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Biomedical subjects

R Owor

Publications and source records attributed to R Owor.

At least 37 records · Page 2Linked to original sources

Pathological aspects of human African trypanosomiasis (HAT) in Uganda. A post-mortem survey of fourteen cases.

The pathological features of 14 cases of human African trypanosomiasis (HAT) occurring in Uganda over an 8 year period are described. Three cases were clinically proven and in all 14 cases a chronic meningoencephalitis was found. In 2 cases there was histological evidence of ganglion radiculitis and in one of these chronic choroiditis and peripheral neuritis associated with chronic myositis were present. The cardiac lesions consisted of a chronic pancarditis of varying degree in 8 cases and in 3 a generalized valvulitis was observed. In 2 cases, specially investigated, generalized lesions of the conducting system were noticed. Previous histopathological descriptions of HAT are briefly reviewed. The present findings are compared with some of those recorded in human american trypanosomiasis and experimental African trypanosomiasis.

Adolescent↗

Epstein-Barr virus genome studies in Burkitt's and non-Burkitt's lymphomas in Uganda.

Burkitt's lymphoma (BL) has been widely investigated and has attracted attention because of the possible etiologic role of the Epstein-Barr virus (EBV). To further determine the role of EBV in the causation of this tumor, we measured EBV-specific nuclear antigen (EBNA) and EBV DNA using immunofluorescence and nucleic acid hybridization techniques, respectively. Of 34 BL biopsies, 27 tissues (79%) were EBNA-positive, whereas none of the 25 non-BL biopsy tissues were EBNA-positive. Of 15 BL tumors tested, 14 (93%) were EBV DNA-positive with a mean of 39 (range, 8-86) EBV genome equivalents per cell. Each of the 15 non-BL biopsy specimens subjected to nucleic acid hybridization had less than two virus genome equivalents per cell, although all had serologic evidence of past EBV infection. The findings further supported the possible etiologic role of EBV in African BL and negated the passenger hypothesis. The EBV genome could, therefore, be used as a separating marker between African BL and non-BL lymphomas.

Adolescent↗

Treatment of Burkitt's lymphoma: randomized clinical trial of single-agent versus combination chemotherapy.

A randomized clinical trial designed to compare the effectiveness of cytoxan (CTX) alone versus a combination consisting of CTX, vincristine (Oncovin) and methotrexate (COM) in the treatment of Burkitt's lymphoma (BL) was carried out. Nineteen patients were selected at random to receive CTX alone while 21 received COM. The two treatment regimens were equally effective in inducing remissions, and complete response rates of 83.3% and 84.3% were observed for CTX- and COM-treated patients, respectively. The relapse frequencies were also equal but the pattern of relapse was clearly different. Seven out of 8 (87.5%) in the CTX group relapsed with systemic and central nervous system (CNS) tumor, while 8 out of 10 (80%) in the COM group relapsed with CNS disease only. This difference is highly significant p = 0.008. The remission durations and survival to date are the same.

Burkitt Lymphoma↗

A fatal case of strongyloidiasis with Strongyloides larvae in the meninges.

A case of fatal strongyloidiasis associated with pyogenic meningitis in an adult male African is reported. Strongyloides larvae were present in the purulent exudate in the the meninges, an observation not, to the authors knowledge, hitherto reported in man. Fatal strongyloidiasis due to autoinfection has been reported by several authors and De Paula (1962) reviewed the literature in 40 cases and added 10 others which he had studied. In Uganda fatal cases have been reported by Craven et al. (1971) and Poltera (1974). Although in some cases of fatal strongyloidiasis there was associated pyogenic meningitis (BROWN & PERNA, 1958; WILSON & THOMPSON, 1964; BASSAN-TREMINGER & EL-LANSHAR, 1968) we have not found in the literature any case in which Strongyloides stercoralis larvae or adult worms were found in the brain or meninges. We are, therefore, now reporting a case of fatal strongyloidiasis with pyogenic meningitis in which S. stercoralis larvae were present in the subarachnoid space.

Humans↗

Childhood Kaposi's sarcoma: clinical features and therapy.

Twelve cases of childhood Kaposi's sarcoma seen at the Uganda Cancer Institute over the last 7 years are reported. The disease presents mainly as generalized lymphadenopathy, with sparsely and anomalously distributed cutaneous nodules, and has a higher proportion of females with the disease than in the adult form. The histology is usually of mixed cell type. If not treated, childhood Kaposi's sarcoma runs a fulminating course, but disease control with chemotherapy is associated with prolonged survival.

Adolescent↗

Pancarditis affecting the conducting system and all valves in human African trypanosomiasis.

This paper describes the pathological features of 10 cases of human African trypanosomiasis occurring in Uganda over an 8-year period. Three cases were clinically proved, and in all 10 cases chronic meningoencephalitis and myocarditis were present. There was chronic pancarditis in 6 cases, and in 3 of these there was a generalized focal valvulitis and in 2 lesions of the conducting system. Previous descriptions of carditis in human African trypanosomiasis are briefly reviewed, and the present findings are compared with some cardiomyopathies as well as American human and experimental trypanosomiasis.

Adolescent↗

Systemic amyloidosis in Uganda. An autopsy study.

Seventy-nine cases of systemic amyloidosis were found in a survey of the autopsy records of 23 years at Mulago Hospital, Kampala, an incidence of 0-57%. The variable world incidence is described. Fifty-two cases were secondary to chronic inflammation and in 27 cases no underlying disease was apparent. Primary amyloid is more common than might be expected, and appears to occur at a younger age to that seen in developed countries. The organ distribution of primary and secondary amyloid is similar, with heavy renal involvement. These findings might be explained by chronic antigenic stimulation enhanced by impaired thymic dependent immunity. Secondary amyloidosis is not as common as would be anticipated in view of the high incidence of chronic inflammatory disease.

Adolescent↗

Hypothermia in the tropics. A review of 24 cases.

The clinical features in a series of 24 patients with hypothermia treated at Mulago Hospital, Kampala, are described. Hypothermia developed in all when the environmental temperature did not fall below 16 degrees. There was a preponderance of males; 14 of the 24 cases were over 50 years old. The most common predisposing factors were severe undernutrition or malnutrition with wasting and almost complete absence of subcutaneous fat, and anaemia present in over two thirds of the patients. Hypoglycaemia appeared to be the immediate precipitating factor in at least five patients. Acute pancreatitis was found in three of the four patients who died unexpectedly 2-7 days after recovery from hypothermia; focal pancreatitis and fat necrosis was also present in six other cases. It is concluded that hypothermia is not uncommon, and is a dangerous complication amongst patients with severe under- or malnutrition, and can occur even under "tropical" conditions, when the environmental temperature does not fall below 16 degrees.

Adolescent↗