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2 results

  • Evaluation of epithelial proliferation in paediatric and adult cholesteatomas using the Ki-67 proliferation marker

  • K Sikka, S C Sharma, A Thakar, S Dattagupta
  • Journal:
    The Journal of Laryngology & Otology / Volume 126 / Issue 5 / May 2012
    Published online by Cambridge University Press:
    14 December 2011, pp. 460-463
    Print publication:
    May 2012
  • Introduction:

    The aggressiveness of cholesteatoma in children compared with adults is well known. However, the factors influencing the poorer prognosis of paediatric cholesteatoma are not well understood. This study compared the proliferative potential of paediatric cholesteatoma with that of adult cholesteatoma, using Ki-67 as a proliferation marker.

    Methods:

    A prospective study of 67 patients with aural cholesteatoma was performed. Thirty-eight adult and 29 paediatric cases were evaluated using clinical parameters including bone erosion, complications and extent of disease. A surgical specimen underwent histological evaluation and measurement of the proliferation index using Ki-67 labelling. Normal epithelium from a control group was also examined.

    Results:

    Cholesteatoma epithelium has a greater rate of proliferation than normal skin. There were however no statistical differences between the paediatric and adult cholesteatoma groups in terms of clinical behaviour or proliferation potential. Paediatric cholesteatoma was similar to adult cholesteatoma in terms of complications, bone erosion and disease spread.

    Conclusion:

    Cholesteatoma is a disorder of epithelial proliferation. Although postulated to be more aggressive in children than adults, this study found no clinicopathological differences between paediatric and adult cases.

  • 7 - Brain development and evolution

  • from Part 3 - Normal development
  • Edited by Monique Ernst, National Institutes of Health, Baltimore, Judith M. Rumsey, National Institute of Mental Health, Bethesda, Maryland
  • Foreword by Joseph T. Coyle
  • Book:
    Functional Neuroimaging in Child Psychiatry
    Published online:
    06 January 2010
    Print publication:
    12 October 2000, pp 113-136

  • Summary

    This chapter reviews the development of the human brain from conception to adult age and its evolution across time and species. The size and the shapes of the various portions of the mature nervous system result from a variety of developmental processes such as cellular proliferation, cellular migration, and cell death, and also from the constraints imposed by the surrounding non-neural tissues. During brain development, neurons are dependent on external factors for guidance and survival. These factors include biochemical influences such as neurotransmitters and steroid hormones. The mechanisms involved are complex and require appropriate spatiotemporal relationships and feedback loops. Human brains appear to be products of evolutionary mechanisms such as selection and genetic variation. During the evolution of the nervous system, certain general trends seem to have occurred. Laterality in the cortex of humans represents a behavioral and morphologic reorganization within the brain.