Biomedical subjects
Publications and source records attributed to S E Ikerionwu.
Secondary cysts of the iris or anterior chamber follow penetrating trauma or surgery of the cornea. These can lead to some serious complications. We describe a case of an intraocular implantation dermoid cyst of the iris that followed a perforating injury of the cornea in a seven-year old Saudi child. The cyst was surgically removed and proved histologically.
A total of 4700 specimens of premenstrual endometrial curettings from infertile women were reviewed at the University of Nigeria Teaching Hospital, Enugu. Ten cases of tuberculous endometritis were found, giving a prevalence of 0.2%. The significance of this low prevalence is discussed. It is suggested that more deliberate efforts should be made to search for genital tuberculosis in infertile women in developing countries.
Nocardia transvalensis was investigated for its ability to cause mycetoma in the skin and foot pad of laboratory mice. Freund's incomplete adjuvant appeared to aid the development of mycetoma lesions. The infection manifested itself as palpable nodules under the skin which discharged white to cream coloured pus containing nocardial granules. The lesions in the skin necrotized, while those of foot pad resulted in bone destruction.
The pattern of childhood malignancies in the developing countries of Africa is characterized by a high incidence of lymphoma and a low incidence of leukaemia. The converse is the case in the developed countries of Europe and North America. A high incidence of lymphoma with low incidence of leukaemia has been associated with poor living standards. The clinical records of 257 children admitted with malignant disease to the University of Nigeria Teaching Hospital, Enugu between January 1978 and December 1982 were studied retrospectively to determine the pattern of malignant diseases amongst these children. The lymphomas were the commonest tumours, constituting nearly 40% of the total, followed by Wilm's tumour (14.0%), leukaemia (12.9%) and CNS tumours (9.7%). However, the incidence of lymphoma was lower while the incidence of leukaemia was higher than in previous reports from other parts of Nigeria and Africa. The rarity of Ewing's tumour, histocytosis-X and testicular tumours in African children is confirmed in the present study.
Nocardia transvalensis was found to be virulent for laboratory mice both by intraperitoneal and intravenous routes of inoculation, the latter route producing a more progressive and disseminating infection. Cortisone administration was found to enhance the susceptibility of mice, the LD50 for the cortisone treated mice being five times less than that for the untreated animals. In the tissues of cortisone treated mice, N. transvalensis grew as dispersed filaments with coccobacillary forms or sometimes their loose aggregates, whereas in normal animals granule formation was a conspicuous feature. The pathogenicity of N. transvalensis is compared with that of N. asteroides, N. brasiliensis and N. caviae from published reports.
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A retrospective analysis of liver biopsies done at the University of Nigeria Teaching Hospital, Enugu, between January 1980 to December 1985 was done to determine the indications, level of preparation and investigation of the patients, biopsy techniques and failure rate, complications and histopathological results. The register of all biopsies sent to the Morbid Anatomy Department and the clinical records of the patients were used for the analysis. Of the 154 biopsies done, the Menghini technique was used in 128 cases (83.1%), the rest was by exploratory laparotomy. The commonest indication was unexplained hepatomegaly with or without splenomegaly 46 cases (29.8%). Adult cases accounted for 132 cases (85.7%) with male/female distribution of 3:1. Histologically proven cases of hepatocellular carcinoma accounted for 38 cases (14.2%). Pain requiring analgesics occurred in 8 cases (5.2%). The need for adequate clinical documentation of patients is emphasized.
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Two cases of esthesioneuroblastoma occurring in African Nigerians are reported, with a review of the literature. Though the tumour has highly suggestive clinical features, histologic diagnosis may be difficult. The name 'esthesioneuroblastoma' is considered to be preferable to 'olfactory neuroblastoma' in order to avoid consideration of such a tumour as a secondary from the adrenal gland. Early diagnosis and treatment by surgery gives the best chance of cure.
A 10-year old Nigerian boy was admitted to hospital with a history of swelling in the neck, change of voice, dysphagia and dyspnoea of 2 weeks duration. He died on the 2nd day of admission. Autopsy revealed a thymoma infiltrating the thyroid, trachea and neck muscles and transforming the tracheal lumen into a slit like space. The condition is considered worthy of record on account of its rarity and of the short clinical course terminating in death. The authors feel that the most important factor in determining the prognosis of thymoma is the presence or absence of gross invasion.
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Autopsy findings of a case of Lassa fever from the Eastern part of Nigeria are presented. The authors suggest that in Lassa fever there is an involvement of the brain in the nature of encephalitis.
The case of an 18-year-old female, with mild left hypochondrial pain and an abdominal mass mimicking gross splenomegaly, with severe small and large bowel fibrosis and adhesions and numerous mononuclear cellular infiltrate on histology, is presented. A clear picture of intestinal obstruction only unfolded terminally. She died within 48 hours of presentation. Our patient illustrates the fact that severe intestinal adhesions may present with very mild symptoms and signs and therefore a high index of suspicion is necessary, to reduce the attendant high mortality in intestinal obstruction in our environment.