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2003| April-June | Volume 40 | Issue 2
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Sentinel lymph node biopsy in the management of breast cancer.
Rakesh Kumar, MF Bozkurt, H Zhuang, A Alavi
April-June 2003, 40(2):60-6
Sentinel node localization is the second most important development in this century after conservative lumpectomy for the treatment of early breast cancer. The sentinel node mapping is a new multidisciplinary approach for staging of axilla in an accurate and less morbid way as compared to axillary node dissection. Sentinel lymph node biopsy in patients with breast cancer has been adopted rapidly into clinical practice. The accuracy of sentinel lymph node biopsy is more than 95%, when performed meticulously (by an experienced multidisciplinary team) with proper patient selection. Sentinel lymph node biopsy is most widely used for both palpable and non-palpable T1 and T2 tumors. Recent studies show application of sentinel lymph node technique in patients with locally advanced breast cancer and after neoadjuvant chemotherapy. Therefore, sentinel lymph node biopsy technique has application in developing countries and other countries where screening for breast cancer is not common and most patients present relatively in advanced stage of the disease. Several aspects of the sentinel lymph node biopsy including technique, case selection, pathologic analysis and accuracy with supportive important studies published in the literature will be discussed in this review.
Haematologic and immunophenotypic profile of acute myeloid leukemia : an experience of Tata Memorial Hospital
S Ghosh, SC Shinde, GS Kumaran, RS Sapre, SR Dhond, Y Badrinath, R Ansari, A Kumar, S Mahadik, AB Chougule, CN Nair
April-June 2003, 40(2):71-6
: To study the hematologic and immunophenotypic profile of 260 cases of acute myeloid leukemia at diagnosis.
MATERIAL AND METHODS
: This is a retrospective analysis of 260 cases of AML diagnosed at our institution between 1998 and 2000. Diagnosis was based on peripheral blood and bone marrow examination for morphology cytochemistry and immunophenotypic studies. SPSS software package, version 10, was used for statistical analysis.
: Seventy-six percent of our cases were adults. The age of the patients ranged from one year to 78 years with a median age of 27.2 years. There were 187 males and 73 females. The commonest FAB subtype, in both children and adults, was AML-M2. The highest WBC counts were seen in AML-M1 and the lowest in AML-M3 (10-97 x 10(9)/L, mean 53.8 x 10(9)/L). The mean values and range for hemoglobin was 6.8 gm/l (1.8 gm/l to 9.2 gm/l), platelet count 63.3 x 10(9)/L (32-83 x 10(9)/L), peripheral blood blasts 41.4% (5 to 77%) and bone marrow blasts 57.6% (34-96%). Myeloperoxidase positivity was highest in the M1, M2 and M3 subtypes. CD13 and CD33 were the most useful markers in the diagnosis of AML. CD14 and CD36 were most often seen in monocytic (38%) and myelomonocytic (44%) leukemias. Lymphoid antigen expression was seen in 15% of cases. CD7 expression was the commonest (11%).
: AML accounted for 39.8% of all acute leukemias at this institution. The most common subtype was AML-M2. Myeloperoxidase stain was a useful tool in the diagnosis of myeloid leukemias. CD13 and CD33 were the most diagnostic myeloid markers.
Tobacco use among students in the eight North-eastern states of India
DN Sinha, PC Gupta, MS Pednekar
April-June 2003, 40(2):43-59
: To obtain baseline information about prevalence of tobacco use among school children in eight states in the North-eastern part of India.
MATERIAL AND METHODS
: A two-stage probability sample of students in grades 8-10 corresponding to 13 to 15 years of age was selected in each state and surveyed through an anonymous, self-administered questionnaire.
