A Case of Osteosarcoma Of The Maxilla-Challenges In Diagnosis And Management

Osteosarcoma is a primary malignant neoplasm of the bone. Osteosarcoma of the jaws especially those of maxilla is rare. The diagnosis of osteosarcomas is diff icult and challenging. In this case report we highlight a rare case of osteosarcoma of the maxilla in a 29 year old male patient which was highly aggressive and was initially diagnosed as rhabdomyosarcoma. This case highlights the difficulty in diagnosing osteosarcoma merely from incisional biopsy specimens which may not be representative of the whole tumour. Limited clinical information at incisional biopsy also adds to the difficulty in arriving at the definitive diagnosis. We further discuss the treatment modalities followed in this case.

Medullary carcinoma of the breast: ten year clinical experience of the Kuwait cancer control centre

Medullary carcinomas of the breast account for fewer than 7% of all invasive breast cancers. Some investigators include medullary carcinomas in the favourable histologic subtype, despite its aggressive histologic appearance. However, others fail to confirm its favourable prognosis. This was a retrospective analysis of sixty-one [61] cases of breast cancer cases diagnosed with Medullary Carcinoma, presenting to the Kuwait Cancer Control Center between 1995 and 2005. Median survival time was 122 months and the seven-year disease free survival was 82%. Overall survival rate was not assessed as no case died during the study period. No cases were metastatic from the start and only eight cases developed metastases, local recurrence or contralateral breast primary. 68.8% of the cases were Stage I or IIA [i.e. no lymph node affection]. There is no overt favourable prognosis of medullary carcinoma when compared to invasive ductal carcinoma. prognosis is more related to stage than histologic subtyping. The majority of cases were negative estrogen and progesterone receptor status and node negative

Response to oral gliclazide in a pre-pubertal child with hepatic nuclear factor-1 alpha maturity onset diabetes of the young

The term "maturity onset diabetes of the young" [MODY] describes a heterogeneous group of monogenic diabetes of which hepatic nuclear factor-1 alpha [HNF-1 alpha] MODY is the most common. Patients with HNF-1 alpha mutations typically present after puberty, and oral sulfonylureas [SU] have been shown to be effective in adults with this condition. A 7-year-old boy presented with asymptomatic hyperglycemia ranging between 6.2 and 10.1 mmol/L and glycosuria for nearly a year. The child's initial HbA [1c] was 6.9% and the pancreatic Islet cell autoantibodies were negative. His response to the oral glucose tolerance test [OGTT] showed a large increment of glucose from basal level of 7.7 to 21.1 mmol/L in 120 min. The mild presentation, family history, and negative autoantibodies were suggestive of HNF-1 alpha MODY, which was confirmed by mutation analysis. Initial management with diet alone was not sufficient, but he responded well to 20 mg oral gliclazide once a day with an improvement of HbA [1c] from 7.2% to 6.5% within 3 months of treatment. The case is an illustration of the clinical utility of molecular genetic tests in the management of childhood diabetes

Anatomical-computerized tomography [CT scan] study on the arteriovenous malformations [AVMs] in the brain of Iraqi patients

Arteriovenous malformations [AVMs] of the brain are anomalies affecting different age groups of the population, and predisposing patients to significant neurological disability from stroke, epilepsy, or other clinical manifestations. Noninvasive modalities are revealing these lesions more frequently, and with more accuracy. Previous studies on Iraqi subjects with intracranial AVMs are scarce. The aim of the study is to correlate the CT findings of intracranial AVMs with the clinical presentations, anatomic locations, the size, and the predictable origin of the arteries feeding these lesions and their venous drainage. The charts and CT scans of fifty-four Iraqi patients with an AVM, 31 males and 23 females [male to female ratio 1.3: 1], ranging in age from 6-74 years [mean 37.7] who were seen at the Neurosurgical Hospital-Baghdad from October 1998 to August 2002 were reviewed. Supratentorial AVMs were present in 53 patients; one patient had a left cerebellar AVM. The lesion was solitary, and directly localized in a single lobe, with more in the right lobes [mainly the parietal and temporal] in the non-haemorrhagic lesions, and in the left lobes of the AVMs presented with haemorrhage. The diameter of the lesion varied from less than 2.5 cm to >/= 6.5 cm. AVM may present symptomatically at any age .The arterial and venous components of the AVM could be explained by the site of the lesion. The size of the AVM could be evaluated as a potential factor predicting future AVM haemorrhage risk. Long-term follow-up evaluation is necessary for assessing the natural history and prognosis for such lesions

