MyMedR

Neurenteric cyst of the cervicothoracic junction: A rare cause of paraparesis in a paediatric patient

Sheaufung S, Taufiq A, Nawawi O, Naicker MS, Waran V

J Clin Neurosci, 2009 Apr;16(4):579-81.

PMID: 19201194 DOI: 10.1016/j.jocn.2008.04.029

Neurenteric cysts are rare congenital spinal masses that result from the dysgenesis of the endoderm tissue during development. We report a 4-year-old girl who presented with an insidious onset of lower limb paraparesis. An MRI scan revealed a cervicothoracic intradural extramedullary neurenteric cyst at the thoracic T1/T2 level, with marked spinal cord compression. No associated spinal dysraphism was noted. The patient underwent laminotomy and excision of the cyst. She recovered her neurological functions completely post-operatively, and at her six-month follow-up she was asymptomatic without any neurological deficits. We will discuss the pathogenesis, clinical presentation, and neuroradiological findings. We emphasize the value of early surgical intervention and long-term follow-up when this type of lesion is only partially excised.

Matched MeSH terms: Cervical Vertebrae/pathology; Neural Tube Defects/pathology*; Thoracic Vertebrae/pathology

Reconstruction of large sacral defects following tumour resection: a report of two cases

Cheong YW, Sulaiman WA, Halim AS

J Orthop Surg (Hong Kong), 2008 Dec;16(3):351-4.

PMID: 19126905

Sacral tumours often present surgical resection and reconstruction challenges. Wide resections result in large sacral defects and neoadjuvant radiotherapy impairs wound healing. The wounds need to be covered with bulky, well-vascularised, healthy tissues. We present 2 cases where large sacral defects were reconstructed following tumour resection. Both defects were reconstructed with inferiorly based, transpelvic, pedicled vertical rectus abdominis myocutaneous flaps. This is a robust flap and carries a well-vascularised muscle bulk and skin paddle. The donor site is distant from the lesion site and is thus unaffected by both the resection and radiotherapy. This is a useful flap for reconstructing large sacral defects.

Matched MeSH terms: Chordoma/pathology; Spinal Neoplasms/pathology; Giant Cell Tumor of Bone/pathology

Term interstitial pregnancy with uterine conservation

Ng PH, NorAzlin MI, Nasri NI

Int J Gynaecol Obstet, 2007 Dec;99(3):251.

PMID: 17888439

Matched MeSH terms: Placenta Diseases/pathology; Pregnancy Complications/pathology*; Pregnancy, Ectopic/pathology

Cranial base and airway morphology in adult malays with obstructive sleep apnoea

Banabilh SM, Suzina AH, Dinsuhaimi S, Singh GD

Aust Orthod J, 2007 Nov;23(2):89-95.

PMID: 18200785

Obstructive sleep apnoea (OSA) has been described as a public health problem comparable to smoking in its impacts upon society.

Matched MeSH terms: Pharynx/pathology*; Skull Base/pathology*; Sleep Apnea, Obstructive/pathology*

Diabetes-associated macrovasculopathy: pathophysiology and pathogenesis

Rahman S, Rahman T, Ismail AA, Rashid AR

Diabetes Obes Metab, 2007 Nov;9(6):767-80.

PMID: 17924861 DOI: 10.1111/j.1463-1326.2006.00655.x

The complications associated with diabetic vasculopathy are commonly grouped into two categories: microvascular and macrovascular complications. In diabetes, macrovascular disease is the commonest cause of mortality and morbidity and is responsible for high incidence of vascular diseases such as stroke, myocardial infarction and peripheral vascular diseases. Macrovascular diseases are traditionally thought of as due to underlying obstructive atherosclerotic diseases affecting major arteries. Pathological changes of major blood vessels leading to functional and structural abnormalities in diabetic vessels include endothelial dysfunction, reduced vascular compliance and atherosclerosis. Besides, advanced glycation end product formation interacts with specific receptors that lead to overexpression of a range of cytokines. Haemodynamic pathways are activated in diabetes and are possibly amplified by concomitant systemic hypertension. Apart from these, hyperglycaemia, non-enzymatic glycosylation, lipid modulation, alteration of vasculature and growth factors activation contribute to development of diabetic vasculopathy. This review focuses on pathophysiology and pathogenesis of diabetes-associated macrovasculopathy.