: Among the sampled schools, the school response rate was 100% in all states except Tripura (92%) and Meghalaya (96%). Among the eligible students, over 80% participated in the survey. Among the respondents, the proportion of boys ranged between 50% to 55%. Ever tobacco users ranged from 75.3% (Mizoram) to 40.1% (Assam). Over 65% of users reported initiation at 10 years of age or earlier in all states except Mizoram (23.1%). The range of current tobacco use (any product) was 63% (Nagaland) to 36.1% (Assam). Current smokeless tobacco use ranged from 49.9% (Nagaland) to 25.3% (Assam). Mizoram reported the highest current smoking (34.5%, mainly cigarette) and Assam reported the lowest (19.7%, again mainly cigarette). Current smoking among girls (8.3% to 28.2%) was also quite high. Over half of current cigarette smokers (53.2% to 96.3%) and a high proportion of current smokeless tobacco users (38.5% to 80.8%) reported feeling like having tobacco first thing in the morning. Only about 20% of students reported having been taught in school about the dangers of tobacco use, except in Mizoram (around 50%). Tobacco use by parents and close friends was positively associated with students' current tobacco use.
: Tobacco use including smoking was very high, even among girls, in all eight states in the North-eastern part of India. Signs of tobacco dependency were already visible in these students, more among those who smoked. In general schools did not educate students about the hazards of tobacco use.
Association of vitamin A, vitamin C and zinc with laryngeal cancer
Umesh Kapil, P Singh, S Bahadur, NK Shukla, S Dwivedi, P Pathak, R Singh
April-June 2003, 40(2):67-70
: The incidence of the cancers of the oral cavity, pharynx, esophagus and larynx in different population groups of India is amongst the highest reported in Asian countries. There is evidence that high dietary carotenoids and vitamin C may possibly decrease the risk of laryngeal cancer. Limited data is available from India on the association between these micronutrients and the risk of laryngeal cancer.
: To assess the levels of vitamin A, vitamin C and zinc in laryngeal cancer patients and healthy controls.
SETTING AND DESIGN
: A hospital based case- control study.
MATERIAL AND METHODS
: One hundred and fifty five laryngeal cancer patients and a control group of 155 healthy individuals constituted the study population. Individuals in the control group were individually matched with the patients for their age +/- 2 years, sex and place of residence. Venous blood was drawn from the cases and controls and estimations of vitamin A, zinc and vitamin C was done utilizing the standard procedures.
STATISTICAL ANALYSIS USED
: Paired 't' test to compare the mean serum levels of vitamin A and zinc and plasma vitamin C between laryngeal cancer patients and controls. Univariate logistic regression analysis to calculate the odds ratios and the confidence intervals.
: The mean serum vitamin A, zinc and plasma vitamin C levels were significantly lower in laryngeal cancer patients as compared to the controls.
: The findings of the present study indicated a strong association of these micronutrients with laryngeal cancer in the Indian population.
Primary chondrosarcoma of the breast : A case report
S Gupta, V Gupta, PN Aggarwal, R Kant, N Khurana, AK Mandal
April-June 2003, 40(2):77-9
Mammary sarcomas are uncommon tumors. Of these pure chondrosarcoma without any other area of epithelial or mesenchymal differentiation feature as even rarer. This excludes tumors like malignant cystosarcoma phyllodes and metaplastic carcinoma where malignant cartilaginous areas may be present. Further primary chondrosarcoma arises from breast stroma and not from underlying bone or cartilage. Only five cases of pure and primary chondrosarcoma have been reported so far. The sixth case is reported here.
Maxillary mass as the presenting manifestation of papillary thyroid carcinoma
Anil Bhansali, RN Kataria, KAV Subrahmanyam, BD Radotra, SK Mathur
April-June 2003, 40(2):80-81
A case of follicular variant of papillary thyroid carcinoma presenting with a right maxillary mass is described. This is perhaps the first instance of maxillary metastasis from papillary thyroid carcinoma.
LETTER TO EDITOR
Alveolar soft part sarcoma : A unique tumor with disputed histogenesis
Amit Nair, Dinker R Pai, S Jagdish, R Krishnan
April-June 2003, 40(2):82-83
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