Gastrointestinal abnormalities in vitamin B[12] deficient patients with megaloblastic anemia

In a retrospective cohort study, hospital records of 220 patients [119 males and 101 females, age 1 year-80 years] with megaloblastic anemia were examined to find out any relationship of gastrointestinal abnormalities with vitamin B[12] and folate deficiencies in these patients. Forty three percent of the patients were folate-deficient [serum folate levels

Reactive Astrocytes Expressing Intense Estrogen Receptor-alpha Immunoreactivities Have Much Elongated Cytoplasmic Processes: An Autopsy Case of Human Cerebellar Tissue with Multiple Genitourinary and Gastrointestinal Anomalies

We performed an immunohistochemical study on the estrogen receptor alpha (ER-alpha) distribution in the cerebellum of a human neonate with multiple congenital anomalies, that had been acquired during autopsy. Although the exact pathology in the brain was not clearly elucidated in this study, an unidentified stressful condition might have induced the astrocytes into reactive states. In this immunohistochemical study on the neonatal cerebellum with multiple congenital anomalies, intense ER-alpha immunoreactivities (IRs) were localized mainly within the white matter even though ER-alpha IRs were known to be mainly localized in neurons. Double immunohistochemical staining showed that ER-alpha IR cells were reactive astrocytes, but not neurons. Interestingly, there were differences in the process length among the reactive astrocytes showing ER-alpha IRs. Our quantitative data confirmed that among the glial fibrillary acidic protein (GFAP)-expressing reactive astrocytes, the cells exhibiting intense ER-alpha IRs have much longer cytoplasmic processes and relatively weaker GFAP IRs. Taken together, the elongated processes of reactive astrocytes might be due to decreased expression of GFAP, which might be induced by elevated expression of ER-alpha even though the elucidation of the exact mechanism needs further studies.

Meckel's diverticulum: revisited

Meckel's diverticulum [MD] remains an interesting congenital anomaly which often eludes the medical profession Over a l6year period [1981-1996] there were 32 patients in all age groups with documented MD presenting to the American University of Beirut Medical Center. Seventeen cases were incidental findings at operation, while 15 patients were symptomatic. Eleven of the 15 patients [73%] were less than 16 years of age. Small bowel obstruction was the presenting symptom in seven cases [47%], rectal bleeding in 5 cases [33%], and diverticulitis in 3 cases [20%]. Seven cases [47%] had more than one associated complication pertaining to the MD. One of our patients underwent laparoscopic diagnosis and resection of MD. There were no complications and no mortality in the overall group. The overall preoperative diagnostic rate in MD is still low, especially in patients presenting with small bowel obstruction or diverticulitis. Emphasis must be placed on cases that present with simultaneous complications of bleeding and obstruction or diverticulitis and obstruction. Laparoscopy is at present an invaluable tool both diagnostically and therapeutically in the management of MD