Cadaveric anatomy of the lumbar triangular safe zone of Kambin’s in North West Indian population / 대한해부학회지

A three dimensional triangular space ‘the Kambin’s triangle (KT)’ present on the dorsolateral aspect of the intervertebral disc, is considered to be a safe area for transforaminal approaches. It allows access to the exiting and traversing nerve roots, the thecal sac and to the intervertebral disc spaces. Our aim was to calculate the area of the triangle by measuring the height and base at all the intervertebral spaces bilaterally in the lumbar region in North West Indian cadavers and to assess the diameter of circle inscribed within this triangle which will correspond to the size of cannula inserted for the minimally invasive transforaminal approaches in this population. Five randomly chosen adult cadavers were used for this study. After clearing the area, the exiting nerve was identified. The height and base of the bony KTs (n=40) were measured with the help of digital Vernier’s calliper (accuracy 0.02 mm) to calculate the area of the KT. There is a steady increase in the area of the bony KT reaching maximum at the level of L4-5 intervertebral space. Statistically there were no differences in the calculated areas between right and left side. The mean diameter of inscribed circle within the triangle also showed gradual increase from 5.82 mm at L1-2 level, reaching maximum value of 7.26 mm at L4-5 level on the right side while on the left side the values were 5.66 mm and 8.16 mm respectively. Careful anatomical consideration is of utmost importance in transforaminal approaches during surgical or interventional procedures in this region. Cannula having external diameter ranging 6–8 mm is recommended for any interventional approach through Kambin’s space.

Cadaveric anatomy of the lumbar triangular safe zone of Kambin’s in North West Indian population / 대한해부학회지

A three dimensional triangular space ‘the Kambin’s triangle (KT)’ present on the dorsolateral aspect of the intervertebral disc, is considered to be a safe area for transforaminal approaches. It allows access to the exiting and traversing nerve roots, the thecal sac and to the intervertebral disc spaces. Our aim was to calculate the area of the triangle by measuring the height and base at all the intervertebral spaces bilaterally in the lumbar region in North West Indian cadavers and to assess the diameter of circle inscribed within this triangle which will correspond to the size of cannula inserted for the minimally invasive transforaminal approaches in this population. Five randomly chosen adult cadavers were used for this study. After clearing the area, the exiting nerve was identified. The height and base of the bony KTs (n=40) were measured with the help of digital Vernier’s calliper (accuracy 0.02 mm) to calculate the area of the KT. There is a steady increase in the area of the bony KT reaching maximum at the level of L4-5 intervertebral space. Statistically there were no differences in the calculated areas between right and left side. The mean diameter of inscribed circle within the triangle also showed gradual increase from 5.82 mm at L1-2 level, reaching maximum value of 7.26 mm at L4-5 level on the right side while on the left side the values were 5.66 mm and 8.16 mm respectively. Careful anatomical consideration is of utmost importance in transforaminal approaches during surgical or interventional procedures in this region. Cannula having external diameter ranging 6–8 mm is recommended for any interventional approach through Kambin’s space.

Dental radiology: an adjunctive aid in age estimation

The concept of using radiographic methods for age estimation has kindled so much interest in the field of forensic dentistry in past few decades. Aim and Objectives: To evaluate the different dental radiographic methods for age estimation and their significance in the field of forensic dentistry. Methodology:- 64articles were collected after an extensive literature review. Literature survey of these articles was done.Conclusion:-Radiographic methods play an indispensible role in age estimation specifically in living persons because of their non-invasive and non-destructive nature. This review paper focus on different radiographic methods and new developments available for radiological dental age estimation and their effective aid in identification and crime investigation.

Dental Radiology: An Adjunctive Aid In Age Estimation

The concept of using radiographic methods for age estimation has kindled so much interest in the field of forensic dentistry in past few decades. Aim and Objectives: To evaluate the different dental radiographic methods for age estimation and their significance in the field of forensic dentistry. Methodology:- 64 articles were collected after an extensive literature review. Literature survey of these articles was done. Conclusion:-Radiographic methods play an indispensible role in age estimation specifically in living persons because of their non-invasive and non-desrtructive nature. This review paper focus on different radiographic methods and new developments available for radiological dental age estimation and their effective aid in identification and crime investigation.

Oligosecretory multiple myeloma: a case report

No abstract available.

Murine models of Aspergillosis: Role of collectins in host defense.

