MECKEL'S DIVERTICULUM – REVISITED

Twenty five cases of Meckel''s diverticulum were studied between 1985-1995. Eight of these were symptomatic and in the remaining 17 it was an incidental finding. The symptomatic patients presented with intestinal obstruction (5 cases), perforated peritonitis (2 cases) and intussusception (1 case). All cases of acute appendicitis were also subjected to a search for Meckel''s diverticulum. Of the 25 Meckel''s diverticuli encountered, 22 were resected and in 3 patients it was left in situ. Both the patients with perforated Meckel''s diverticulum showed ectopic gastric mucosa. Complications occurred only after surgery for symptomatic Meckel''s diverticulum. All patients undergoing incidental diverticulectomy had a smooth and uncomplicated recovery.KEYWORDS: Incidental diverticulectomy, Meckel''s diverticulum     

Tuberculosis in infants less than 3 months of age

The clinical and radiological features in 38 infants less than 3 months of age with tuberculosis proved by culture are described and may aid early diagnosis of this often fatal condition. Respiratory symptoms, cough in 33 (87%) and tachypnoea in 31 (82%), were the commonest presenting symptoms. Twenty five infants (66%) had hepatomegaly and 20 (53%) splenomegaly. Mantoux testing gave an induration of > 15 mm in three of 17 (18%) infants. In a further five a Tine test gave confluent response. Chest radiography in 27 infants showed miliary tuberculosis in seven (26%) and hilar or paratracheal adenopathy in 14 (52%) and 10 (37%) respectively. Compression of either the bronchi or trachea or both was noted in 15 (56%). Detection of this complication was aided by high kilovolt radiographs. A culture of Mycobacterium tuberculosis was obtained from gastric aspirate in 35 (92%) infants, but positive cultures were also obtained from cerebrospinal fluid, tracheal or bronchial aspirate and liver and lymph node biopsy. Of 30 mothers evaluated seven (23) had previously unsuspected pulmonary tuberculosis.     

胎儿皮肤神经肽P物质和肥大细胞与无瘢痕愈合的关系

目的:比较胎儿、正常成人皮肤及瘢痕中神经肽P物质(substance P,SP)阳性细胞的形态、分布和数量差异,探讨P物质表达和肥大细胞数量与无瘢痕愈合之间的关系。方法:实验于2004-01/2005-01在重庆医科大学附属第一医院整形美容科和重庆医科大学病理教研室进行。收集胎龄为16～33周因车祸等原因引产的32例胎儿皮肤(家属知情同意)、26例整形手术中切除的正常成人皮肤以及18例不同时期的增生性瘢痕(患者均知情同意),用免疫组织化学的方法分别检测神经肽P物质的表达,P物质阳性细胞观察和计数采用分等级的方法。以细胞浆着色程度(浅、中、深)来判定。甲苯胺蓝染色的方法检测肥大细胞,在高倍镜下(×400倍)随机计数5个视野中阳性细胞数,取其平均值,为肥大细胞数。结果:①苏木精-伊红染色结果:孕早期胎儿皮肤表皮由1～3层细胞组成,真皮层细胞数量较多,胶原成分少、排列整齐,随着胎龄的增加,表皮细胞层数逐渐增加,出现角质层,逐渐分化为典型的五层细胞。②胎儿皮肤P物质的表达:孕22周以前胎儿皮肤中无P物质的表达,孕22周以后可见表皮细胞的下3层表达较多、且染色强度基本一致,随着胎龄的增加,至孕33周后的胎儿皮肤,P物质表达部位和阳性强度无明显变化。在正常成人皮肤中P物质表达于除角质层外的表皮全层,正常成人皮肤中的P物质染色强于胎儿皮肤;在瘢痕中P物质大量表达于表皮层、真皮中成纤维细胞及小血管周围,染色强。28周孕前胎儿皮肤、28周孕后胎儿皮肤、正常成人皮肤P物质的表达明显少于瘢痕组织(P<0.005)。③胎儿皮肤肥大细胞形态学观察结果:胎儿皮肤中未见典型的肥大细胞。正常皮肤肥大细胞计数少于瘢痕组织[(3.60±2.56),(8.41±4.06)个/视野,P<0.01]。结论:①胎儿发育早期(22周以前)皮肤中不表达P物质可能是早期胎儿皮肤无瘢痕愈合的原因之一。②瘢痕的形成同时与皮肤中的过多聚集并持续存在的肥大细胞和过多释放的P物质有关。     

Serum thyroid hormone profile in critically III children

Objective  

To study thyroid hormone profile in critically ill children and its correlation to disease severity and clinical outcome.