Aetiology of Legg-Calvé-Perthes disease:A systematic review

BACKGROUND Legg-Calvé-Perthes disease(LCPD) is a clinical condition affecting the femoral head of children during their growth. Its prevalence is set to be between 0.4/100000 to 29.0/100000 children less than 15 years of age with a peak of incidence in children aged from 4 years to 8 years. LCPD aetiology has been widely studied, but it is still poorly understood.AIM To analyse the available literature to document the up-to-date evidence on LCPD aetiology.METHODS A systematic review of the literature was performed regarding LCPD aetiology,using the following inclusion criteria: studies of any level of evidence, reporting clinical or preclinical results and dealing with the aetiology or pathogenesis of LCPD. Two reviewers searched the PubMed and Science Direct databases from their date of inception to the 20th of May 2018 in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines. To achieve the maximum sensitivity of the search strategy, we combined the terms: ‘‘Perthes disease OR LCPD OR children avascular femoral head necrosis" with "pathology OR aetiology OR biomechanics OR genetics" as either key words or MeSH terms.RESULTS We include 64 articles in this review. The available evidence on LCPD aetiology is still debated. Several hypotheses have been researched, but none of them was found decisive. While emerging evidence showed the role of environmental risk factors and evidence from twin studies did not support a major role for genetic factors, a congenital or acquired predisposition cannot be excluded in disease pathogenesis. One of the most supported theories involved mechanical induced ischemia that evolved into avascular necrosis of the femoral head in sensible patients.CONCLUSION The literature available on the aetiology of LCPD presents major limitations in terms of great heterogeneity and a lack of high-profile studies. Although a lot of studies focused on the genetic, biomechanical and radiological background of the disease, there is a lack of consensus on one or multiple major actors of the etiopathogenesis. More studies are needed to understand the complex and multifactorial genesis of the avascular necrosis characterizing the disease.

Aetiology of bipolar disorder: contribution of the L-type voltage-gated calcium channels

LTCCS ARE IMPLICATED IN THE PATHOLOGY OF BIPOLAR DISORDER Bipolar disorder (BPD) is a common mental illness with significant morbidity and mortality.1 Although evidence have suggested changes in oxidative stress, dopamine and inflammation in BPD, it is hard to define the aetiological mechanism of BPD clearly. Recently, some but not all candidate gene association studies, family-based association studies, linkage studies, genome-wide association studies (GWASs) and meta-analyses showed that mutation of L-type voltage-gated calcium chan? nels (LTCCs) gene CACNAlCis implicated in the mechanism of BPD.'-8 These findings support the possibility that BPD might have calcium channelopathy.

Further Investigation on the Role of Selenium Deficiency in the Aetiology and Pathogenesis of Keshan Disease

Selenium supplements were not able to restore the ultrastructural changes in the myocardiurn of latent Keshan disease patients taken by using cardiac catheter endomyocardial biopsy. Observations on the changes of seleniurn status and the incidence of Keshan disease showed that new latent and naturally-occurring chronic cases were found in the endemic area even after selenium levels had been elevated in the residents to the levels typical in the non-endemic area. These results indicate that although selenium deficiency might be a primary pathogenetic geogen in the occurrence of Keshan disease, it is rather a conditional predisposing factor than a specific or initiative aetiologic factor for the occurrence of Keshan disease. Selenium supplmentation could apparently alleviate the higher platelet responsiveness of residents in the endemic area, which might contribute to eliminating the basis for the occurrence of the multifocal perivascular necroses in myocardium of acute and subacute Keshan disease

Mother’s of Children with Cleft Lip and/or Palate, Perception about Aetiology, Social Reaction and Treatment of Cleft

Background: Religious, cultural beliefs and demographical differences can have a huge impact in shaping people’s reactions and attitudes toward cleft children. Myths and folk beliefs frequently accompany the birth of a child with deformities especially in Africa. Objective: Evaluate cleft mothers with cleft children attending a multidisciplinary cleft clinic at Komfo Anokye Teaching Hospital about their experiences on aetiology, expectation, family reaction and treatment of cleft lip and palate. Methodology: The study design was a cross-sectional study which involved consecutive mothers of cleft lip and palate children reporting to Komfo Anokye Teaching Hospital (KATH) Cleft clinic by using a structured questionnaire. The study period was from January to June 2013. Results: The highest recorded response (47.50%) from mothers was that their nuclear families had been supportive. The least recorded nuclear family reaction was indifferent to child’s condition (3.70%). 47.50% of mothers reported their extended family members had been supportive whereas the least recorded reaction of extended family members (1.25%) was avoidant behaviour. 52 Mothers (65%) answered that they are not mocked by members of the society whereas 28 (35%) answered they were mocked. Conclusion: The above study demonstrates that mother’s educational background was low. Some mothers still believe CL/P is caused by evil spirit even though they are in the minority. Most mothers were hopeful that their babies will have a normal life after surgery. There was high level of family support for cleft families.

