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Occasional Cases (occasional + case)
Selected AbstractsRenal Transplantation to the Ovarian Vein: A Case ReportAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2008V. K. H. Wong Renal failure patients with absent or thrombosed inferior vena cava (IVC) and iliac veins are considered technically unsuitable for transplantation. Occasional cases have been reported in literature of transplant using inferior and superior mesenteric veins. We describe a case in which kidney was transplanted on to an ovarian vein in a young patient who had thrombosed IVC and iliac veins and was previously declared unsuitable for transplantation. [source] An Analysis of Possible Mechanisms of Unexpected Death Occurring in Hydatid Disease (Echinococcosis)JOURNAL OF FORENSIC SCIENCES, Issue 4 2009Roger W. Byard M.B.B.S. Abstract:, Most cases of hydatid disease in human populations are due to Echinococcus granulosus. The hydatid life cycle involves passage between definitive hosts such as dogs and intermediate hosts such as sheep. Humans become accidental intermediate hosts following ingestion of food or water contaminated with eggs or by contact with infected dogs. Although hydatid disease may remain asymptomatic, occasional cases of sudden and unexpected death present to autopsy. Causes of rapid clinical decline involve a wide range of mechanisms including anaphylaxis (with or without cyst rupture), cardiac outflow obstruction or conduction tract disturbance, pulmonary and cerebral embolism, pericarditis, cardiac tamponade, myocardial ischemia, pulmonary hypertension, peritonitis, hollow organ perforation, intracerebral mass effect, obstructive hydrocephalus, seizures, cerebral ischemia/infarction, and pregnancy complications. The autopsy assessment of cases therefore requires careful examination of all organ systems for characteristic cystic lesions, as multiorgan involvement is common, with integration of findings so that possible mechanisms of death can be determined. Measurement of serum tryptase and specific IgE levels should be undertaken for possible anaphylaxis. [source] Posttransplant lymphoproliferative disorder: A pictorial reviewJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 5 2006K Burney Summary Posttransplant lymphoproliferative disorder (PTLD) is a serious and potentially fatal complication after solid organ and haemopoietic stem cell transplantation. The frequency of PTLD varies with the type of organ transplant but overall it affects 2,10% of all solid organ transplant recipients. Most cases develop within 1 year after the transplant, although occasional cases present 5,10 years later. Posttransplant lymphoproliferative disorder is clinically and pathologically heterogeneous , the majority are of the non,Hodgkin's lymphoma type, whereas Hodgkin's lymphoma arising after transplantation is rare. We have retrospectively reviewed patients with a histological diagnosis of PTLD after a solid organ transplant. We present the imaging features and a clinical review of this condition. Early diagnosis of PTLD may alter the management and outcome of the disease. The radiologist can play a vital role in establishing the diagnosis by imaging features supplemented with percutaneous biopsy and also in monitoring the disease response to treatment. [source] Desmoglein 1 and 3 enzyme-linked immunosorbent assay in Iranian patients with pemphigus vulgaris: correlation with phenotype, severity, and disease activityJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2007M Daneshpazhooh Abstract Background, Pemphigus vulgaris (PV) is a chronic autoimmune blistering disorder of the skin and mucosa characterized by the presence of autoantibodies against desmoglein3 (Dsg3). Some patients also have antibodies against desmoglein1 (Dsg1). The aims of this study were to evaluate the diagnostic value of Dsg enzyme-linked immunosorbent assay (ELISA) in Iranian PV patients, to assess its correlation with the clinical phenotype and severity of disease and to investigate the changes of these antibodies after treatment. Methods, Seventy-three patients with PV (29 men, 44 women) presenting to the Pemphigus Research Unit at Razi Hospital, Tehran, Iran were enrolled. ELISAs were used to detect IgG autoantibodies reactive with the ectodomains of Dsg1 and Dsg3, and the correlation of antibodies with the clinical phenotype as well as oral and skin disease severity was assessed. In addition, the tests were repeated in 18 patients after treatment and the resulting remission. Results, Anti-Dsg1 and anti-Dsg3 were detected in 56 (76.7%) and 69 (94.5%) patients, respectively. Anti-Dsg1 and anti-Dsg3 antibodies were present in 48 (94.1%) and 