Characteristics of acute pancreatitis in University Kebangsaan Malaysia

We analyzed the characteristics of patients presenting with acute pancreatitis to our unit. A total of 71 patients were admitted to the Surgical Department at University Kebangsaan Malaysia (UKM) over a period of seven years, between January 1990 to December 1996 with acute pancreatitis. There was a fourfold increase in incidence of acute pancreatitis in our hospital from January 1990 to December 1996. The commonest identifiable aetiology was gallstones followed by alcohol. There were two deaths. We conclude that acute pancreatitis is increasingly being diagnosed in our local population. This may be due to either greater awareness or changes in lifestyle of the population.     

Regional IFNgamma expression is insufficient for efficacious control of food-borne bacterial pathogens at the gut epithelial barrier

IFNgamma is critical for host defence against various food-borne pathogens including Salmonella enterica and Listeria monocytogenes, the causative agents of salmonellosis and listeriosis, respectively. We investigated the impact of regional IFNgamma expression at the intestinal epithelial barrier on host invasion by salmonellae and listeriae following oral challenge. Transgenic mice (IFNgamma-gut), generated on an IFNgamma knock-out (KO) background, selectively expressed IFNgamma in the gut driven by the modified liver fatty acid-binding protein (Fabpl(4x at -132)) promoter. Infections with attenuated S. enterica Typhimurium or with L. monocytogenes did not differ significantly in IFNgamma-KO, IFNgamma-gut and wild-type mice. Further, Listeria-specific CD4+ and CD8+ T cells were not altered in IFNgamma-gut mice. Thus, this model indicates that local IFNgamma expression by non-immunological cells in the distal part of the small intestine, caecum and colon is insufficient for prevention of gut penetration by S. enterica Typhimurium and L. monocytogenes.     

Victims of violence: an Asian scenario

The term 'violence' is difficult to define. Aggressive behaviour with actual use of physical force may result in some form of physical and emotional trauma to an individual and this could be considered as violence against the person. The trauma may range from minimal physical injury to death. It is also relevant to note that in some jurisdictions if members of the law enforcement agencies with appropriate authority resort to certain acts of 'violence' for lawful purposes, then such acts of violence may be excluded from this category. However, if the law enforcement personnel exceed their limits of authority, or resort to various unacceptable and unauthorized methods of violence, then certainly such acts will become violence against the person. In today's context the word violence has expanded to encompass many issues, besides the usual physical violence such as assault. Rape, child sexual abuse, other forms of sexual abuse, non-accidental injury to children, battered wife, assault in custody, torture, victims of war, civil unrest and ethnic violence are all considered under 'violence'. While general violence is almost endemic in many countries, assault in custody, torture, political and ethnic violence are serious problems in some of the developing world. In these countries, particularly, the law enforcement agencies and other unlawful groups who are backed by politicians may inflict politically motivated violence against its citizens. In such cases attempts are often made to cover up such crimes. Forensic physicians and forensic pathologists who examine these cases may be placed in difficult positions at times owing to various 'pressures' being brought upon them to issue 'favourable' reports. On the other hand there is also a general dearth of suitably trained forensic physicians and forensic pathologists in many of these countries. Medical officers without any training in forensic medicine often undertake the examination of victims of violence, both living and fatal cases. Lack of training makes them more vulnerable to political and other forms of 'pressure'. The objective of this article is to highlight some of the common problems that are encountered, particularly in developing countries.     

Apprasial of the surface anatomy of the Thorax in an adolescent population

Surface anatomy is considered a fundamental part of anatomy curricula and clinical practice. Recent studies have reappraised surface anatomy using CT, but the adolescent age group has yet to be appraised. Sixty adolescent thoracoabdominal CT scans (aged 12–18 years) were examined. The surface anatomy of the central veins, cardiac apex, diaphragmatic openings, and structures in relation to the sternal angle plane were analyzed. The results showed that the brachiocephalic vein (left and right) formed mostly posterior to the sternoclavicular joint. The superior vena cava formed close to the second costal cartilage, ±16.3 mm to the right of the midline. The apex of the heart was located in relation to the fifth intercostal space; ±78.6 mm to the left of the midline. The caval hiatus was in relation to T9 and T10; the esophageal hiatus was at T10; whereas the aortic hiatus was at T11. The sternal angle plane was in relation to the upper half of T5, which was also where the bifurcations of the trachea and pulmonary trunk were observed. The SVC/azygos vein junction and the concavity of the aortic arch were observed to be more than 10 mm superior to this plane. The results of this study further highlight the substantial variability of the surface anatomy between age groups. It also emphasizes the notion that surface anatomy is a dynamic variable and cannot be treated as a static observation. Clin. Anat. 32:762–769, 2019. © 2019 Wiley Periodicals, Inc.