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Biomedical subjects

Subramanian Krishnakumar

Publications and source records attributed to Subramanian Krishnakumar.

31 records · Page 2Linked to original sources
PubMed2003

Ocular filariasis due to Wuchereria bancrofti presenting as panuveitis: a case report.

PURPOSE: To report a case of ocular filariasis due to Wuchereria bancrofti manifesting as panuveitis. DESIGN/METHODS: Observational case report. RESULT: A 30-year-old, healthy, Asian, Indian male presented with decreased vision and panuveitis with secondary glaucoma in the right eye. Careful slit-lamp examination revealed multiple, tiny, motile larvae in the anterior chamber. Indirect ophthalmoscopy showed vitritis with plenty of vitreous membranes, and subretinal yellow lesions in the peripheral retina along with retinal pigment epithelial tracts. An aqueous tap and a peripheral blood smear isolated microfilariae of W. bancrofti. Therapy with diethyl carbamazine citrate along with systemic steroids provided symptomatic relief. CONCLUSIONS: Ocular filariasis due to W. bancrofti is very rare. It can present in an otherwise asymptomatic patient without any constitutional symptoms. Careful examination, prompt diagnosis, and early treatment can reduce ocular morbidity.

Adult↗
PubMed2003

Expression of HLA class I, beta(2)-microglobulin and HLA class II antigens in primary orbital melanoma.

Major histocompatibility antigens (MHC) play a crucial role in the recognition of tumor cells by the immune system. There is not much information on the role of MHC molecule expression in primary orbital melanomas. In the present study, the authors examined the expression of human leukocyte antigen (HLA) class I, beta(2)-microglobulin (beta(2)-m) and HLA class II antigens in primary orbital melanoma and correlated this with the clinical and pathological findings. HLA class I antigen, beta(2)-m and HLA class II antigen expression were evaluated immunohistochemically in three primary orbital melanomas and correlated with cell type and metastasis. Immunohistochemistry showed heterogeneous expression of HLA class I, beta(2)-m and HLA class II antigen in two cases with no liver metastasis and negative expression in one case with liver metastasis. This preliminary observation deserves further investigation, which may shed more light on the immune escape mechanisms of this tumor and thus make possible novel therapeutic strategies.

Female↗
PubMed2003

Loss of antigen-processing molecules in primary orbital melanoma.

OBJECTIVE: To study the antigen-processing molecules in primary orbital melanomas and correlate them with the clinicopathological features. METHODS AND MATERIALS: Antigen-processing molecules comprising the low molecular weight proteins LMP2 and LMP10, transporter associated with antigen-processing TAP1, the binding protein tapasin and the chaperone protein calnexin were analyzed by immunoperoxidase staining with monoclonal antibodies in three primary orbital melanomas. The results were correlated clinicopathologically. RESULTS: The three primary orbital melanomas were composed of spindle cells. LMP2, LMP10, TAP1, tapasin and calnexin were heterogeneous in the two cases with no hepatic metastasis and negative in one case with hepatic metastasis. CONCLUSIONS: Antigen-processing molecules are decreased in orbital melanomas with increasing aggressiveness. This could have important implications for immunotherapy. This preliminary observation deserves further investigation, which may shed more light on the immune escape mechanisms of this tumor and thus make possible novel therapeutic strategies.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2003

Chloroma of the orbit in a non-leukemic adult: A case report.

Granulocytic sarcoma has been reported as an isolated lesion in non-leukemic patients. However, the majority of these subjects develop acute leukemia within a mean interval of 10.5 months from the time of diagnosis. We present a case of granulocytic sarcoma of the orbit in a non-leukemic patient who was treated with chemotherapy and is doing well after a 2-year period. Patients who do not develop leukemia have a better prognosis. Appropriate treatment is delayed in most cases because of a high rate of misdiagnosis.

Adult↗
PubMed2003

Malignant teratoma of the orbit: a clinicopathological study of a case.

