Molecular characterisation of two mumps virus genotypes circulating during an epidemic in Lithuania from 1998 to 2000

Summary.  An epidemic of mumps in Lithuania started in December 1998 and continued until May 2000. The total registered number of cases was about 11.000 of a total of 3,7 million inhabitants in Lithuania (29,7 cases/10000). Virus- containing samples were collected from 80 patients treated at the hospital of Kaunas from October 1999 until the end of the epidemic. Out of the 80 patients with parotitis, meningitis was observed in 11 patients and orchitis in 22 of 69 male patients. Twenty-seven virus strains were genotyped by nucleotide sequencing of the small hydrophobic (SH) protein gene, and the 57 amino acid sequences of the gene were deduced. Twenty-five virus strains belonged to the C genotype and two were of the D genotype. By phylogenetic analysis the virus strains causing meningitis grouped in a separate cluster, designated C1, within the C genotype. Another group of ten of the 25 genotype C strains exhibited an amino acid triplet at amino acid positions 28 to 30 of the protein, consisting of valine, alanine and serine, instead of the previously recognised valine, valine and serine combination of genotype C. The amino acid alanine at position 29 was found in combination with the amino acid serine at position 48. This variant was designated C2 and it was associated with parotitis. The amino acid alanine at position 29 and serine in position 48 of the C2 genotype may constitute a marker of low neurovirulence compared to other genotype C strains. Received July 9, 2001 Accepted October 23, 2001     

The diagnostic value of magnetic resonance imaging in subacromial impingement syndrome

The aim of this study was to assess the diagnostic ability of magnetic resonance imaging (MRI) in subacromial impingement syndrome (SIS), using a physiological standard of reference. MRI of the rotator cuff (RC) and subacromial injection test (SIT), a reference standard for SIS diagnosis, were performed in 125 painful shoulders. MRI diagnostic accuracies were determined using a 2 x 2 table and the percentage values of SIS diagnosis in patients with the three Zlatkin MRI stages were determined. Shoulder function was evaluated using the Constant Scale, and results were compared for stages. The sensitivity, specificity, accuracy, positive and negative predictive values of MRI for SIS diagnosis were 98.85%, 36.84%, 80%, 78.18% and 93.33% respectively. Of the 32 patients with Zlatkin stage 1 changes in MRI, 20 (62%) had SIT approved SIS diagnosis, while 47 (79%) of the 59 patients with Zlatkin 2 and all of the 19 (100%) patients with Zlatkin 3 changes were diagnosed with SIS by SIT. Mean Constant scores were 78.04 +/- 18.3, 65.0 +/- 19.9 and 54.52 +/- 20.7 in patients with Zlatkin stages 1, 2 and 3, respectively (p < 0.05). The MRI of RC did not prove to be an excellent tool for SIT based SIS diagnosis, with its low specificity. However, the technique can give important clues, as its sensitivity and negative predictive values are high.     

Microcirculation in the upper trapezius muscle during varying levels of static contraction,fatigue and recovery in healthy women —a study using percutaneous laser-Doppler flowmetry and surface electromyography

Summary Microcirculation in the upper portion of the trapezius muscle was measured percutaneously by continuous laser-Doppler flowmetry (LDF) during two 10-min series of alternating 1-min periods of static contraction and rest determined electromyographically (EMG). Stepwise increased contraction was induced by keeping the arms straight and elevated at 30, 60, 90 and 135°, which was repeated with a 1-kg load carried in each hand. Thereafter, fatigue and recovery were recorded while the subject kept her arms straight and elevated at 45° carrying the 1-kg hand load as long as possible, followed by rest with arms hanging and no load. A group of 16 healthy women of different ages was studied. Signal processing was done on line using a 386 SX computer. The LDF- and root-mean-square (rms) EMG signals were normalized. Spectrum analyses of EMG mean power frequency (MPF) and median spectrum frequency were performed. The rms-EMG increased significantly with an increase in the calculated shoulder torque (r=0.75). Accumulated local fatigue was indicated by a decrease in MPF with increased shoulder angle and added load (r = –0.54). Blood flow increased with increased shoulder angle (r=0.82, with hand loadr=0.62) and with increased shoulder torque (r=0.72), and also showed a significant increase with increased EMG activity (r=0.74). The LDF showed a negative correlation to MPF (r= –0.67), with increased values when MPF was lowered. During the endurance test, a moderate increase of LDF occurred which reached its maximum during the 1st min of recovery. Then, a slow return to the base level was recorded. The ability to increase the flow in the microcirculation with increasing muscle load was not diminished with age.     