Variations in the origin and contributions of arteries supplying the human hippocampus: an anatomical study

Variations in the arterial supply in the human brain are not uncommon. Of particular interest is that of the hippocampus. Knowledge of the vascular anatomy is a key to the surgical treatment of pathologies in this region. The aim of the work is a detailed description of the variations and contribution of the anterior choroidal artery and the branches of the posterior cerebral artery to the supply of the hippocampus and comparing the results with previous studies. Formalin-fixed brains from 15 adult cadavers [30 hemispheres] were examined using a magnifying lens. The hippocampus is identified, and the arteries that are in the vicinity to hippocampus were carefully dissected and studied. The anterior choroidal artery [AchA], and the lateral posterior choroidal arteries [LPChAs] were present in 100% of the specimens examined. AChA anastomosed with the anterior branches of LPChA in 31% of specimens. The hippocampal artery, a branch of the posterior cerebral artery, was present in 82.8% of specimen. The anterior and middle temporal arteries were present in 80% of hemispheres. ACA has the most constant origin, course and distribution. It supplied the rstral and middle portions of the hippocampus and in the absence of the hippocampal arterial branches of the posterior cerebral artery [PCA], AchA supplied the major portion of the hippocampus. The branches, mainly from P-2 A and P-2P segments, of the PCA supplied the middle and posterior portions of the hippocampus. Variations in their origin from different segments were noted. The major branches were: the LPChAs, the hippocampal arteu, the anterior and middle temporal arteries. The common temporal artery did not contribute to the arterial supply of the hippocampus

antagonistic role of cinnamon on a destructive effect of alloxan on the rat testis a histological study

Diabetes mellitus is a chronic metabolic disorder characterized by a high blood glucose concentration [hyperglycemia] which is due to insulin deficiency and / or insulin resistance. As a consequence of the metabolic derangements various complications develop, so the aim of this investigation is to study [histological] the role of cinnamon - oil on the testis tissue of alloxan -induced diabetes rat. Forty -six male rats were used and divided into 3 groups : group 1,6= animal control. group II, 20 = treated with alloxan and the 3[rd] group, 20 = treated with alloxan + cinnamon. Testis of group I revealed normal distribution of seminiferous tubules and spermatozoa filled the lumen of these tubules. Group II showed reduction in number of seminiferous tubules, and absence of spermatozoa in their lumen, besides the significant decrease in testis weight. Group III elicited retrained these changes to approximately its normal view. This herbs [cinnamon] decrease or protect the destructive effect of alloxan on testis tissue

effect of sepsis on the histochemical activity of some hepatic enzymes

The effect of sepsis, induced by caecal ligation and puncture, on the histochemical activity of some hepatic enzymes concerned with carbohydrate metabolism was studied in male rats. This activity was assessed by the staining intensity and zonal distribution of the reaction product in the livers of septic rats, the activity of glucokinase was decreased while that of phosphorylase was increased, In contrast the activity of hexokinase was not affected. These findings provided morphological basis for some of the known biochemical results of other researchers. The possible mechanisms and effects of these findings are discussed in morphobiochemical terms. A new histochemical method has been devised in this study for the demonstration of Liver glucokinase and hexokinase separately. Essentially this method depends on the use of an appropriate concentration of a substrate and a modifier