Matched MeSH terms: Blood Vessels/pathology*; Diabetes Mellitus, Type 2/pathology; Diabetic Angiopathies/pathology

A viable secondary intra-abdominal pregnancy resulting from rupture of uterine scar: role of MRI

Teng HC, Kumar G, Ramli NM

Br J Radiol, 2007 Jul;80(955):e134-6.

PMID: 17704308

Pre-natal diagnosis of intra-abdominal pregnancy is difficult. Ultrasound has been the frontline modality to date; however, it gives a diagnostic error of 50-90% and its use is disappointing. In recent years, MRI has emerged as an appealing imaging modality. With its good soft tissue contrast and non-ionizing property, it acts as a means of definitive non-invasive assessment before surgical intervention when ultrasound is inconclusive.

Matched MeSH terms: Cicatrix/pathology; Placenta Accreta/pathology; Uterus/pathology

Fulltext Intra-cranial metastatic lacrimal gland tumour

Wahab NA, Ramasamy U, George J, Madhavan M, Arif AR, Abdullah J

Med J Malaysia, 2006 Dec;61(5):641-3.

PMID: 17623971 MyJurnal

We report a case of an adult who presented with progressive swelling in the right eye with suggestive of intracranial lesion on imaging. Histopathological revealed a lacrimal gland malignant mixed tumour.

Matched MeSH terms: Eye Neoplasms/pathology; Lacrimal Apparatus/pathology*; Lacrimal Apparatus Diseases/pathology

Fulltext Renal angiomyolipoma with inferior vena caval involvement

Haritharan T, Sritharan S, Bhimji S

Med J Malaysia, 2006 Oct;61(4):493-5.

PMID: 17243531 MyJurnal

Renal angiomyolipomas are innocuous benign tumours which rarely behave aggressively. This is a case of a 48 year old Malay lady presenting with right sided abdominal pain associated with a large right sided abdominal mass. She was diagnosed with renal angiomyolipoma of the right kidney complicated by inferior vena caval tumour thrombosis. She successfully underwent a radical nephrectomy and inferior vena caval thrombectomy using cardiopulmonary bypass and deep hypothermic circulatory arrest.

Matched MeSH terms: Kidney Neoplasms/pathology*; Vena Cava, Inferior/pathology*; Angiomyolipoma/pathology*

The effect of infection of hatched blastocyst bovine embryos with border disease and bovine viral diarrhea viruses

Mabruk MJ, Sheahan B, Atkins G

Southeast Asian J. Trop. Med. Public Health, 2006 Jan;37(1):113-9.

PMID: 16771222

The effect of infection with teratogenic viruses at early stages of pregnancy is not fully understood. This study aimed to look at the effect of infection with teratogenic viruses such as bovine viral diarrhea virus (BVDV) and border disease virus (BDV), on early stage embryos at the hatched blastocyst stage. BVDV and BDV are known to cross the placenta of infected mothers and lead to congenital defects and death of developing fetuses. This study can be a good model for better understanding the effects of other teratogenic viruses such as Rubella virus in humans.

Matched MeSH terms: Blastocyst/pathology; Border Disease/pathology; Bovine Virus Diarrhea-Mucosal Disease/pathology

Fulltext Epidermal cyst of submandibular gland

Prepageran N, Rahmat O, Kuljit S

Med J Malaysia, 2005 Oct;60(4):483-4.

PMID: 16570711

The differential diagnosis of a cystic lesion in the submandibular area can be difficult. We report a case of epidermal cyst of submandibular gland which is relatively rare compared to the commoner epidermoid cyst.

Matched MeSH terms: Epidermal Cyst/pathology*; Submandibular Gland/pathology*; Submandibular Gland Neoplasms/pathology*

Fulltext Extradural spinal cord and intraabdominal ganglioneuroblastoma

Kanakaraj G, Zamzuri I, Abdullah J, Mohd Ghazali M, Mahamood Z, Shafiee A, et al.

