Tear Secretion and Tear Film Function in Diabetics.

In the present study, the evaluation of the amount of the tear production, the stability of the tear film and the condition of the conjunctival surface by the use of impression cytology in the diabetics and the non diabetic individuals was done to detect the possible tear film anomalies in the Type 2 diabetic patients. We performed Schirmer 1 test, TFBUT (Tear film break up time) and CIC (Conjunctional Impression Cytology) on each subject in both groups. The mean values for Schirmer 1 test, TFBUT were significantly decreased in diabetes patient as compared to healthy controls. The CIC revealed pronounced degree of metaplasia with loss of goblet cells in diabetic patients. We found decreased tear production, unstable tear film and squamous metaplasia in diabetic patients.

Recurrent endocervical-like mucinous borderline tumor (ELMBT) arising in a case of long-standing endometriosis--a case report.

Endometriosis is a well-known precursor lesion of ovarian malignancies, particularly those of endometrioid and clear-cell types and rarely of serous or mucinous types. The association of endometriosis with mucinous borderline tumors also varies. This case is of a 60 year old female, who had a long history of more than thirty years of endometriosis and developed recurrent endocervical-like mucinous borderline tumor (ELMBT) in endometriotic foci. This case highlights challenges in the management of such complications associated with endometriosis and emphasizes the importance of long-term follow-up in cases of endometriosis.

Filiform papillae in the mucosa of the human vaginal wall.

BACKGROUND & OBJECTIVE: While giving the gross anatomy of the mucosa of the vagina, textbooks of Anatomy and Obstetrics and Gynaecology describe the presence of a median longitudinal ridge on its anterior wall (columna rugarum anterior) and another similar ridge (columna rugarum posterior) on its posterior wall is described, and transverse rugae separated by sulci of variable depth, extend bilaterally from these ridges. While conducting autopsy of female cases the routine examination of vaginal mucosa did not show the presence of longitudinal ridges. In addition, some small areas bearing filiform papillae were seen in the lower third of the vagina in young subjects. As these papillae have not been described earlier, it was decided to study them in detail using scanning electron microscopy. METHODS: A total of 215 vaginal specimens were studied. At autopsy the vagina was slit open on the lateral sides up to the upper ends of the lateral fornices. The anterior vaginal wall was turned up over the uterus and mucosa of both walls examined macroscopically. In 16 subjects, small pieces of vaginal mucosa bearing filiform papillae were cut out and processed for examination under scanning electron microscope (SEM) and a light microscope. In addition, vaginae of 55 married women (20-40 yr age) with complain of lower abdominal pain or infertility were examined particularly for the median longitudinal ridges on the vaginal walls. RESULTS: At autopsy, the two median longitudinal ridges were not seen in any instance. Small variable areas of the lower third of the vagina showed the presence of filiform papillae on the two walls and at sides; they were prominent in the young individuals and tended to become absent in multipara and in old age. They were 2 to 3 in number on each wall. Histologically the papilla showed a core of highly vascular connective tissue covered by non-keratinized squamous epithelium. Immunoperoxidase staining with S-100 showed a large number of small nerve fibres in the subepithelial tissue which seemed to be more than in the surrounding areas not covered with papillae. INTERPRETATION & CONCLUSION: Anterior and posterior median longitudinal ridges were not seen on the vaginal mucosa in the autopsy specimens. In all autopsy specimens of young subjects between the ages of 15 and 40 yr, variable areas bearing filiform papillae were observed on the mucosa of the lower third of the vagina. Further studies need to be done to throw light on the role of these papillae.

Melanin containing cells of the uterine cervix and a possible histogenesis--a case report.

A 30 year old nulligravidfemale attended gynaecological OPD for investigation of primary infertility. Local examination revealed presence of a dark pigmented area in the posterior lip of the cervix. The biopsy from cervix showed, squamous metaplasia of the lining epithelium with presence of granules of melanin pigment in the basal layer. Schmorl's stain for melanin and immunohistochemical staining for S-100 and HMB-45 showed strong positivity in these cells. Melanosis of the uterine cervix is usually an incidental finding in females with uterine prolapse in their fifth and sixth decade. The origin of melanin containing cells in the uterine cervix is debatable till date. Amongst the various possibilities for the origin of these cells in the uterine cervix, neural origin is probably more acceptable than epithelial cell origin. The combined expression of melanocytic and Schwanian markers in the index case, suggest a biphasic differentiation of melanin containing cells in the uterine cervix. Although the exact histogenesis and clinical significance of these are still unknown, a long term follow-up is needed to study the nature of these lesions to look for any precursor lesion for development of malignant melanoma.

In vitro comparative kinetics of adhesive and haemolytic potential of T. vaginalis isolates from symptomatic and asymptomatic females.

The host parasite relationship and pathogenic mechanisms of the commonly reported sexually transmitted urogenital disease, trichomoniasis, are poorly understood. This study was planned to correlate the adhesion properties of Trichomonas vaginalis isolates from symptomatic and asymptomatic women to vaginal epithelial cells in vitro (in presence and absence of L. acidophilus) and to ascertain the haemolytic activity of the isolates, in order to assess these properties as possible markers of pathogenicity. Cytoadherence assay study shows the significant difference in adhesion only up to first 15 minutes of incubation in symptomatic versus asymptomatic isolates. The presence of L. acidophilus was found to be more effective in enhancing the attachment of T. vaginalis in a time dependent manner mostly operative through its pH lowering effect, whereas the excretory secretory products of L. acidophilus reduced the attachment in case of both symptomatic and asymptomatic isolates. Amount of haemoglobin released by isolates from symptomatic patients was significantly higher than by the isolates from asymptomatic women. This investigation forms the basis for future studies to explore the role of other known virulence factors of T. vaginalis in initiation and persistence of vaginal infection by the parasite.