Signet ring cell carcinoma of ampulla of Vater in a young adult.

Signet ring cell carcinoma of the ampulla of Vater is extremely rare. The 7 cases reported earlier have been in older patients. We report a 32-year-old lady with this condition, who also had metastases in the bone marrow, vertebrae, lungs and liver.

Cerebral chromoblastomicosis--a rare case report of cerebral abscess and brief review of literature--a case report.

A rare case of Cerebral Chromomycosis caused by chromogenic fungus Cladosporium trichoides in a 35 year old male with classical presentation of cerebral abscess is being presented. The case report lays emphasis on the histological diagnosis of chromogenic fungus in the wall of the abscess cavity, surgically removed from a well delineated circumscribed lesion in the frontal lobe of the cerebrum. The causative fungus could be detected even in unstained paraffin sections. The diagnosis could be made only after surgical removal and histopathological examination. The mycological culture could not be made as the material was received in formaldehyde fixative. The unique features of the case is its recurrence free uneventful survival five years after surgical excision. This is probably the fifth reported case of cerebral chromomycosis from India and first of its type from arid zone of Rajasthan.

Jejunal perforation: a complication of colonoscopy.

Perforation of a hollow viscus following fibreoptic endoscopy is rare. Perforation following colonoscopy has been reported to occur in the large intestine. We report a case. Small bowel perforation subsequent to colonoscopy.

Endoscopic variceal ligation: an effective method of variceal obliteration.

Endoscopic variceal ligation was performed in 20 patients with portal hypertension of varied etiology. Variceal obliteration was achieved in 18 patients (90%) while recurrence of bleeding occurred in two patients (10%). The average number of bands required was four per patient and average number of sessions required for variceal obliteration was two. We found the procedure to be cheap, safe and effective in achieving early variceal obliteration.

Usefulness of immunoperoxidase test for serodiagnosis of genital chlamydial infections.

An immunoperoxidase test detecting Chlamydia trachomatis specific serum IgG and IgA antibodies, was carried out to determine its efficacy in establishing chlamydial etiology in 104 clinically diagnosed patients attending a major STD Clinic in Delhi. The patients consisted of 58 with nonspecific urethritis/cervicitis (NSU/NSC), 11 with pelvic inflammatory disease (PID), 23 with primary infertility in either male or female and 12 with lymphogranuloma venereum (LGV). IgG antibodies were tested at a dilution of 1:64 and 1:128 and IgA antibodies at 1:16. Although 27.7 per cent (5 of 18) of the controls had IgG antibodies (> or = 1:128), none had IgA, showing the IgA marker as 100 per cent specific. In 80.8 per cent of all the patients, active infection was detected, 81.0 per cent in NSU/NSC, 81.8 per cent in PID, 76.9 per cent in female infertility, 80 per cent in male infertility and 83.3 per cent in LGV patients. The immunoperoxidase test was found to be an extremely simple and rapid test especially suited for laboratories where facilities are limited.

Healing of a graft in vascularized and non-vascularized corneal lesions.

The healing of graft and visual results were compared in 21 vascularized and 29 non-vascularized corneal lesion. The healing and visual results were better in those cornea which were non-vascularized.

Utility of semithin sections in the diagnosis of donovanosis.

The relative merits of tissue smears, paraffin sections and semithin plastic embedded sections in the diagnosis of donovanosis were assessed. In three cases reported negative or doubtful for the organisms by the former two methods, semithin plastic sections provided definite diagnosis. The latter method revealed in addition the organisms in epidermis and perivascular locations. From amongst the three stains: toluidine blue, Leishman's and thionine azure II basic fuchsin, the last mentioned was found to be the method of choice for demonstrating the organisms differently from the host cells.

An ultrastructural study of donovanosis.

In an ultrastructural study undertaken on donovanosis, the inflammatory response was studied along with the fine structure of causative organisms, Calymmatobacterium granulomatis. Macrophages were seen to be activated and showed presence of numerous filopodia and increase in the number of lysosomes and rough endoplasmic reticulum. Many cells showed vacuoles of varying size in the cytoplasm some of which contained the organisms. Other cells seen included plasma cells, polymorphonuclear cells and sparse lymphocytes. In one case few multinucleated giant cells and dendritic cells with long cytoplasmic processes making cell-cell contact with other inflammatory cells were seen. Such cells have not been described in donovanosis so far. The organisms showed surface structures like pili and vesicles, the role of which is yet to be clearly understood.