Re: Spielmann PM, Oliver CW. The carpal bones: a basic test of medical students'and junior doctors' knowledge of anatomy. Surgeon 2005; 3 (4): 257-59.
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Anatomy↗
Biomedical subjects
A Loganathan
Publications and source records attributed to A Loganathan.
Comparative study of bacteriology in recurrent tonsillitis among children and adults.
INTRODUCTION: Diagnosis and treatment of acute tonsillitis are one of the most common problems seen at an otorhinolaryngology clinic in both adult and paediatric populations. Much has been written about bacteriology of recurrent tonsillitis but it remains a controversial topic. Despite the fact that tonsillitis is so common, consensus seems to be lacking as to the main causative organism and the differences between children and adults. The tonsillar core bacteriology of 233 patients with recurrent tonsillitis who underwent tonsillectomy from January 2000 to June 2003 is presented. METHODS: The patient population was divided into two groups, namely: the paediatric group and the adult group. 132 patients, whose age was more than 12 years, were in the adult group. 101 patients aged between two and 12 years, were in the paediatric group. The bacteriology of the children and adults were tabulated according to their species, and were compared. RESULTS: 138 patients grew single pathogenic bacteria in their tonsillar core culture, 52 grew two different pathogenic bacteria, and the rest (43) grew normal bacterial flora. Staphylococcus aureus was the most commonly-isolated bacterium and accounted for 40.9 percent of the total cultures isolated; its prevalence was the same in the adults and children. Beta-haemolytic Streptococcus was isolated in 23 percent of subjects, and was predominantly from group A (Streptococcus pyogens). Group A beta-haemolytic Streptococci was more prevalent in children. Pseudomonas aeruginosa, which rarely cause pathogenicity in tonsils, was cultured from nine (3.8 percent) of our study subjects. CONCLUSION: This study showed that Staphylococcus aureus is the most common pathogenic bacteria cultured both in adults and children. Klebsiella pneumonia, Streptococcus pneumonia, Escherichia coli and Enterobacter are more prevalent in adults. Haemophilus influenza and Streptococcus pyogens are more prevalent in children. Pseudomonas aeruginosa is not a rare causative organism in recurrent tonsillitis. Since the mechanism of activation of infection in recurrent tonsillitis is unknown, knowing the bacteriology does not help us to treat the disease. However, it may be a stepping stone to eventually understanding whether the bacteria play a role in reactivating recurrent infections. From previous and current studies, there is no relationship between bacteriology and recurrent infections.
Acute Disease↗
Cancer of ileostomy: a late complication of colectomy for ulcerative colitis.
Cancer arising at an ileostomy site represents a rare late complication of total colectomy performed for ulcerative colitis. There are no more than 36 published cases in the literature. We describe a case of adenocarcinoma of the mucocutaneous junction at the ileostomy site, occurring 31 years after total colectomy for ulcerative colitis. Wide excision of the moderately differentiated adenocarcinoma was performed with refashioning of the ileostomy. Polypoid adenomas or adenocarcinomas of the ileostomy after colectomy performed for non-neoplastic conditions are extremely uncommon. Biopsies of polypoid lesions at the stoma site are recommended.
Adenocarcinoma↗
Parotid duct mucocele.
Parotid swelling is a common presentation in ENT clinic. Most of the cases involve pathology of the gland. There are not many reported cases about parotid duct pathology. We describe a case of a large parotid duct mucocele with a calculus. Excision of the mucocele and superficial parotidectomy was performed. The post-operative recovery was uneventful.
Adult↗
Cadasil: presenting as a mood disorder.
CADASIL is an autosomal dominant non-atherosclerotic vasculopathy that frequently presents as recurrent subcortical strokes, or vascular dementia in middle age. Some patients may have prominent mental symptoms or migraine. Widespread white matter demyelination and subcortical lacunar infarcts are demonstrated by magnetic resonance imaging. Demonstration of granular osmophilic material in arteries in skin biopsies is a useful diagnostic tool. CADASIL has been linked to mutation in the Notch 3 gene locus on chromosome 19. Genetic testing is available for clinical diagnosis.
Dementia, Multi-Infarct↗
N-terminal sequence analysis of bovine dentin phosphophoryn after conversion of phosphoseryl to S-propylcysteinyl residues.
Bovine dentin phosphophoryn (BDP), a protein rich in aspartyl (Asp) and O-phosphoseryl (Ser[P]) residues, is synthesized by odontoblasts and is believed to be involved in matrix-mediated biomineralization of dentin. We have purified BDP, using selective precipitation and ion exchange chromatography, from an EDTA soluble dentin extract and converted the Ser(P) residues to S-propylcysteinyl residues that are stable to Edman degradation, facilitating the determination of the amino acid sequence of the N-terminal 38 residues. After the initial Asp-Ser(P)-Pro-Asn-Ser(P)-Ser(P)-Asp-Glu-Ser(P)-Asn-Gly-, the sequence contained the repeated motifs Asp-Ser(P) and Asp-Ser(P)-Ser(P). Purified BDP migrated as a single band on gradient SDS-PAGE with an apparent molecular weight of 156 kDa. This value was consistent with the molecular weight of the dephosphorylated protein of 105 kDa determined by means of MALDI mass spectrometry.
Amino Acid Motifs↗