Med J Malaysia, 2005 Dec;60(5):663-6.

PMID: 16515125

We report a rare case of a giant extradural and intraabdominal ganglioneuroblastoma in a young Malay girl who presented to a paediatrician initially at 5 days of life with a palpable abdominal mass. Unfortunately, the parents refused any form of surgical intervention until the child was 3 years old. She subsequently underwent vascular embolisation followed by the removal of this large tumour both via the abdomen and through a laminectomy approach and subsequently refused chemotherapy. The c-myc amplication in this patient was absent and there were no chromosomal aberrations, During the 2 year folow-up the patient remained well, and ambulatory with no tumour recurrence.

Matched MeSH terms: Abdominal Neoplasms/pathology*; Spinal Cord Neoplasms/pathology*; Ganglioneuroblastoma/pathology*

Fulltext Forequarter amputation of the upper extremity for musculoskeletal tumors: posterior approach revisited

Faisham WI, Zulmi W, Nor Azman MZ, Rhendra Hardy MZ

Med J Malaysia, 2006 Feb;61 Suppl A:57-61.

PMID: 17042232

Forequarter amputation entails surgical removal of entire upper extremity, scapula and clavicle. Several techniques of forequarter amputation have been described. The anterior approach has been the preferred technique of exploration of axillary vessels and brachial plexus. The posterior approach has been condemned to be unreliable and dangerous for most large tumor of the scapula and suprascapular area. We describe a surgical technique using posterior approach of exploration of major vessels for forequarter amputation of upper extremity in eight patients who presented with humeral-scapular tumor. There were six patients with osteosarcoma: three with tumor recurrent and three chemotherapy recalcitrant tumors with vessels involvement. One patient had massive fungating squamous cell carcinoma and another had recurrent rhabdomyosarcoma. Four patients had fungating ulcer and six patients had multiple pulmonary metastases at the time of surgery. The mean estimated blood transfusion was 900 ml (range 0-1600 ml) and two patients did not require transfusion. The duration of surgery ranged 2.5-6.0 hours (mean 3.8 hours). Two patients with known pulmonary metastases required post-operative intensive care monitoring. The mean duration of survival was 5.8 months. The posterior approach of exploring major vessels for forequarter amputation of upper extremity with musculoskeletal tumor is safe and reliable.

Matched MeSH terms: Humerus/pathology; Musculoskeletal System/pathology; Scapula/pathology

Magnetic resonance imaging of Asians with multiple sclerosis was similar to that of the West

Chong HT, Ramli N, Lee KH, Kim BJ, Ursekar M, Dayananda K, et al.

Can J Neurol Sci, 2006 Feb;33(1):95-100.

PMID: 16583730

Magnetic resonance imaging (MRI) of the brain is the most important paraclinical diagnostic test in multiple sclerosis (MS). The appearance of MRI in Asians with MS is not well defined. We retrospectively surveyed the first brain and spinal cord MRI in patients diagnosed to have MS, according to Poser's criteria in seven regions throughout Asia to define the MRI changes among Asians with MS. There were 101 patients with first brain, and 86 with first spinal cord MRI, 66 of whom had both. The brain MRI showed a mean of 17 lesions per patient in T2 weighted images, mostly asymptomatic. Almost all the lesions were in the white matter, particularly in the juxtacortical, deep and periventricular white matter. A third of the lesions were greater than 5 mm, 14% enhanced with gadolinium. There were more supratentorial than infratentorial lesions at a ratio of 7.5: 1. Ninety five percent of the spinal cord lesions were in cervical and thoracic regions, 34% enhanced with gadolinium. The lesions extended over a mean of 3.6 +/- 3.3 vertebral bodies in length. Fifty (50%) of the brain and 54 (63%) of the spinal MRI patients had the optic-spinal form of MS. The MRI of the optic-spinal and classical groups of patients were similar in appearance and distribution, except that the optic-spinal MS patients have fewer brain but longer and more severe spinal cord lesions. In conclusion, the brain and spinal cord MRI of Asian patients with MS was similar to that of the West, although, in this study, Asian MS patients had larger spinal cord lesions.