The Biomechanical Aetiology of the So-Called Idiopathic Scoliosis. The Role of Gait and Standing at “Ease” on the Right Leg in the Development of the Deformity

The article presents the biomechanical etiology of the so-called idiopathic scoliosis. The research was conducted in the years 1985-2013, but the importance of the observations connected with the so-called idiopathic scoliosis were completed in 2007 (4, 5, 6, 7, 8, 9). All types of spine deformity are proved to have a connection with gait and with standing “at ease” on the right leg. Every type of scoliosis begins to develop at the age of 2 - 3. The article provides short information about new screening tests and new exercises in the course of causal prophylaxis and treatment.

Screening for hypertension-mediated organ damage and aetiology:still of value after 65 years of age?

BACKGROUND Secondary forms and hypertension-mediated organ damage(HMOD) may differ between younger and older hypertensive patients.The aim of the present study was to explore the specificity of HMOD and secondary forms in patients≥ 65 years in comparison to younger ones in a contemporary cohort.METHODS We analysed 938 patients recruited between 2004 and 2014(Cardiology department,Croix-Rousse Hospital,Lyon)who had at baseline HMOD and secondary forms screening among them 190 were≥ 65 years.RESULTS The mean(2.1±0.8 vs.1.2±0.9,P <0.001) and frequency of HMOD(96.3% vs.72.9%,P <0.001) was higher in patients≥ 65 years than younger ones.Carotid femoral pulse wave velocity> 10 m/s was the most frequent HMOD in patients≥ 65 years(90.1%),while echocardiographic left ventricular hypertrophy was the most common in the younger patients(45.0%).Among ECG left ventricular indexes,only R wave in aVL lead was significantly more frequently observed in patients≥ 65 years(32.6%) than in younger ones(19.0%,P <0.001).The frequency of secondary hypertension was not significantly different between younger and older patients(respectively;30.5% vs.27.8%,P=0.487).The most frequent aetiology was primary aldosteronism regardless of age,followed by renovascular hypertension(6.3% vs.3.3%,P=0.038).Among older patients,3.2% were treated with adrenalectomy and 6.3% with percutaneous transluminal renal angioplasty.CONCLUSION Extensive screening of HMOD in older patients may be questionable as nearly all patients had one;aetiology must however be explored as a third of older patients had a secondary form.

Prevalence of fever of unidentifed aetiology in East African adolescents and adults: a systematic review and meta-analysis

Background Primary health care settings and hospitals of low-and middle-income countries have few accessible diagnostic tools and limited laboratory and human resources capacity to identify multiple pathogens with high accu‑racy.In addition,there is a paucity of information on fever and its underlying aetiology in the adolescent and adult population in East Africa.The purpose of this study was to estimate the pooled prevalence of fever of unidentifed aetiology among adolescent and adult febrile patients seeking health care in East Africa.Methods We pursued a systematic review using readily available electronic databases(i.e.PubMed,Cumulative Index to Nursing&Allied Health Literature,Scopus,Cochrane Library and Web of Science)without language restric‑tion from inception date of the respective databases to October 31,2022.We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Identifed studies were screened for relevance.Further analyses based on pre-set eligibility criteria were carried out for fnal inclusion.Two reviewers independently screened and extracted data.Risk of study bias was assessed.Meta-analysis of the prevalence of fever of unidentifed aetiology was performed.Results We identifed 14,029 articles of which 25 were eligible for inclusion,reporting data from 8538 participants.The pooled prevalence of febrile cases with unidentifed aetiology was 64%[95%confdence interval(CI):51–77%,I 2=99.6%]among febrile adolescents and adults in East Africa.For the proportion of patients with identifed aetiol‑ogy,the studies documented bacterial pathogens(human bloodstream infections),bacterial zoonotic pathogens and arboviruses as the main non-malarial causative agents in East Africa.Conclusions Our study provides evidence that almost two-thirds of adolescent and adult febrile patients attending health care facilities in East Africa might receive inappropriate treatments due to unidentifed potential life-threat‑ening fever aetiology.Hence,we call for a comprehensive fever syndromic surveillance to broaden a consequential diferential diagnosis of syndromic fever and to considerably improve the course of patients’disease and treatment outcomes.