PURPOSE: To present a case of malignant sarcomatous changes in an orbital teratoma with clinicopathological correlation. MATERIALS AND METHODS: Retrospective interventional case report. RESULTS: A 10-month-old child presented with protrusion of the left eye of 8 months duration. Computerized tomography (CT) revealed a heterogeneous retrobulbar mass in the left orbit. Fine needle aspiration biopsy (FNAB) revealed sarcomatous cells. The child was treated with chemotherapy and radiotherapy with a provisional diagnosis of sarcoma. However, as the proptosis worsened, a repeat CT scan showed a possibility of an intracranial extension. Exenteration was done. Histopathological examination revealed a teratoma with (malignant) sarcomatous changes. The child is doing well at 3 years follow-up with no recurrences. CONCLUSION: Orbital teratomas should be considered in the differential diagnosis of all neonatal orbital masses. Although rare, malignant changes can occur in teratomas. FNAB is not helpful in the diagnosis. Surgical excision of the mass is recommended for a definitive diagnosis. Although the prognosis of orbital teratoma is good, there is always a chance of vision loss.

Combined Modality Therapy↗
PubMed2003

Presence of a 88 kDa Eales protein in uveitis, tuberculosis, leprosy and rheumatoid arthritis.

BACKGROUND: Eales disease (ED) is an idiopathic retinal vasculitis affecting young adult males. We have earlier reported the identification, purification and partial characterization of a novel 88 kDa protein found in the serum of patients with ED. The aim of the present study was to look for the 88 kDa protein in serum samples obtained from cases of retinal vasculitis mimicking ED and in other systemic inflammatory diseases. MATERIAL/METHODS: Serum samples from healthy volunteers and from patients with ED, uveitis, parsplanitis ocular sarcoidosis, toxoplasmosis, leprosy, diabetic retinopathy, viral hepatitis, and rheumatoid arthritis were analyzed for the presence of the 88 kDa protein by polyacralymide gel electrophoresis (PAGE). The immunological identity of the 88 kDa protein found in ED and in other diseases was investigated by Western blot. Immunohistochemistry was performed on epiretinal membranes (ERM) obtained from ED patients to localize the 88 kDa protein. RESULTS: 88 kDa protein were detected in serum samples obtained from patients with posterior uveitis, tuberculosis, leprosy and rheumatoid arthritis. The 88 kDa protein found in serum from patients with ED is immunologically identical to that found in other systemic inflammatory conditions. 88 kDa protein was localized in inflammatory cells and in nonvascular endothelium in ERMs obtained from patients with ED. CONCLUSIONS: We have identified a novel acute phase reactant, which is elaborated in ocular and systemic inflammatory conditions other than Eales disease. Further work is necessary to decipher the precise role of the 88 kDa protein in the pathophysiology of these inflammatory diseases.

Adult↗
PubMed2003

Ocular manifestations of Wegener's granulomatosis. Analysis of nine cases.

PURPOSE: To report a series of nine patients of Wegener's granulomatosis (WG) with diverse ocular and systemic manifestations. METHODS: Retrospective analysis of nine consecutive patients seen between 1987 and 2002. RESULTS: The mean age at the time of diagnosis was 43.89 years (range: 33-56 years). Redness, pain and photophobia (8 patients) were the common presenting complaints. Sinusitis (6 patients) and arthralgia (6 patients) were the commonly associated systemic complaints. Necrotising scleritis with peripheral keratopathy (6 patients) was the most common ocular sign. Serum antibodies against the cytoplasmic component of neutrophils and monocytes (cANCA) were positive in 7 of 8 patients. Biopsy diagnosis was done in one patient for whom cANCA was not done. Cyclophosphamide and corticosteroids alleviated the symptoms in 6 patients. Ocular and systemic condition remained stable in 7 patients. One patient expired due to the severity of the disease and another patient was lost to follow-up. CONCLUSIONS: Scleritis with peripheral corneal involvement was the most commonly observed ocular manifestation of WG in our series. cANCA was a useful adjunct in the diagnosis of WG. When clinical and serologic findings were inconclusive, biopsy remained indispensable. A combination of cyclophosphamide and corticosteroids is essential and critical not only for the ocular condition but also for the survival of the patient.