Matched MeSH terms: Brain/pathology*; Multiple Sclerosis/pathology*; Spinal Cord/pathology*

Fulltext Malignant myeloid transformation in a child with severe congenital neutropenia (Kostmann's syndrome)

Chong LA, Josephine P, Ariffin H

Med J Malaysia, 2006 Jun;61(2):236-8.

PMID: 16898320 MyJurnal

We report a case of a child with severe congenital neutropenia (Kostmann's syndrome) who was treated with daily prophylactic subcutaneous granulocyte colony-stimulating factor (G-CSF) from the age of eight to sixteen years before being discontinued for poor haematological and clinical response. She did not have a HLA-matched sibling to enable bone marrow transplantation. She subsequently developed acute megakaryoblastic leukemia at the age of 17 years and succumbed during induction chemotherapy. The role of G-CSF in the pathogenesis of her malignant transformation to AML is complicated as this disorder has a propensity for myelodysplasia or AML as part of its natural history.

Matched MeSH terms: Cell Transformation, Neoplastic/pathology*; Leukemia, Myeloid/pathology*; Neutropenia/pathology

Adenoid mast cells and their role in the pathogenesis of otitis media with effusion

Abdullah B, Hassan S, Sidek D, Jaafar H

J Laryngol Otol, 2006 Jul;120(7):556-60.

PMID: 16834804 DOI: 10.1017/S002221510

INTRODUCTION: Otitis media with effusion (OME) is an inflammation of the middle ear in which a collection of liquid is present in the middle-ear space while the tympanic membrane is intact. The association between adenoid inflammation and OME has long been noted but the exact mechanism is still much debated. We studied the role of adenoid mast cells in the causation of OME.
OBJECTIVE: To study the distribution and role of adenoid mast cells in the causation of OME.
METHODOLOGY: A cross-sectional, prospective study was carried out in the otorhinolaryngologic clinic, department of otorhinolaryngology (ORL), Science University of Malaysia, from June 1999 to September 2001. A total number of 50 cases were studied. Twenty-five of these patients underwent adenoidectomy, while another 25 patients underwent adenoidectomy and myringotomy with ventilation tube insertion. The adenoid specimens from all patients were examined for the number of adenoid mast cells present, using light microscopy and toluidine blue as the staining agent. The results were analysed using SPSS version 10.0 computer software.
RESULT: The population of adenoid mast cells in children with OME was significantly greater than that in children without OME (p=0.000).
CONCLUSION: The increased number of adenoid mast cells in patients with OME suggests that inflammation may play a role in this condition.

Matched MeSH terms: Adenoids/pathology*; Mast Cells/pathology*; Otitis Media with Effusion/pathology*

Microfilaria in hydrocele fluid cytology

Chandran PA, Jayaram G, Mahmud R, Anuar AK

Malays J Pathol, 2004 Dec;26(2):119-23.

PMID: 16329565

Filariasis, a parasitic infection endemic in parts of India, Myanmar, islands of the South Pacific, West and East Africa and Saudi Arabia can be diagnosed from various types of cytopathological specimens. This case documents the detection of filarial infection from hydrocele fluid cytology in a 30-year-old Myanmar migrant worker in Malaysia.

Matched MeSH terms: Filariasis/pathology; Testicular Hydrocele/pathology; Peritoneal Diseases/pathology

Benign orbital apex tumors treated with multisession gamma knife radiosurgery

Goh ASC, Kim YD, Woo KI, Lee JI

Ophthalmology, 2013 Mar;120(3):635-641.

PMID: 23149128 DOI: 10.1016/j.ophtha.2012.08.015

OBJECTIVE: The orbital apex is an important anatomic landmark that hosts numerous critical neurovascular structures. Tumor resection performed at this complex region poses a therapeutic challenge to orbital surgeons and often is associated with significant visual morbidity. This article reports the efficacy and safety of multisession gamma knife radiosurgery (GKRS) in benign, well-circumscribed tumors located at the orbital apex.

