Changing pattern of bronchogenic carcinoma : A statistical variation or a reality?

OBJECTIVES: To document the various CT appearances of bronchogenic carcinoma with histopathologic correlation, to identify changing trend in the radiographic pattern of bronchogenic carcinoma, if any and to evaluate the role of CT in staging of bronchogenic carcinoma was also evaluated. MATERIALS AND METHODS A prospective study of 81 patients over a period of 2 yrs with clinical and or radiological suspicion of bronchogenic carcinoma and confirmed histopathogical diagnosis was undertaken with CT of the thorax using 10 mm collimation sections from the level of lung apices to the diaphragm and routinely included the adrenals. RESULTS : Squamous cell carcinoma is the most common histologic subtype followed by adenocarcinoma and small cell carcinoma. There was a definite male preponderance with smoking being the most common risk factor. Adenocarcinoma is presenting predominantly as central tumor( 70.5% ) Squamous cell carcinoma is presenting predominantly as peripheral tumor (52.7% ) . CONCLUSION Computed tomography is the modality of choice for evaluating bronchogenic carcinoma because of its better spatial resolution. CT provides precise characterization of the size, contour, extent and tissue composition of the suspicious lesion. If the lesion represents a bronchogenic carcinoma, CT serves as a part of the staging process to assess the extent of the disease. The radiologic presentation of adenocarcinoma and squamous cell carcinoma is showing a changing pattern. In our study, adenocarcinoma is presenting predominantly as a central tumor and Squamous cell carcinoma is presenting predominantly as a peripheral tumor. This relative increase in the percentage of centrally located adenocarcinoma is a statistical variation or a reality needs to be evaluated further

Widespread cognitive impairment in psychogenic anterograde amnesia.

A 34-year-old man without a past history of any psychiatric or neurological disorder developed severe anterograde amnesia following a psychological trauma. Initial assessment of neuropsychological functions 3 months after the psychological trauma indicated severe memory deficits for acquiring new information in both verbal and visual modalities with widespread cognitive deficits in attention, executive functions, and intellectual ability. Importantly, working and remote memory were intact. The case illustrates that psychogenic anterograde amnesia might be associated with a wider range of cognitive deficits. Possible neurobiological explanations are discussed to explain large cognitive impairments associated with anterograde psychogenic amnesia

Strength Symmetry Index: A measure of seizure adequacy in ECT

Seizure electroencephalography (EEG) was recorded from two channels-right (Rt) and left (Lt)-during bilateral electroconvulsive therapy (ECT) (n = 12) and unilateral ECT (n = 12). The EEG was also acquired into a microcomputer and was analyzed without knowledge of the clinical details. EEG recordings of both ECT procedures yielded seizures of comparable duration. The Strength Symmetry Index (SSI) was computed from the early- and midseizure phases using the fractal dimension of the EEG. The seizures of unilateral ECT were characterized by significantly smaller SSI in both phases. More unilateral than bilateral ECT seizures had a smaller than median SSI in both phases. The seizures also differed on other measures as reported in the literature. The findings indicate that SSI may be a potential measure of seizure adequacy that remains to be validated in future research

Subclinical autonomic neuropathy in alcoholics: Decreased heart rate variability

Cardiac autonomic neuropathy is known to occur in alcoholics but the extent of its subclinical form is not usually recognized, Heart Rate Variability (HRV) analysis can detect subclinical autonomic neuropathy. In this study the HRV parameters were compared in 20 neurologically asymptomatic alcoholics, 20 age-matched normals and 16 depressives. All were males, ECG was recorded in a quiet room for four minutes in supine position. Time and Frequency domain parameters of HRV were computed by a researcher blind to clinical details. Alcoholics had significantly smaller Coefficient of Variation of R-R intervals (CVR-R) on time domain analysis and smaller HF band (0.15-0.5 Hz) power on spectral analysis. The decreased Heart Rate Variability indicates cardiac autonomic dysfunction