Treatment of uveitis and scleritis patients in Malaysia

●AIM:To determine the common causes and visual outcome after treatment among uveitis and scleritis patients.●METHODS:This is a retrospective cohort observational study.All consecutive clinical records of patients with newly diagnosed uveitis and scleritis over a 4-year period,from Jan.1,2017 to Dec.31,2020,were analysed.Data was collected at the presentation and included a follow-up period of one year.●RESULTS:A total of 288 patients were recruited during the study period.Anterior uveitis was the most common anatomical diagnosis(50.0%)followed by panuveitis(25.0%),scleritis(13.5%),posterior uveitis(6.9%),and intermediate uveitis(4.5%).Viral Herpes was the most common cause of infectious cases,while Vogt-Koyanagi-Harada(VKH)disease and human leucocyte antigen(HLA)B27 spondyloarthropathy were the leading causes of identifiable non-infectious cases.Majority of patients presented with unilateral,non-granulomatous uveitis with an absence of hypopyon.Anatomical locations like posterior uveitis and panuveitis,and visual acuity worse than 3/60 at presentation were the factors associated with poor visual outcomes(P<0.05).About 60%of patients had an identifiable cause for the uveitis and scleritis,with nearly equal distribution of infectious(n=85,29.5%)and noninfectious causes(n=84,29.2%).About 14.5%of patients were clinically blind at 1y of follow-up.The most common complication in our uveitis patients was glaucoma(47.5%),followed by cystoid macula oedema(18.9%)and cataract(13.9%).●CONCLUSION:Uveitis and scleritis are important causes of ocular morbidity.They are potentially blinding diseases which can have a good outcome if diagnosed and treated early.

A Multicenter Study of Viral Aetiology of Community-Acquired Pneumonia in Hospitalized Children in Chinese Mainland

Community-acquired pneumonia(CAP) is one of the leading causes of morbidity and mortality in children worldwide.In this study,we aimed to describe the aetiology of viral infection of pediatric CAP in Chinese mainland.During November2014 to June 2016,the prospective study was conducted in 13 hospitals.The hospitalized children under 18 years old who met the criteria for CAP were enrolled.The throat swabs or nasopharyngeal aspirates(NPAs) were collected which were then screened 18 respiratory viruses using multiplex PCR assay.Viral pathogens were present in 56.6%(1539/2721) of the enrolled cases,with the detection rate of single virus in 39.8% of the cases and multiple viruses in 16.8% of the cases.The most frequently detected virus was respiratory syncytial virus(RSV)(15.2%,414/2721).The highest detection rate of virus was in <6-month-age group(70.7%,292/413).RSV,human metapneumovirus(HMPV),human parainfluenza viruses(HPIVs) and influenza B virus(Flu B) showed the similar prevalence patterns both in north and south China,but HPIVs,Flu A,human bocavirus(HBoV),human adenovirus(HAdV) and human coronaviruses(HCoVs) showed the distinct circulating patterns in north and south China.Human enterovirus/human rhinovirus(HEV/HRV)(27.6%,27/98),HBoV(18.4%,18/98),RSV(16.3%,16/98) and HMPV(14.3%,14/98) were the most commonly detected viruses in severe pneumonia cases with single virus infection.In conclusion,viral pathogens are frequently detected in pediatric CAP cases and may therefore play a vital role in the aetiology of CAP.RSV was the most important virus in hospitalized children with CAP in Chinese mainland.

Acute hepatitis of unknown aetiology among children around the world

By 26 August 2022, the number of cases of acute hepatitis of unknown etiology (AHUA) has drastically increased to 1115 distributed in 35 countries that fulfill the World Health Organization definition. Several hypotheses on the cause of AHUA have been proposed and are being investigated around the world. In the recent United Kingdom (UK) report, human adenovirus (HAdV) with adeno-associated virus (AAV) co-infection is the leading hypothesis. However, there is still limited evidence in establishing the causal relationship between AHUA and any potential aetiology. The leading aetiology continues to be HAdV infection. It is reported that HAdV genomics is not unusual among the population in the UK, especially among AUHA cases. Expanding the surveillance of HAdV and AAV in the population and the environment in the countries with AUHA cases is suggested to be the primary action. Metagenomics should be used in detecting other infectious pathogens on a larger scale, to supplement the detection of viruses in the blood, stool, and liver specimens from AUHA cases. It is useful to develop a consensus-specific case definition of AHUA to better understand the characteristics of these cases globally based on all the collected cases.

