ABSTRACT
Castleman's disease is an atypical lymphoproliferative disorder having two types of presentation--the localized and the multicentric form. The localized form presents as a slowly growing mass with a relatively benign course. Multicentric Castleman's disease has a more aggressive clinical course with diffuse lymph node enlargement and systemic illness. It is rarely seen in childhood and only thirteen cases have been reported in literature. This is the first report of 2 cases from the Indian subcontinent with a maximum follow-up of 44 months one of whom had asplenia.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biopsy, Needle , Child , Follow-Up Studies , Castleman Disease/drug therapy , Humans , Immunohistochemistry , Male , Prednisolone/therapeutic use , Risk AssessmentABSTRACT
Nemaline rod myopathy (NM) is a rare form of congenital myopathy characterized by slowly progressive or nonprogressive muscle weakness and pathognomonic rod-like structures within the muscle fibers. To the best of our knowledge, this is first documentation of the clinicopathological features of this rare entity from India. All cases of NM diagnosed in our laboratory were retrieved. Clinical and pathological features were reviewed. During a period of 1.5 years (Jan 2004 to June 2005), we received 750 muscle biopsies for various reasons. Of which, 15 were diagnosed as congenital myopathies and four as nemaline rod myopathies. Thus, NM comprises 0.53% of all muscle diseases and 22.6% of all congenital myopathies. All of them presented in childhood (first five years of life) with generalized hypotonia, feeding problems, repeated respiratory infections and muscle weakness. Both males and females were equally affected. The CPK levels were normal and EMG was myopathic. Microscopic examination revealed minimal changes but characteristic red-colored material was seen on modified Gomori trichrome staining which was immunopositive to alpha actinin. Ultrastructural examination confirmed this material to be nemaline rods. NM, although a rare form of congenital myopathies, should be suspected in children who present with generalized hypotonia, repeated chest infections and slowly progressive muscle weakness. This report highlights the importance of histochemistry and ultrastructural examination in the diagnosis of this entity, in the absence of the availability of methodology for genetic studies.
Subject(s)
Child , Child, Preschool , Electromyography/methods , Female , Humans , Infant , Male , Microscopy, Electron, Transmission/methods , Muscle, Skeletal/pathology , Myopathies, Nemaline/pathology , Neuromuscular Diseases/complicationsABSTRACT
Congenital fiber type disproportion is a rare type of congenital myopathy which presents as hypotonia, delayed motor milestones and dysmorphic facies. During the past 2 years we received 449 muscle biopsies, of which 4 cases were diagnosed as congenital fiber type disproportion (CFTD). In addition to CFTD, one case also had centronuclear features. Three of them were females and one was a male child. Although rare, it should be considered in the differential diagnosis of childhood muscle diseases. Histochemical staining is necessary for the diagnosis of this entity.
Subject(s)
Adolescent , Biopsy , Child , Child, Preschool , Diagnosis, Differential , Female , Histocytochemistry/methods , Humans , Male , Muscle, Skeletal/metabolism , Myopathies, Structural, Congenital/metabolism , Staining and LabelingABSTRACT
To estimate the biostimulatory effects of low intensity laser radiation on healing of skin wounds, two linear skin wounds were produced on either side of dorsal midline in rats and immediately sutured. Wounds on the left side were irradiated daily with helium neon laser at 4 Joules/sq.cm for 5 min., while those on right side were not exposed and served as controls. The mean time required for complete closure in control group was 7 days while irradiated test wounds took only 5 days to heal (P < 0.01). The mean breaking strength, as measured by the ability of the wound to resist rupture against force, was found to be significantly increased in the test group. Early epithelization, increased fibroblastic reaction, leucocytic infiltration and neovascularization were seen in the laser irradiated wounds. The results establish the biostimulatory effects of low intensity laser radiation on healing of skin wounds.
Subject(s)
Animals , Laser Therapy , Male , Rats , Skin/injuries , Time Factors , Wound Healing/radiation effectsABSTRACT
Experience with peri-operative oxytetracycline coverage in prevention of wound infection following elective surgery is presented; of 150 cases included in control group 21 developed infection (14%), whereas only 4 of the study group (170 cases) had infection (2.5%). The importance of peri-operative antibiotic umbrella is emphasised and some of the shortcomings of recommended schedule is highlighted.