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Biomedical subjects

T Malatani

Publications and source records attributed to T Malatani.

10 recordsLinked to original sources

Value of rebound tenderness in acute appendicitis.

This is a prospective study on 123 randomly selected patients admitted with the diagnosis of acute appendicitis. The value of rebound tenderness as a clinical diagnostic tool was statistically compared to those of some other physical signs; namely guarding, rigidity and Rovsing's sign. Rebound tenderness was found to carry the highest sensitivity (94.7%), negative predictive value (81.3%), reliability (49.1%), and association with histological diagnosis (P < 0.05). However, its specificity and positive predictive value was not significantly different from those of other physical signs. It is concluded that, in contradistinction to some previously published reports, our study emphasizes the role of rebound tenderness in the clinical diagnosis of acute appendicitis.

Acute Disease↗

Colo-rectal carcinoma in a tropical African population: an overview report.

Fifty-one selected cases of colo-ano-rectal carcinoma seen in a tropical African population over a period of two decades were reviewed. The patients were divided into three groups. Group A were those cases seen under the age of thirty years, Group B were the resectable rectal carcinoma because they were bulky and occupied the whole of the pelvis. This we referred to as cases with "frozen" pelvis. Our modality of treatment consists of surgical excision when possible, the use of Levamisole, the use of 5-Fluoro-Uracil either intravenously, intraperitonealy and intrarectally as the case requires and radiotherapy when available. For Group A, the average survival period is 10.6 months, for Group B, it is 17.3 months and for Group C, it is 14.5 months. Symptoms of tenesmus and ascites improved by intrarectal and intraperitoneal infusion of calculated dose of 5-Fluoro-Uracil.

Adenocarcinoma↗

Peripheral T-cell lymphoma with unique immunologic features.

BACKGROUND: The autologous mixed lymphocyte reaction (AMLR) is an important immunoregulatory phenomenon in human immune disorders. The authors have determined the phenotype and assessed the response of malignant lymph node T-cells, from histologically and immunologically proven cases of peripheral T-cell lymphoma, in AMLR and allogeneic mixed lymphocyte reaction (MLR) and studied the secretion of lymphokines. METHODS: The proliferative response, tritiated 3H-thymidine incorporation assay, was used to determine the AMLR and allogeneic MLR of the responding T-cells. An interleukin-2 (IL-2)-dependent T-cell line (CTLL) was used for the production of IL-2 by phytohemagglutinin-stimulated T-cells in a cytotoxic assay. B-cell growth and differentiation factor activity of T-cells was studied by enzyme-linked immunosorbent assay. RESULTS: The AMLR of malignant lymph node T-cells was increased characteristically in 12 of the 14 lymphoma cases studied; however, that of the blood T-cells was decreased. The allogeneic MLR of the malignant lymph node T-cells and blood-purified T-cells of the eight cases investigated was decreased. Expression or deficiency of CD2 and CD3 antigens on malignant T-cells did not show any difference in the AMLR assay. CONCLUSIONS: This study demonstrates an important tendency of malignant T-cells from patients with peripheral T-cell lymphoma to proliferate in AMLR. The highly augmented AMLR but deficient allogeneic MLR observed in these malignant T-cells indicate that autologous recognitive events may play an important role in the immunopathogenesis of this human disease.

Adult↗

"Silent" abdominal tuberculosis: a report of six cases.

Six cases of "silent" or subclinical abdominal tuberculosis seen in patients who belong to the upper socio-economic class, but with a humble childhood are presented. The patients are usually from the Third World countries and the condition is often missed or mis-diagnosed. This condition is often precipitated by some stressful situation, and the presentation is not typical of the well-known clinical features of abdominal tuberculosis. This is most likely due to the fact that the high standard of living later in life tends to distort the classical clinical features of tuberculous abdomen as seen in the rest of the population. There is usually a dramatic response to anti-tuberculosis therapy.

Abdomen↗

Hydatid disease of the urinary tract: evaluation of diagnostic methods.

Eight patients with histologically proven hydatid disease of the urinary tract underwent eosinophil count, ultrasonography (US) and computed tomography (CT). The findings were compared with those in 8 age-matched controls with simple renal cysts. Eosinophilia was not significantly different in the 2 groups. Mixed echogenicity on US and multivesicular cyst with mixed density on CT were the diagnostic features of hydatid cysts. Using these factors, both US and CT could diagnose or exclude hydatid disease in a significant number of patients with renal cysts. However, CT was more sensitive (88 vs 50%) and accurate (94 vs 75%) than US in the diagnosis of urinary tract hydatid disease. Retrograde pyelography confirmed communicating renal hydatid cysts in 2 patients. A practical algorithm for the investigation of urinary tract hydatid disease is suggested.