Progress in diagnosis and treatment of acute injury to the anterior talofibular ligament

Injury to the anterior talofibular ligament(ATFL)is a common acute injury of the lateral foot ligament.Untimely and improper treatment significantly affects the quality of life and rehabilitation progress of patients.The purpose of this paper is to review the anatomy and the current methods of diagnosis and treatment of acute injury to the ATFL.The clinical manifestations of acute injury to the ATFL include pain,swelling,and dysfunction.At present,non-surgical treatment is the first choice for acute injury of the ATFL.The standard treatment strategy involves the“peace and love”principle.After initial treatment in the acute phase,personalized rehabilitation training programs can be followed.These may involve proprioception training,muscle training,and functional exercise to restore limb coordination and muscle strength.Static stretching and other techniques to loosen joints,acupuncture,moxibustion massage,and other traditional medical treatments can relieve pain,restore range of motion,and prevent joint stiffness.If the non-surgical treatment is not ideal or fails,surgical treatment is feasible.Currently,arthroscopic anatomical repair or anatomical reconstruction surgery is commonly used in clinical practice.Although open Broström surgery provides good results,the modified arthroscopic Broström surgery has many advantages,such as less trauma,rapid pain relief,rapid postoperative recovery,and fewer complications,and is more popular with patients.In general,when treating acute injury to the ATFL,treatment management and methods should be timely and reasonably arranged according to the specific injury scenario and attention should be paid to the timely combination of multiple therapies to achieve the best treatment results.

Aetiologic Factors of Anemia During Heart Failure in Brazzaville (The Republic of the Congo)

To contribute to improving the management of patients with heart failure and anemia in Brazzaville, a prospective and descriptive study was conducted in the University Hospital of Brazzaville for nine months (January 1st to September 30, 2017). Included 57 patients hospitalized for left or global heart failure and presenting anemia. Anemia was defined by an haemoglobin level < 12 g/dL in men and <11 g/dL in women. Proportionings of the reticulocytes rate, serum iron, ferritin, erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP), electrophoresis of proteins, and evaluation of renal function by glomerular filtration rate (GFR), as well as the treatments of heart failure, and the auxiliary therapeutic ones, in particular the antithrombotic drugs, allowed aetiologic research. They were 20 men (35%) and 37 women (65%), old on average of 59 ± 17 years. The average rate of haemoglobin was 11.4 ± 1.4 g/dL. Heart failure was de novo in 24 cases (42.1%), old in 33 cases (57.9%);it was global in 54 cases (94.7%).The maintenance treatment associated diuretics in 32 cases (97%), angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) in 31 cases (94%), beta-blockers in two cases (6.1%), digoxin in four cases (12.1%), aspirin in five cases (15.1%) and anti-vitamin K in four cases (12.1%). Anemia was microcytic hypochromic in 30 cases (52.6%), normocytic normochromic in 20 cases (35.1%), and macrocytic normochromic in one case (1.7%). The main aetiologic factors were hemodilution in 46 cases (80.7%), renal insufficiency in 30 cases (52.3%), inflammation in 29 cases (50.8%), and iron deficiency in one case (1.7%). The HIV serology, carried out in 11 cases, was negative. Anemia is a frequent comorbidity among heart failure patients. Aetiologic research remains difficult in our context, and its often multifactorial origin.

Hepatocellular carcinoma: Epidemiology, risk factors and pathogenesis

Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Given that the burden of chronic liver disease is expected to rise owing to increasing rates of alcoholism, hepatitis B and C prevalence and obesity-related fatty liver disease, it is expected that the incidence of HCC will also increase in the foreseeable future. This article summarizes the international epidemiology, the risk factors and the pathogenesis of HCC, including the roles of viral hepatitis, toxins, such as alcohol and aflatoxin, and insulin resistance.