Aspergillus fumigatus, a ubiquitous fungus, causes a wide spectrum of clinical conditions ranging from allergic to invasive aspergillosis depending upon the hosts’ immune status. Several animal models have been generated to mimic the human clinical conditions in allergic and invasive aspergillosis. The onset, duration and severity of the disease developed in models varied depending on the animal strain/fungal isolate, quantity and mode of administration of fungal antigens/spores, duration of the treatment, and type of immunosuppressive agent used. These models provide insight into host and pathogen factors and prove to be useful for evaluation of diagnostic markers and effective therapies. A series of studies established the protective role of collectins in murine models of Allergic Bronchopulmonary Aspergillosis and Invasive Pulmonary Aspergillosis. Collectins, namely surfactant protein A (SP-A), surfactant protein D (SP-D) and mannan binding lectin (MBL), are pattern recognition molecules regulating both innate and adaptive immune response against pathogens. In the present review, we discussed various murine models of allergic and invasive aspergillosis and the role of collectins in host defense against aspergillosis.

Case of immature mesenteric teratoma.

Mesenteric teratomas are extremely rare tumor arising from totipotent primordial cells, which displays a mixture of tissues of tridermal or bidermal origin. Immature teratoma in mesentery is still rarer. Here we report a case of immature mesenteric teratoma in a two day old neonate, which is youngest such patient except for one case, which has been diagnosed prenataly with the help of ultrasonography.

Usefulness of fine needle aspiration cytology in diagnosis of neck masses.

Background: Fine needle aspiration cytology (FNAC) is a well established, simple, quick, inexpensive and minimally invasive diagnostic technique. Neck region of human body is relatively small area but houses a fairly large number of organs with a variety of lesions and consequently require from conservative to aggressive management protocols. Aims and objectives: To assess sensitivity and specificity or diagnostic value of FNAC of neck masses keeping histopathology as gold standard. Materials and Methods: Surgical biopsies or excisions from neck masses were received in fifty nine cases in which prior FNAC was done. The findings of histopathological study were correlated with the diagnosis given on FNAC. Further the sensitivity and specificity were calculated. Results: Twenty eight aspirates were from lymph nodes, fourteen were from thyroid gland, thirteen were of salivary gland origin and four were others. Out of the Fifty nine cases the diagnosis of forty four (74.57%) was corroborated by histopathology. In fifteen (25.42%) cases the histopathological diagnosis was dissimilar to that of FNAC. The overall sensitivity of FNAC in the diagnosis of neck masses was calculated to be 83.01% and specificity was 78.94%. Sensitivity was highest (82.14%) for neck lymph nodes and lowest for thyroid masses (64.28%). Specificity was the highest for other neck masses (100%) and the lowest for neck nodes (71.2%). Conclusion: FNAC of neck masses is an effective diagnostic tool but its sensitivity and specificity of diagnosis in different organs should be kept in mind while creating a management protocol for the patient.

Central neurocytoma in the vermis of the cerebellum.

In neuropathology, anatomic landmarks and topographic relationships bear particularly on issues of differential diagnosis. A case of central neurocytoma of the vermis of the cerebellum is being reported in this article. A 45-year-old male with features of hydrocephalous and a posterior fossa space-occupying lesion was diagnosed as having central neurocytoma upon a microscopy of Hematoxylene and Eosin stained sections. The diagnosis was confirmed by a positive immunohistochemical reaction for Neuron Specific Enolase (NSE) and Synaptophysin. This case report is being made to emphasize that a high index of suspicion is required even for reporting neuropathology where the site does not match the conventional location of the lesion seen and also to emphasize the importance of immunohistochemistry in proving such unusually located lesions.

Prophylactic and Therapeutic Potential of Asp f1 Epitopes in Naive and Sensitized BALB/c Mice

BACKGROUND: The present study examines a hypothesis that short allergen-derived peptides may shift an Aspergillus fumigatus (Afu-) specific TH2 response towards a protective TH1. Five overlapping peptides (P1-P5) derived from Asp f1, a major allergen/antigen of Afu, were evaluated for prophylactic or therapeutic efficacy in BALB/c mice. METHODS: To evaluate the prophylactic efficacy, peptides were intranasally administered to naive mice and challenged with Afu-allergens/antigens. For evaluation of therapeutic efficacy, the mice were sensitized with Afu-allergens/antigens followed by intranasal administration of peptides. The groups were compared for the levels of Afu-specific antibodies in sera and splenic cytokines evaluated by ELISA. Eosinophil peroxidase activity was examined in the lung cell suspensions and lung inflammation was assessed by histopathogy. RESULTS: Peptides P1-, P2- and P3 decreased Afu-specific IgE (84.5~98.9%) and IgG antibodies (45.7~71.6%) in comparison with Afu-sensitized mice prophylactically. P1- and P2-treated ABPA mice showed decline in Afu-specific IgE (76.4~88%) and IgG antibodies (15~54%). Increased IgG2a/IgG1 and IFN-gamma/IL-4 ratios were observed. P1-P3 prophylactically and P1 therapeutically decreased IL-5 levels and eosinophil peroxidase activity. P1 decreased inflammatory cells' infiltration in lung tissue comparable to non-challenged control. CONCLUSION: Asp f1-derived peptide P1, prophylactically and therapeutically administered to Balb/c mice, is effective in regulating allergic response to allergens/antigens of Afu, and may be explored for immunotherapy of allergic aspergillosis in humans.

