Lymphoid follicular hyperplasia–a distinctive feature of diversion colitis

Diversion colitis refers to the inflammatory changes that occur in the defunctioned segment of the large intesting following diversion of the faecal stream. We report the histological features in the defunctioned rectums from seven patients: one each with severe constipation and Behcet's disease, two with Crohn's disease with rectal sparing and three with ulcerative colitis. The appearances of diversion colitis in a previously normal rectum are compared with diversion colitis with superimposed inflammatory bowel disease. Lymphoid follicular hyperplasia was found in all cases. This was marked in patients with inflammatory bowel disease. with or without initial rectal involvement. Other changes comprised surface epithelial degeneration and ulceration, mucosal inflammation including crypt abscesses, and crypt branching. Inflammatory and crypt changes were mild, except in ulcerative colitis where changes were marked and resembled those of the proximal colon. Lymphoid hyperplasia is a distinctive feature in diversion colitis. The term follicular proctitis, previously used to indicate chronic ulcerative colitis exclusively, should be re-examined.     

The relationship between blood pressure and left ventricular mass in essential hypertension is observed only in the presence of the angiotensin-converting enzyme gene deletion allele

An insertion/deletion polymorphism in the angiotensin-convertingenzyme (ACE) gene accounts for approximately 50% of the variancein plasma ACE concentration: deletion homozygotes (DD) havethe highest, and insertion homozygotes (II) the lowest ACE concentrations.ACE is responsible for the generation of angiotensin II, whichis implicated in the development of left ventricular hypertrophy,an independent risk factor for morbidity and mortality in hypertension.The aim of this study was to investigate the contribution ofACE genotype to the development of left ventricular hypertrophyin patients with essential hypertension. Eighty-five patientswith essential hypertension underwent echocardiographic assessmentof left ventricular mass index (LVMI) and determination of ACEgenotype from leukocyte DNA by polymerase chain reaction. Therewas no significant difference in LVMI among the genotypes (II,ID, DD). Analysis of covariance modelled for LVMI showed a significantinteraction with systolic blood pressure (p = 0.036). but notdiastolic blood pressure (p = 0.453). The relationship betweenLVMI and systolic blood pressure was strongest in the deletionhomozygotes (p = 0.002, R² = 0.47), and also present in theheterozygotes (p = 0.013, R² = 0.40). No relationship was seenin the insertion homozygotes (p = 0.914, R² = 0.23) These findingssuggest that the effect of blood pressure on LVMI in essentialhypertension is expressed only in the presence of the ACE genedeletion allele.     

AZATHIOPRINE INDUCED BONE MARROW SUPPRESSION IN LIVE RELATED RENAL ALLOGRAFT RECIPIENTS

Over a follow-up period of 6 years, 4 out of 31 live related renal allograft recipients (12.9%) developed azathioprine induced bone marrow suppression. Presentation in 3 patients was with fever and 2 patients also had associated graft dysfunction. All patients had leucopenia, 2 patients in addition had anaemia and one patient had pancytopenia. Bone marrow suppression developed 9.6 months (3.5-16.0 months) following transplantation and recovery followed over a period of 30 (18-49 days) days after withdrawal of the drug. One patient succumbed during the phase of bicytopenia.KEY WORDS: Azathioprine, Bone marrow suppression, Kidney transplantation     

Biomedical Support Requirements in the Space Era

Chest radiographs made on 1,007 canine subjects at the University of Pennsylvania Veterinary Hospital between 1965 and 1968 were reviewed to determine whether a relationship between nonspecific chronic canine pulmonary disease and the urban environment could be demonstrated. Radiographs were graded for evidence of chronic pulmonary changes without prior knowledge of the animal’s age or residence. The environment was divided into urban and rural segments based upon the concentration of industrialization in the Philadelphia area and available atmospheric pollution data. No significant differences were noted in the urban-rural distribution of absent, moderate, and severe changes in younger dogs. In middle-aged and older dogs, however, significant differences appeared in the distribution of changes between environmental groups.     

Relating tooth‐ and blood‐lead levels in children residing near a zinc–lead smelter in India

International Journal of Paediatric Dentistry 2010; 20: 186–192 Background. Lead toxicity particularly affects children because of their increased capacity for absorption and retention. Blood‐lead (BPb) levels reflect recent exposure and are of limited value in predicting neurotoxicity, whereas in teeth, lead accumulates over a long period of time and provides an integrated record of lead exposure from intrauterine life until the teeth are shed. Aim. The present study aimed to relate tooth‐lead (TPb) and BPb levels in children residing near a zinc–lead smelter in India, and to evaluate the effectiveness of primary teeth as bioindicators of life‐long lead exposure. Design. The lead levels in primary teeth and blood of 100 children aged between 5 and 13 years, living in the proximity of a zinc–lead smelter were measured by atomic absorption spectrophotometry. The mean levels were tabulated based on village, age, sex and tooth type, and analysed statistically. Results. The mean BPb level was significantly influenced by proximity to the lead source, but not by age or sex. There was no consistent pattern of correlation between BPb and TPb levels. Conclusion. Primary teeth showed significantly high lead levels compared to blood; they reflect cumulative exposure to lead and prove to be better indicators of body lead burden.     

Carcinoma of Müllerian Vestigial Origin: Report of a Case

Benign tumours of the epididymis, which are very rare, are variously regarded as adenomas, mesotheliomas and lymphangiomas, but an alternative opinion considers them to be of Müllerian vestigial origin. Their malignant counterparts are extremely rare, and this case is probably the second authentic instance to be reported in the English literature. Complete excision of the mass with wide resection of the cord followed by prophylactic local deep X-ray therapy has provided total relief to the patient over the year which has elapsed since these measures were undertaken.