Role of cytochrome P450 polymorphisms and functions in development of ulcerative colitis

Cytochromes P450 s(CYPs) are terminal enzymes in CYP dependent monooxygenases, which constitute a superfamily of enzymes catalysing the metabolism of both endogenous and exogenous substances. One of their main tasks is to facilitate the excretion of these substances and eliminate their toxicities in most phase 1 reactions. Endogenous substrates of CYPs include steroids, bile acids, eicosanoids, cholesterol, vitamin D and neurotransmitters. About 80% of currently used drugs and environmental chemicals comprise exogenous substrates for CYPs. Genetic polymorphisms of CYPs may affect the enzyme functions and have been reported to be associated with various diseases and adverse drug reactions among different populations. In this review, we discuss the role of some critical CYP isoforms(CYP1 A1, CYP2 D6, CYP2 J2, CYP2 R1,CYP3 A5, CYP3 A7, CYP4 F3, CYP24 A1, CYP26 B1 and CYP27 B1) in the pathogenesis or aetiology of ulcerative colitis concerning gene polymorphisms. In addition, their significance in metabolism concerning ulcerative colitis in patients is also discussed showing a clear underestimation in genetic studies performed so far.

Comorbidity of bipolar and anxiety disorders:An overview of trends in research

Over the last three decades burgeoning research has shown that anxiety disorder comorbidity is not only highly prevalent in bipolar disorder(BD),but it also adversely impacts the course,outcome,and treatment of BD.The present review provides an overview of the current trends in research on comorbid anxiety and BDs based on prior reviews and meta-analyses(n=103),epidemiological surveys,and large-scale clinical studies.The results reiterated the fact that at least half of those with BD are likely to develop an anxiety disorder in their lifetimes and a third of them will manifest an anxiety disorder at any point of time.All types of anxiety disorders were equally common in BD.However,there was a wide variation in rates across different sources,with most of this discrepancy being accounted for by methodological differences between reports.Comorbid anxiety disorders negatively impacted the presentation and course of BD.This unfavourable clinical profile led to poorer outcome and functioning and impeded treatment of BD.Despite the extensive body of research there was paucity of data on aetiology and treatment of anxiety disorder comorbidity in BD.Nevertheless,the substantial burden and unique characteristics of this comorbidity has important clinical and research implications.

Adjuncts to case assessment of vaginal discharge syndrome in pregnant women

Objective:To investigate the aetiology of abnormal vaginal discharge,using a non-culture based method,among pregnant women presenting at the University of Calabar Teaching Hospital, Calabar,Nigeria.Methods:Two hundred consecutive antenatal patients,aged 18 to 38 years,with complaints of abnormal vaginal discharge between 1st April and 31st July 2004 were investigated clinically for the characteristics of the vaginal discharge.High vaginal swabs taken from the vaginal fornices were examined using a non-culture based method to determine the possible aetiology of the discharge.The possibility of integrating non-culture based laboratory methods in the syndromic case management of abnormal vaginal discharge in an antenatal clinic setting is discussed.Results: The commonest form of abnormal discharge was curdy white in 66%of cases.Ten(5%) women had malodourous vaginal discharged,92%had vulval itching;and superficial dyspareunia was seen in 29%of cases.Microscopic studies of vaginal discharge revealed the following findings: lactobacilli(96%),polymorphs(96%),’clue’ cells(4%);positive Whiff test(5%),and pH 】 4.5 (7%).The clinical and laboratory assessment of each patient lasted between 35 and 45 minutes.The procedures used were acceptable to 78%of women.Conclusion:The use of non-culture based laboratory methods in the initial assessment of abnormal vaginal discharge can be a useful adjunct in the syndromic case management of abnormal vaginal discharge in pregnant women.

Descriptive epidemiological study of burn admissions to the Burns Intensive Care Unit of the Komfo Anokye Teaching Hospital, Kumasi-Ghana, 2009–2016

Objective: To determine the trends in burn admissions, and aetiology, severity and mortality of patients admitted to the Burns Intensive Care Unit of the Komfo Anokye Teaching Hospital from May 2009 to April 2016 (7 years). Methods: Patients' data used in this longitudinal and retrospective study were accessed from the records of the Reconstructive Plastic Surgery and Burns Unit. Processed data were depicted in tables and figures as appropriate. Univariate and multivariate analysis and Pearson's rank correlation were used in comparing relevant groups. Data analysis was conducted using Excel version 2013 and SPSS version 17.0. Results: A total of 681 patients, with a male to female ratio of 1.1:1.0, were analysed. The average annual incidence was 97.28 with a progressive decline in incidence. Mortality rate was 24.2%. Majority of the patients were children less than 10 years (43.5%) with scalds as the main aetiology in this group. Open flame was the major aetiology of burns (49.9%). Majority of the patients spent less than 10 days on admission (67.1%). Mean total body surface area was 30.54%. There was correlation between TBSA and disposition, total body surface area and aetiology and number of days in the Burns Intensive Care Unit, total body surface area and aetiology, and aetiology and number of days in the Burns Intensive Care Unit. Conclusions: Children below 10 years were the main victims. There was a shift from scald to open flame burns in this current study. Mean total body surface area and mortality rate have increased. There is urgent need for prevention campaign of flame burn and first aid education on intensive burns.