Adult↗
PubMed2002

Choroidal metastasis of a gingival squamous cell carcinoma.

PURPOSE: To report a case of choroidal metastasis of a gingival squamous cell carcinoma. DESIGN: Interventional case report. METHODS: Review of the clinical history and pathologic findings. RESULTS: A 59-year-old woman with a history of right gingival squamous cell carcinoma presented with sudden dimness of vision in the left eye of 4 weeks duration. Fundus examination of the left eye revealed a yellowish elevated subretinal lesion involving the optic disk and macula. Fine-needle aspiration biopsy of the choroidal lesion, left eye, revealed metastatic squamous carcinoma cells. The patient was referred to a radiation oncologist for further management. CONCLUSION: Choroidal metastasis from gingival squamous cell carcinoma is rare, and it may develop from hematogeneous spread.

Antineoplastic Agents↗
PubMed2002

Bilateral corneal fibrosis in homocystinuria: case report and transmission electron microscopic findings.

PURPOSE: To report the unusual occurrence of bilateral, superficial, corneal fibrosis with pannus formation in a young woman with homocystinuria, and to describe the light and transmission electron microscopic findings of these deposits. METHODS: Excision of the corneal lesion and amniotic membrane transplantation was performed in both eyes. The excised material was studied using light and transmission electron microscopy. RESULTS: Whitish, elevated, irregular masses with superficial vascularization in the peripheral cornea were noted in both eyes. Histopathologic evaluation of the excised corneal tissue revealed variable epithelial thickness with melanin pigment in the basal layer. A fibrovascular pannus, fibrosis and disruption of the Bowman's layer, and fibrosis of anterior stroma were evident. Transmission electron microscopy revealed numerous empty intracytoplasmic vacuoles in the corneal epithelial cells and intracytoplasmic inclusions containing fibrillogranular material in the cytoplasm of keratocytes. CONCLUSION: We report the unusual association of corneal fibrosis and scarring in a young woman with homocystinuria. The deposits revealed the presence of membrane-bound inclusions containing fibrillogranular material in the corneal epithelium and keratocytes. Although the etiology of these deposits is not clear, the condition improved following excision of these lesions and amniotic membrane transplantation.

Adult↗
PubMedDate not supplied

Eccrine duct carcinoma of the eyelid mimicking meibomian carcinoma: clinicopathological study of a case.

Eccrine duct carcinoma belongs to a group of malignant sweat gland tumors showing de novo eccrine differentiation, but without features of benign adnexal counterparts. They are therefore likely to be confused with visceral adenocarcinomas that have metastasized to the lid. These tumors require important diagnostic considerations when adenocarcinoma is encountered in the lid in the absence of a known primary tumor. We present the case of a 60-year-old man with a nodule in the right upper eyelid that was histopathologically diagnosed as eccrine duct carcinoma of the lid. The differential diagnosis of eccrine carcinomas based on light microscopy, enzyme histochemistry, and immunohistochemistry is discussed, and a list of the various malignant eccrine tumors reported in the lid is presented.

Carcinoma↗
PubMedDate not supplied

Solitary fibrous tumor of the orbit: a clinicopathologic study of six cases with review of the literature.

Solitary fibrous tumor of the orbit is a rare spindle cell neoplasm. There are 42 cases of solitary fibrous tumor of the orbit available in the literature. We present six more cases of orbital solitary fibrous tumors, which presented to our institute between 1999 and 2001. We highlight the need for clinical recognition of these tumors as a distinct entity and inclusion of this tumor in the etiological differential diagnosis of well-circumscribed orbital lesions presenting as unilateral proptosis in both children and in adults. The diagnosis may be suspected based on radiological features supported by histopathologic and immunohistochemical study. The strong CD34 immunoreactivity of this tumor supports its diagnosis. Complete surgical resection is the most important prognostic factor of this tumor.

Adult↗