A rare diagnosis of Langerhans cell histiocytosis made on thyroid histology with coexisting papillary thyroid cancer and AVP deficiency.

Summary: A 48-year-old Asian male, presented to the hospital for an elective total thyroidectomy in the context of 6.3 cm thyroid nodule. The fine needle aspiration cytology of the nodule confirmed papillary thyroid cancer (PTC) with some atypical histiocytes.

Fungal appendicitis in a non-immunocompromised woman.

We describe a previously fit and well 54-year-old woman who presented with 3 weeks of right-sided lower abdominal pain with CT showing a non-specific thickening of the caecal/appendiceal wall. Although initially concerning for a neoplastic process, histology demonstrated yeast-like organisms colonising and invading into the appendiceal wall, confirming the diagnosis of fungal appendicitis. Fungal appendicitis is an important clinical entity that has previously been reported to affect immunocompromised individuals.

Dyspnoea and constipation: rare case of large bowel obstruction secondary to an incarcerated Morgagni hernia.

Incarcerated diaphragmatic hernias are often challenging to diagnose. Patients often present with non-specific abdominal symptoms, and barring an imaging modality that confirms herniation of intra-abdominal contents, there is no investigation sensitive or specific enough to identify it. It is a rare cause of mechanical bowel obstruction that clinicians should be aware of.

Appendiceal fat stranding on CT: a red herring in a post-caesarean section woman with Ogilvie's syndrome (OS).

A 30-year-old woman was referred for a surgical review with abdominal pain and distension 2 days post-caesearean section. Abdominal X-ray showed dilated bowel loops. CT of her abdomen however showed fat stranding around a thickened appendix, suggesting a differential diagnosis of acute appendicitis on top of a postoperative ileus.

Laparoscopic repair of a right diaphragmatic hernia in a post-partum lady.

Traumatic diaphragmatic injuries (TDI) are often challenging to diagnose. Research suggests that no single diagnostic study is sensitive or specific enough to identify such an injury, unless there is established herniation of intrabdominal contents. It is a rare cause of small bowel obstruction, which carries a substantial mortality rate.

Molecular cloning and expression of heteromeric ACCase subunit genes from Jatropha curcas.

Acetyl-CoA carboxylase (ACCase) catalyzes the biotin-dependent carboxylation of acetyl-CoA to produce malonyl-CoA, which is the essential first step in the biosynthesis of long-chain fatty acids. ACCase exists as a multi-subunit enzyme in most prokaryotes and the chloroplasts of most plants and algae, while it is present as a multi-domain enzyme in the endoplasmic reticulum of most eukaryotes. The heteromeric ACCase of higher plants consists of four subunits: an α-subunit of carboxyltransferase (α-CT, encoded by accA gene), a biotin carboxyl carrier protein (BCCP, encoded by accB gene), a biotin carboxylase (BC, encoded by accC gene) and a β-subunit of carboxyltransferase (β-CT, encoded by accD gene).

Intraoperative ultrasound-guided excision of nonpalpable breast lesions.

The methods commonly used to guide surgical excision of impalpable breast lesions include preoperative placement of hookwires, carbon injections, and, more recently, radioisotope injections. However, all of these techniques have disadvantages, not the least of which is subjecting the patient to an additional stressful and often traumatic procedure preoperatively. The use of intraoperative ultrasound to guide the excision of sonographically visible impalpable lesions is a new technique that avoids the need for a preoperative localization procedure.

Marking the surgical margins of specimens: commercial acrylic pigments are reliable, rapid and safe.

Aim: To find a medium to mark the surgical margins and orientation of complex specimens that is reliable, easy to use, safe and inexpensive.

Methods: Several different paints, dyes and pigments were tested. A series of pigments supplied by SICPA Australia Pty Ltd, when fixed to the specimen in acetic formalin, was used on over 7000 complex specimens.

Selective association of nerve fibres immunoreactive for substance P or bombesin with putative cholinergic neurons of the male rat major pelvic ganglion.

The male rat major pelvic ganglion contains both sympathetic and parasympathetic neurons that supply the lower urinary and digestive tracts, and the reproductive organs. The aim of this study was to describe the distribution and identify potential targets of sensory and intestinofugal axons in this ganglion. Two putative markers of these projections were chosen, substance P for primary sensory axons and bombesin for myenteric intestinofugal projections.

Change in self-concept during adolescence.

Malaysian adolescents, like their Western counterparts, undergo rapid growth and development. It is hypothesized that self-concept improves as adolescents mature and become more adjusted to the changes. This study therefore sought to ascertain whether the self-concept changes with age, not only in the global sense but in the various components of the self-concept.

The prevention of postappendicectomy sepsis by metronidazole and cotrimoxazole: a controlled double blind trial.

A double-blind, randomized controlled trial was carried out in University Hospital, Kuala Lumpur to study the effect of metronidazole and cotrimoxazole on the incidence of wound infection following appendicectomy from November 1978 to January 1980. Patients were allocated at random into one of four groups: cotrimoxazole injection and placebo suppository, metronidazole suppository and cotrimoxazole injection, metronidazole suppository and placebo injection or placebo suppository and placebo injection. Treatment was started 30 min before operation and continued for 72h.

Application of a noninhibitory growth model to predict the transient response in a chemostat.

A method of adapting a kinetic model based on steady-state chemostat data to predict the transient performance of a chemostat culture is presented. The proposal provides for a time delay which can be considered equivalent to a period of reduced activity of the organism subsequent to the introduction of a step change in operating conditions. The adapted kinetic model gives substantially better performance in predicting the transient response of an experimental system than the unmodified kinetic model.

A model for noninhibitory microbial growth.

A model for noninhibitory microbial growth has been developed which is superior to the Monod model in that it can predict the decline in steady-state growth yields at both the slow and the fast specific growth rates. The model parameters are evaluated from data obtained for steady-state, phenol-limited Pseudomonas putida growth using a conventional 1-dm(3) cheniostat. The model also has been successfully applied to Mor and Fiechter's data for cheniostat yeast cultures.

Cholelithiasis in Singapore. II. A clinical study.

In the present study of 241 patients submitted for gallbladder and biliary tract surgery, it is found that choledocholithiasis in cases in Singapore presents with a wide spectrum of clinical manifestations. It is essential that the less common clinical presentations should be recognized.