Bifurcated intraarticular long head of biceps tendon

Though rare, many anomalous origins of long head of the biceps tendon (LHBT) have been reported in the literature. Anatomic variations commonly explained are a third humeral head, anomalous insertion, congenital absence and adherence to the rotator cuff. We report a rare case who underwent shoulder arthroscopy with impingement symptoms where in LHBT was found to be bifurcated with a part attached to superior labrum and the other part to the posterior capsule of joint. Furthermore, intraarticular portion of LHBT was adherent to the undersurface of the supraspinatus tendon. Awareness of such an anatomical aberration during the shoulder arthroscopy is of great importance as it can potentially avoid unnecessary confusion and surgery.     

MURCS association

The MURCS association i.e. MUllerian duct aplasia, Renal aplasia, Cervicothoracic Somite dysplasia is a rare developmental disorder. The authors report a case of MURCS association with supernumerary ribs in a 7-month-old infant who presented with failure to thrive     

Transesophageal guided left atrial positioning of a percutaneous ventricular assist device

Cardiogenic shock in the setting of myocardial infarction continuesto represent a high proportion of immediate mortality in thispatient population, despite ongoing advances in thrombolytics,PCI, and medical management of AMI. We present a case of peri-MIcardiogenic shock necessitating deployment of a percutaneousventricular assist device (pVAD). TEE guidance played a crucialrole in optimal positioning of the venous cannula in the leftatrium.     

31P MRS studies of exercising human muscle at high temporal resolution.

Methods for measuring mitochondrial activity from 31P magnetic resonance spectroscopy data collected during and after exercise were compared in controls, weight lifters, and peripheral vascular occlusive disease (PVOD) patients. There were trends toward increasing mitochondrial activity during exercise in order from PVOD patients, moderately active controls, highly active controls, to weight lifters. Results from PVOD patients show divergence of some measures due to 1) the non-exponential nature of phosphocreatine recovery, and 2) potential breakdown of [ADP] control of the mitochondria due to lack of oxygen (for Qmax calculation). These results demonstrate the utility of obtaining and directly analyzing high time resolution data rather than assuming monoexponential behavior of metabolite recovery.     

Zoonotic sporotrichosis of lymphocutaneous type in a man acquired from a domesticated feline source: report of a first case in southern Karnataka, India

Background  Sporotrichosis is commonly encountered due to traumatic implantation of thorns or decayed vegetation with the dimorphic fungi, Sporothrix schenckii . Zoonotic spread of Sporotrichosis is rare and we describe here the first case of feline transmission of lymphocutaneous sporotrichiosis encountered in India.
Methods  An excision biopsy of nodulo-ulcerative lesion from the patients right elbow and forearm were collected for histopathology and portion of the specimen processed for mycological work up. Animal pathogenicity test performed in Swiss albino mice with intraperitoneal & foot pad inoculation. In addition an investigation of the ulcerative skin lesion from the domesticated cat was carried out.
Results  Histopathology examination of tissue sample from the patient and feline lesion revealed granulomatous reaction and a few slender elongated yeast cells consistent with Sporotrichosis. The diagnosis was confirmed by culturing Sporothrix schenkii and demonstration of thermal dimorphism. Pathogenicity testing in mice lead to orchitis in 12–15 days and the organism was re-isolated in pure culture. The patient was treated with oral saturated potassium iodide solution with complete resolution of the lesions.
Conclusion  Close contact with infected domesticated feline can be a potential source of transmission for Sporotrichosis as evidenced in this report.     

The pelvic digit ��eleventh finger��

Described as asymptomatic and an incidental finding on a plain x-ray film, the “pelvic digit” is a rare congenital anomaly. A 35-year-old man is of a rare symptomatic pelvic digit that warranted surgical excision. Its importance lies in its differentiation from acquired abnormalities due to trauma such as myositis ossificans and avulsion injuries of pelvis. If this entity is kept in mind, unnecessary investigations or interventions can be avoided.