Adult↗

Hydatid disease of the liver: evaluation of ultrasound and computed tomography.

We have evaluated computed tomography (CT) and ultrasonography (US) in 41 patients with hepatic hydatid disease. CT was diagnostic in all patients, while US performed on 36 patients was diagnostic in 34. In the remaining two cases, heavy calcification in one and a large amount of intracavitary air in the other prevented accurate diagnosis. The US findings in the liver regarding cyst form (multilocular or unilocular), size and location were comparable to those of CT. CT detected associated extrahepatic cysts in the abdomen and pelvis in 11 patients while US performed on the same group of patients detected such cysts in seven patients. It is suggested that the entire abdomen and pelvis should be scanned in patients suspected of hydatid disease and when a hepatic lesion is suggestive of the disease.

Abdomen↗

Khat and oral cancer.

Oral cancers in the Asir region of Saudi Arabia have been observed to occur mostly among patients who have been long-term khat users. In a survey that reviewed cancers for the past two years there were 28 head and neck cancer patients, 10 of whom presented with a history of having chewed khat. One of these was a case of metastatic cervical lymph node and unknown primary, one was a parotid tumour, and the remaining eight presented with oral cancers. All were non-smoking khat chewers and all of them had used it over a period of 25 years or longer. We conclude that this strong correlation between khat chewing and oral cancer warrants attention.

Catha↗

Timing of surgery in acute cholecystitis.

Eighty-one cases of cholecystectomy performed over a period of 12 months were reviewed. Those operated upon acutely, those operated upon electively, and those initially treated in the hospital before surgery was performed were compared with regards to the length of hospital stay, injury to the common bile duct, wound infection and mortality rate. There is no significant difference in the mortality rate, but the rate of wound infection 23%, and injury to the common bile duct (17.95%) are highest in those operated upon acutely. It would seem as if the "delayed" surgery, that is, conservative treatment for about a week to two in the hospital before surgery, is preferred if common bile duct exploration or a choledocho-enterostomy is anticipated.

Acute Disease↗

Peripheral T-cell lymphomas. Immunophenotype, lymphokine production, and immunologic functional characteristics of the lymph-node malignant T cells.

Immunophenotype and functions of the malignant T cells to secrete various T-cell derived lymphokines and to respond in autologous mixed lymphocyte reaction (AMLR) and allogeneic mixed lymphocyte reaction (MLR) of the six patients with peripheral T-cell lymphomas (PTL) are presented. Three cases showed CD3/TcR alpha beta discordance (1 CD3+/TcR alpha beta-; 2 CD3-/TcR alpha beta+) and one showed absence of both these antigens (CD3-/TcR alpha beta-). In addition, we found that 50% of cases expressed CD25+, CD38+, and CD71+ activation antigens. The CD3/TcR alpha beta discordance and expressions of activation antigen noted in these cases were typical and similar to those reported from elsewhere. These malignant T cells from all cases whether CD25+ or CD25- (resting) expressed elevated interleukin-2 receptors (IL-2R) on stimulation with phytohemagglutinin (PHA) or human recombinant interleukin-2(rIL-2), and secreted elevated IL-2 by PHA, than do T cells from patients with tuberculosis (TB) or normal healthy controls. These malignant T cells also demonstrated elevated AMLR but deficient MLR B cells growth factor (BCGF) (except in one unusual case) secretion was increased, whereas B-cell differentiation factor (BCDF) secretion decreased. These results suggest that malignant T cells from lymph nodes of patients with PTL have uniform multiple immunologic defects in IL-2, BCGF, and BCDF lymphokine secretion and respond in AMLR and MLR, which do not correlate with immunophenotype or histologic types. These functions differentiate them from lymph-node T cells of patients with TB or blood T cells of normal healthy controls.

Aged↗

Primary closure of breast abscess compared with the conventional gauze packing and daily dressings.

Because of the reported success of primary closure of Skeletal Muscle abscess we conducted a retrospective study of breast abscess treated over a period of 24 months. There were essentially two groups: In one group the abscess cavities were initially packed with gauze and then dressed daily. In the second group, the abscess cavities were primarily closed and a negative suction drain instituted for about five to seven days. The second group had shorter healing period, better scar formation and reduction of cost in terms of labour and material. But a recurrence could occur within two to three days especially if the drain is removed prematurely.

Abscess↗