Degenerated lumbricals in the feet of adult human cadavers: case series / 대한해부학회지

In the foot, the lumbricals flex the metatarsophalangeal joints and extend the interphalangeal joints. The lumbricals are known to be affected in neuropathies. It is not known whether they may degenerate in normal individuals. Here, we report our findings of isolated degenerated lumbricals in seemingly normal feet of two cadavers. We explored lumbricals in 20 male and 8 female cadavers that were 60–80 years of age at the time of death. As part of routine dissection, we exposed the tendons of the flexor digitorum longus and the lumbricals. From the degenerated lumbricals, we took some tissue for paraffin-embedding, sectioning, and staining by hematoxylin and eosin, and Masson’s trichrome technique. Of the 224 lumbricals studied, we found four apparently degenerated lumbricals in two male cadavers. In the first, the 2nd and 4th lumbricals in the left foot and the 2nd in the right foot were degenerated. In the second, the right 4th lumbrical was degenerated. Microscopically, the degenerated tissue was made of bundles of collagen. The lumbricals may have degenerated due to compression of their nerve supply. We cannot comment on whether the functionality of the feet were affected by these isolated degeneration of the lumbricals.

Unusual bilateral sensory innervation of the dorsum of hand by lateral antebrachial cutaneous nerve: a case report / 대한해부학회지

A 68-year-old male cadaver showed bilateral variation in the sensory innervation of the dorsum of hand. On the dorsum of right hand, first digit and lateral half of second digit were supplied by lateral antebrachial cutaneous nerve (LABCN); medial side of second digit and lateral side of third digit were supplied by superficial branch of radial nerve (SBRN) and medial side of third digit, the fourth and fifth digits were supplied by dorsal cutaneous branch of ulnar nerve (DBUN). On the dorsum of the left hand, lateral side of first digit was supplied by LABCN, medial side of first digit, the second and third digits as well as the lateral side of fourth digit were supplied by SBRN; medial side of fourth digit and fifth digit were supplied by DBUN. These variations would be helpful in understanding peripheral neuropathy, in interpretation of conduction velocity studies and in reconstructive surgery of hand.

Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patients

Tuberculosis is one of the leading causes of development of Immune reconstitution inflammatory syndrome (IRIS) in HIV patients receiving antiretroviral therapy (ART). OBJECTIVE: To determine the incidence of IRIS in HIV-TB coinfected patients, and to find out the possible risk factors associated with IRIS. MATERIALS AND METHODS: Study commenced with 96 patients adhered to standard antitubercular therapy (ATT) and ART without defaultering, and followed up for six months. RESULT: The mean (± SD) CD4 count and CD4 percentage at baseline was 59.16 (± 24.63) per mm³ and 4.59 percent (± 1.73) respectively. Only 18.75 percent developed IRIS after 57.05 (± 14.12) days of initiation of ART. Extrapulmonary tuberculosis was the most significant factor associated with IRIS (83.33 percent) than those without IRIS (44.87 percent) (p = 0.0032). Specifically, tubercular lymphadenitis (38.88 percent, p = 0.0364) and disseminated tuberculosis (33.33 percent, p = 0.0217) were significantly associated with IRIS. The other risk factors associated with appearance of IRIS were higher CD4 count (p = 0.0212) at three months after initiation of ART and increment of CD4 count (p = 0.0063) and CD4 percentage (p = 0.0016) during this period. The major manifestations of IRIS were fever (40 percent), followed by lymphadenitis (38 percent). The mortality rate in IRIS was not higher than those without IRIS. CONCLUSION: Patients with extrapulmonary tuberculosis, especially tubercular lymphadenitis, were more likely to develop IRIS and fever was associated in most of them. Higher increment of CD4 count may indicate development of IRIS in presence of new or worsening tuberculosis lesion.

Molecular typing of clinical Staphylococcus aureus isolates from northern India using coagulase gene PCR-RFLP.

Molecular typing of total 84 Staphylococcus aureus clinical isolates was performed using coagulase gene PCR. Out of 84 S. aureus strains total 33 different types of S. aureus strains were prevalent in this hospital and community. Types 2-7 and 9 were the most prevalent S. aureus strains accounting for more than 53% of total isolates. This technique is relatively inexpensive and is simple to perform and analyze.