ABSTRACTS OF PAPERS AT THE 89TH RESEARCH
MEETING OF THE MEDICAL RESEARCH CENTRE OF BOMBAY HOSPITAL ON MONDAY, 13TH AUGUST,
2001, 2.30 PM SP JAIN CAFETERIA (CONVENOR DR. HL DHAR)
1. THE MOLECULAR NEUROPATHOLOGY OF MUSCULAR DYSTROPHIES
Rashna S Dastur,
Daya K Manghani
Muscular dystrophy covers a diverse group
of inherited disorders in which the main clinical defects in the skeletal muscle
i.e. weakness and wasting are mainly similar in all patients, but show genetically
different diseases. This suggests that the various gene products participate
or work together as a common functional structure or "biochemical cascade".
In striated muscle cells, dystrophin - glycoprotein complex (DGC) serves as
a link between the extracellular matrix and the subsarcolemmal cytoskeleton.
The absence or dysfunction of one gene product (protein) in the DGC affects
the functioning of the others causing the muscle cell to breakdown. Variability
of clinical severity and the age of onset found in different types of dystrophies
therefore depend on the functional importance of their gene products to the
Cohen’s technique for reimplantation was used in 40 patients (73 ureters), Leadbetter-Politano
Technique in 31 patients (41 ureters), Lich-Gregoir Technique in 11 patients
(15 ureters), and Paquin’s Technique in 9 patients (11 ureters). Ureteric tailoring
was performed in 27 ureters while ureteric plication was done in 11 ureters.
Ureteric stents were placed post-operatively in 94 ureters.
The focus on the recent findings about muscular dystrophies, especially duchenne
muscular dystrophy caused by mutations in the DGC components will be illustrated
through immunohistochemical staining and discussed.
2. SPONTANEOUS INTRACRANIAL HYPOTENSION
Rahul T Chakor, NE Bharucha
We present a case of 36 year old man with
orthostatic headache. Clinically low CSF pressure headache was suspected. CT
brain showed effacement of basal cisterns, brain stem swelling and bilateral
thin subdural collection. The third and lateral ventricles were chinked. MRI
(enhanced) showed diffuse pachymeningeal enhancement. Descent of brainstem effacement
of basal cisterns. Bilateral chronic subdural collection. The imaging findings
were consistent of intracranial hypotension. No further invasive tests were
done to demonstrate CSF leak. One week later his sensorium worsened and subdural
collection increased. Tapping of subdural collection was done after which he
improved. He was asymptomatic with two weeks of complete bed rest in head low
position and hydration. CT brain two months later did not show increase in size
of subdural collection. We conclude that MRI (enhanced) findings are diagnostic
of intracranial hypotension. Invasive tests may not be required tapping. Conservative
treatment with complete bed rest for two weeks may be satisfactory method of