Barium poisoning mimicking Guillain-Barre syndrome.

Barium poisoning is an important cause of areflexic quadriplegia associated with hypokalemia. Presenting features may mimic Guillain-Barre syndrome. A high index of suspicion of barium poisoning in two patients who presented with features resembling Guillain-Barre syndrome, led to timely management and early recovery in both the cases.

Prostate specific antigen ratio: for diagnosis and assessment of aggressiveness of malignancy of prostate.

The search for a perfect tumour marker, which would be able to distinguish benign from malignant enlargement of prostate accurately, is still not complete. Total Prostate Specific Antigen (TPSA), a good test, has it's own inadequacies but Free Prostate Specific Antigen (FPSA) to TPSA ratio is emerging as a better adjuvant to it. This prospective study was done to verify the utility of FPSA to TPSA ratio in diagnosis of malignancy of prostate and its relationship to Gleason grading (indicating the aggressiveness) of adenocarcinoma of prostate. 100 patients with urinary symptoms, who were above fifty years of age and had prostatic enlargement, formed the study group. TPSA and FPSA were assayed by ELISA method and FPSA to TPSA ratio was calculated. Prostatic biopsy of all the cases was obtained and diagnostic histopathology and Gleason grading (in cases where adenocarcinoma was diagnosed) was done. Sensitivity, specificity, predictive value of positive test and predictive value of negative test for TPSA and FPSA to TPSA ratio were calculated. They were found to be 100%, 76.7%, 74.1% and 100% for TPSA and 82%, 100%, 100%, 89% for FPSA/TPSA ratio. Thus making it very obvious that FPSA to TPSA ratio is an excellent adjuvant to TPSA for diagnosis of malignancy of prostate increasing the specificity and predictive value for positive test. An inverse correlation (correlation coefficient = -0.95) was also found between PSA ratio and aggressiveness of prostate cancer, pointing towards its capability to predict the histological (Gleason) grade of the tumour.

Pure malignant myoepitheliomas of the breast: an immunohistochemical study.

Myoepithelioma of breast are extremely rare. We report two cases of pure malignant myoepithelioma of the breast, utilising light microscopic and immunohistochemical methods for diagnosis. Both the cases presented as breast lump. Hematoxylin and Eosin (H&E) stained microscopic sections revealed a predominantly spindle cell tumor. Immunohistochemical work up was done. Case number one expressed positivity for vimentin, Smooth Muscle Actin (SMA), S-100 and CD10. Case number two expressed positivity for Vimentin, CD10 and p63. This led to the diagnoses of malignant myoepithelioma in both of them. Documentation of such cases prospectively and from archival material, using immunohistochemistry, is of extreme importance to assess the prevalence, various phenotypic patterns, long-term biological behaviour and to establish management protocols for malignant myoepithelioma.

Diagnosis of malignancy of prostate.

Minimal or complete lack of symptoms hinders early diagnosis of malignancy of prostate leading to undue morbidity and mortality. Therefore early detection is imperative, making use of simple and safe technique with least of expense. Five hundred consecutive patients, who reported with urinary complaints, were assessed by digital rectal examination, transabdominal suprapubic ultrasonography for prostatic volume/weight and serum assay of prostate specific antigen (PSA). Histopathological examination of prostatic biopsy of all the cases was also done. Benign prostatic hyperplasia was found in 83.6% of cases and 16.4% of the cases were of adenocarcinoma prostate of varying severity (mild, moderate and severe). It was found that volume/weight of gland and PSA levels were very good indicators of the probable diagnosis and grade of adenocarcinoma. Statistical tests taking various levels of PSA values in account also validated the results.

Cartilagenous choristoma of palatine tonsil--a case report.

Choristoma is defined as a histologically normal tissue proliferation or nodule of a tissue type not normally found in anatomic site of proliferation. Here a case of chronic tonsillitis is being reported where mature cartilage was found embedded in the tonsil, making the surgical removal of the tonsil difficult. Cartilaginous choristoma of the tonsil appears to be a developmental anomaly in the second pharyngeal arch and could be one of the causes of recurrent tonsillitis.