DESIGN: Retrospective interventional case series.

PARTICIPANTS: Five patients with visual disturbances resulting from a benign, well-circumscribed orbital apex tumor (3 cases of cavernous hemangioma and 2 cases of schwannoma).

METHODS: Each patient treated with GKRS with a total radiation dose of 20 Gy in 4 sessions (5 Gy in each session with an isodose line of 50%) delivered to the tumor margin.

MAIN OUTCOME MEASURES: Best-corrected visual acuity, visual field changes, orbital imaging, tumor growth control, and side effects of radiation.

RESULTS: All patients demonstrated improvement in visual acuity, pupillary responses, color vision, and visual field. Tumor shrinkage was observed in all patients and remained stable until the last follow-up. No adverse events were noted during or after the radiosurgery. None of the patients experienced any radiation-related ocular morbidity.

CONCLUSIONS: From this experience, multisession GKRS seems to be an effective management strategy to treat solitary, benign, well-circumscribed orbital apex tumors.

Matched MeSH terms: Hemangioma, Cavernous/pathology; Neurilemmoma/pathology; Orbital Neoplasms/pathology

Collagen fibers an important entity in skin tissues remodeling

Norhayati MM, Mazlyzam AL, Asmah R, Fuzina H, Aminuddin BS, Ruszymah BH, et al.

Med J Malaysia, 2004 May;59 Suppl B:184-5.

PMID: 15468879

Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM) evaluation were carried out in the in vivo skin construct using fibrin as biomaterial. To investigate its progressive remodeling, nude mice were grafted and the Extracellular Matrix (ECM) components were studied at four and eight weeks post-grafting. It was discovered that by 4 weeks of remodeling the skin construct acquired its native structure.

Matched MeSH terms: Extracellular Matrix/pathology; Fibroblasts/pathology; Skin/pathology*

Histological evaluation of the early bone response to hydroxyapatite (HA) implanted in rabbit tibia

Khadijah K, Mashita M, Saidu MF, Fazilah F, Khalid KA

Med J Malaysia, 2004 May;59 Suppl B:123-4.

PMID: 15468849

This study is to qualitatively evaluate a locally produced hydroxyapatite (HA), made by AMREC-SIRIM in an experimental animal bone defect using New Zealand White (NZW) rabbits. HA cylindrical blocks measuring 2.5 mm (D) x 1.0 mm (H) were implanted in the rabbits' left tibia. The tibias were harvested within one to three weeks post-implantation. The implantion site was cut into thin undecalcified sections of about 30 microm to 60 microm and stained with Toluidine Blue and Goldner's Masson Trichrome. Microscopic examinations using standard light microscopy of these slides were performed.

Matched MeSH terms: Bone and Bones/pathology; Osteoblasts/pathology; Tibia/pathology

Fulltext Disseminated tuberculosis masquerading primary myelodysplastic syndrome

Shaharir SS, Tumian NR, Yu Lin AB, Abdul Wahid SF

J Infect Dev Ctries, 2013 Mar;7(3):286-8.

PMID: 23493009 DOI: 10.3855/jidc.2691

Tuberculosis is notoriously known to be a great mimicker of other diseases and may cause various haematologic abnormalities, especially with marrow involvement. A 61-year-old man who presented with right empyema and pancytopenia was diagnosed to have disseminated tuberculosis supported by the presence of caseating granuloma with Langhan's giant cells in the marrow and demonstration of acid-fast bacilli in the pleural fluid. Trilineage dysplasia from marrow aspirate was initially attributed to be reactive to the infection. A cytogenetic study was repeated after he showed poor response to a year of anti-tuberculosis treatment. The underlying primary myelodysplastic syndrome was unmasked when his cytogenetics showed trisomy 8. This case report has demonstrated the various haematological manifestations of tuberculosis and highlighted the importance of cytogenetic study in differentiating between primary and secondary myelodysplastic marrow changes.

Matched MeSH terms: Bone Marrow/pathology; Myelodysplastic Syndromes/pathology*; Tuberculosis/pathology*

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