable molecular mass in all the isolates tested, whereas, the other one (47 Kd in FCR-3) was found to have a variable molecular mass, from 47 to 50 Kd. The molecular mass of the precursor varied from 126 Kd to 128 Kd. No correlation was found between geographic origin and antigenic size.

Fine needle aspiration cytology in a case of hepatoblastoma

The cytologic features of a case of hepatoblastoma diagnosed by fine needle aspiration (FNA) in an 18-month-old female infant are described. A mass detected in the left lobe of the liver on routine examination was subjected to FNA. The distinctive cytologic findings included malignant cells in small clusters and in acinar arrangements. Some of the acinar structures had bile plugs. Fat vacuoles were present within the cytoplasm of some of the malignant cells. Immature hematopoietic cells were also present.

Interactions of protein calorie malnutrition, malaria infection and immune responses

The course of parasitaemia and certain immune responses in protein or calorie-deficient albino rats infected with Plasmodium berghei (NICD) were studied. Wide variations observed in the course of parasitaemia in protein-deficient animals were (a) prolonged prepatent period, short patent period with low parasitaemia (50% of animals), (b) short prepatent period and an inability to resolve the infection (14% of animals) and (c) no patent parasitaemia at any stage of observation (23.5% of animals). The calorie-deficient animals had significantly lower parasitaemia (P less than 0.05) compared with well fed animals. Protein deficiency resulted in depression of T-dependent immune responses in uninfected as well as P. berghei-infected animals. The outcome of the parasitaemia in protein- as well as calorie-deficient animals seems to be the combined result of deficiencies of certain essential nutrients, proteins and calories in the diet as well as the immune responses of the host.

Variable virulence of isolates of Giardia lamblia in mice

Groups of inbred mice were inoculated intraoesophageally with Giardia lamblia cysts isolated from the stools of 15 patients with various clinical conditions: symptomatic diarrhoeic, symptomatic non-diarrhoeic and asymptomatic cyst carriers. The virulence of these isolates was studied in terms of two-hour cyst excretion rate and trophozoite counts in the duodenum. The basic pattern of the cyst excretion was similar in all the groups: cysts appeared in the stools by Day 3 +/- 1, reaching a maximum by Day 11 +/- 2. There was then a gradual decline until Day 23 +/- 2, with a low output until Day 31 post-inoculation. However, statistically significantly higher numbers of cysts were excreted by animals which had received cysts isolated from symptomatic diarrhoeic patients than by mice which received cysts from symptomatic non-diarrhoeic or asymptomatic cases. Identical results were obtained with the trophozoite counts. Haemagglutinating (HA) antibodies appeared after Day 11 post-inoculation in each group regardless of different cyst isolates, and the HA titre increased until Day 31 post-inoculation. The results indicate that variable symptomatology in patients could be due to variation in the virulence of the parasite.

Induction of acrosome degeneration of mouse spermatozoa with blood serum collected from females in various hormonal states

Blood serum collected from female mice treated with oestrogen and progesterone was assayed for its ability to induce acrosome degeneration. The maximum activity was found in serum obtained from females treated with 1.0 mug oestrogen/day for 5 days. Lower doses did not produce any significant difference from the control group. Blood serum from pregnant or ovariectomized females treated with progesterone did not significantly depress the incidence of acrosome degeneration. The possibility that removal of the acrosome may not be a morphological concomitant of capacitation in mice has been discussed.