Vaginal Bleeding in the Nonpregnant Patient Received in Emergency at Yalgado Ouedraogo University Hospital of Ouagadougou, Burkina Faso

Objective: To describe the epidemiological, clinical and therapeutic aspects of cases of vaginal bleeding in the nonpregnant patient received in emergency at Yalgado OUEDRAOGO University Hospital. Materials and Methods: It was a retrospective and descriptive study that involved the clinical records of 326 patients collected from January 01, 2009 to December 31, 2013. Results: The average age of women was 47 years old with extremes at 12 and 82 years old. Women of childbearing age accounted for 61.6% and postmenopausal women 18.7%. 70.7% of women were pauciparous or nulliparous. Menorrhagia and pelvic pain were the main signs associated. This symptomatology required hospitalization in 85.2% of cases. The main aetiologies were uterine myomas 49.69%, cervical cancer 23% and functional metrorrhagia 11.04%. Progestin was the most used drug in 67.1% of cases. Total abdominal hysterectomy and abdominal myomectomy were the most commonly used surgical methods with 22.3%, 44.4% of cases. Eleven death cases were observed. Conclusion: Gynecological metrorrhagia is more common in women of childbearing age than in menopausal women. The main causes are fibroma, cervical cancer and functional metrorrhagia.

Preeclampsia-What is to blame?The placenta,maternal cardiovascular system or both?

Preeclampsia(PE)is a pregnancy-specific syndrome,complicating 2%-8% of pregnancies.PE is a major cause of maternal mortality throughout the world with 60000 maternal deaths attributed to hypertensive disorders of pregnancy.PE also results in fetal morbidity due to prematurity and fetal growth restriction.The precise aetiology of PE remains an enigma with multiple theories including a combination of environmental,immunological and genetic factors.The conventional and leading hypotheses for the initial insult in PE is inadequate trophoblast invasion which is thought to result in incomplete remodelling of uterine spiral arteries leading to placental ischaemia,hypoxia and thus oxidative stress.The significant heterogeneity observed in pre-eclampsia cannot be solely explained by the placental model alone.Herein we critically evaluate the clinical(risk factors,placental blood flow and biomarkers)and pathological(genetic,molecular,histological)correlates for PE.Furthermore,we discuss the role played by the(dysfunctional)maternal cardiovascular system in the aetiology of PE.We review the evidence that demonstrates a role for both the placenta and the cardiovascular system in early-and late-onset PE and highlight some of the key differences between these two distinct disease entities.

THE ESOPHAGEAL CARCINOMA OF RHESUS MONKEYS FROM TAIHANG MOUNTAIN AREA OF HIGH MORBIDITY OF ESOPHAGEAL CARCINOMA

Taihang Mountain area, a high Incidence area of human esophageal cancer in Northern China. 124 Rhesus monkeys (Macacs Mulatta) were caught in the area in January 1989. Among them, two monkeys died of esophageal carcinoma in 1990. Case 1, a male monkey about 6. 5 yean old and weighing 14. 5 kg, had symptoms of salivation, vomiting and dysphagia in Fabruary 1990. The symptoms became gradually more serious and died in march 1990. Postmortem examination revealed a huge tumor in the distal segment of esophagus, causing severe structure of the organ. The tumor was classified as medullary type and histopathologically diagnosed as a well differentiated squamous cell carcinoma, with metastases to mediastinum and lymph nodes of right gastric group. Case 2, a female monkey ablut 11-year-old and weighing 10. 0 kg, showed loss of appetite, tiredness, somnolence, caughing and vomiting in September and died in December 1990. Autopsy revealed an annular tumor involving the whole clcumference of lower portion of the esophagus. The tumor was of ulcerative type and diagnosed as a well differentiated squamous cell carcinoma. The symptoms and pathological changes of the two monkeys showed high similarity to esophageal cancer in humen. We believe that the present findings would provide important leads for further study to clarify the etiology and pathogenesis ofhuman esophageal cancer in this high Incidence area of esophageal cancer.of