50 (98%) patients with mucocutaneous type, in 2 (12.5%) and 15 (93.7%) patients with mucosal type, and in 6 (100%) and 4 (66.7%) patients with cutaneous PV, respectively. The mean anti-Dsg1 index values were significantly higher in cutaneous and mucocutaneous phenotypes than mucosal PV (P < 0.001). The mean anti-Dsg3 index values were significantly lower in cutaneous and mucosal phenotypes than mucocutaneous PV (P < 0.01). The severity of skin lesions (but not oral lesions) was correlated with anti-Dsg1 antibody level (P < 0.001); on the other hand, the severity of oral lesions (P < 0.01) as well as skin lesions (P < 0.001) was significantly correlated with anti-Dsg3 antibody levels. Both anti-Dsg1 and anti-Dsg3 levels were significantly reduced after treatment and clinical remission (P < 0.001). Conclusion,, Dsg ELISA is not only a sensitive tool for the diagnosis of PV, it can also serve as a predictive means for assessing the severity as well as for monitoring the disease activity. Although, in general, the clinical phenotype is related to the antibody profile, there are occasional cases with discordant phenotype and antibody profile. These discrepancies might be explained by genetic variations or the presence of possible minor antigens involved in the pathogenesis of pemphigus. [source] Spinal angiography and epidural venography in juvenile muscular atrophy of the distal arm "Hirayama disease"MUSCLE AND NERVE, Issue 2 2009Bakri Elsheikh MBBS Abstract We studied two 16-year-old males with juvenile muscular atrophy of the distal arm, "Hirayama disease," resulting in asymmetric atrophy and weakness of the distal upper extremities. Pathogenic theories include a compressive myelopathy with or without ischemia, and occasional cases are accounted for by genetic mutations. To specifically address the ischemia hypothesis we performed spinal angiography and epidural venography. Neck flexion during spinal angiography showed a forward shift of a nonoccluded anterior spinal artery without impedance to blood flow. Epidural venography demonstrated engorgement of the posterior epidural venous plexus without obstruction to venous flow. The findings do not support large vessel obstruction as a contributory factor. The Hirayama hypothesis continues to best explain the disease pathogenesis: neck flexion causes tightening of the dura and intramedullary microcirculatory compromise with resultant nerve cell damage. The age-related factor can most likely be accounted for by a growth imbalance between the vertebral column and the cord/dural elements. Resolution of progression is associated with cessation of body growth, after which the symptoms plateau or modestly improve. Muscle Nerve 40: 206,212, 2009 [source] Prevalence and etiology of acquired anemia in Medieval York, EnglandAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2005Amy Sullivan Abstract This paper presents three distinct models for the development of acquired anemia: iron-deficiency anemia produced by the inadequate intake and/or absorption of iron, the anemia of chronic disease (ACD) caused by the body's natural iron-withholding defense against microbial invaders, and megaloblastic anemia caused by insufficient intake and/or absorption of vitamin B12 or folic acid. These etiological models are used to interpret the distribution and etiology of anemia among adult individuals interred at the Medieval Gilbertine Priory of St. Andrew, Fishergate, York (n = 147). This bioarchaeological analysis uncovered not only a strong relationship between decreasing status and increasing prevalence of anemia for both men and women, but also identified clear sex-based differences at this site. Within the high-status group, blood and iron loss as a result of rampant parasitism likely produced an environment ripe for the development of iron-deficiency anemia, while the parasitic consumption of vitamin B12 may have caused occasional cases of megaloblastic anemia. As status decreases, the interpretation of anemia becomes more complex, with megaloblastic anemia and ACD emerging as viable, potentially heavy contributors to the anemia experiences of low-status people at St. Andrew's. Apart from status effects, women (especially young women) are disproportionately affected by anemia when compared to men within their own status group and, on average, are also more likely to have experienced anemia than their male peers from other status groups. This suggests that high iron-demand reproductive functions helped to make iron-deficiency anemia a chronic condition in many women's lives irrespective of their status affiliation. Am J Phys Anthropol, 2005. © 2005 Wiley-Liss, Inc. 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