Chromosome 22q11.2 deletion and phenotypic features in 30 patients with conotruncal heart defects

This report describes the dysmorphic features and frequency of 22q11.2 deletion (del22q11) in 30 Turkish patients with conotruncal heart defects (CTHDs). Fluorescence in situ hybridization (FISH) analysis revealed deletions in the 22q11.2 region in nine (30%) individuals. The CTHDs in this group were tetralogy of Fallot (four cases), double-outlet right ventricle (DORV) (two cases), transposition of great arteries (two cases), and ventricular septal defect (VSD) associated with other CTHDs (one case). The frequency of del22q11 in the study group was relatively high because many of the patients with dysmorphic findings also had cardiac anomalies involving the pulmonary artery, ductus arteriosus, or the aortic arch and its main branches. Twenty of the 30 patients exhibited several dysmorphic findings. Two of the nine patients with del22q11 exhibited no apparent dysmorphic features other than sacral dimple. Interestingly, one of the patients with del22q11 had a phenotypic appearance similar to that seen in oculo-auriculo-vertebral spectrum (OAVS). This individual had left microtia, atresia of the external meatus, mandibular asymmetry, and peripheral facial nerve paralysis. His mental development was normal and there were no abnormalities on ophthalmological examination. The CTHDs in this patient were situs inversus dextrocardia, DORV, pulmonary stenosis, and VSD. Radiographs of this patient showed platybasia, complete fusion of C2-C3, and posterior fusion of the T1-T2 vertebrae. This particular case indicates that the phenotypic features of del22q11 and OAVS may overlap.     

A novel amperometric biosensor based on artichoke (Cynara scolymus L.) tissue homogenate immobilized in gelatin for hydrogen peroxide detection

A biosensor for specific determination of hydrogen peroxide was developed by using homogenized artichoke (Cynara scolymus L.) tissue in combination with a dissolved oxygen probe and applied in determination of hydrogen peroxide in milk samples. Artichoke tissue, which has catalase activity, was immobilized with gelatine by means of glutaraldehyde and fixed on a pretreated teflon membrane. The electrode response was maximum when 0.05 M phosphate buffer was used at pH 7.0 and at 30 degrees C. Upon addition of hydrogen peroxide, the electrode gives a linear response in a concentration range of 5.0-50 x 10(-5) M with a response time of 3 min. The method was also applied to the determination of hydrogen peroxide in milk samples.     

Somatic mosaicism for a MECP2 mutation associated with classic Rett syndrome in a boy

Rett syndrome is a severe neurodevelopmental disorder that arises from mutations in the X-linked MECP2 gene. It is almost exclusively seen in girls due to the predominant occurrence of the mutations on the paternal X-chromosome, and also the early postnatal lethal effect of the disease causing mutations in hemizygous boys. We identified a boy with features of classic Rett syndrome who is mosaic for the truncating MECP2 mutation R270X. Chromosome analysis showed normal karyotype. These results indicate that a MECP2 mutation associated with Rett syndrome in females could lead to a similar phenotype in males as a result of somatic mosaicism.     

Poly(D,L-lactide/epsilon-caprolactone)/hydroxyapatite composites as bone filler: an in vivo study in rats

In this study, a novel composite bone substitute was implanted in animal models (rats) and their in vivo characteristics were examined. A D,L-lactide and E-caprolactone copolymer (Mw: 80,000; Mn:40,000, and PI:2.00) was synthesized by ring-opening polymerization of the respective dimers using stannous octoate as the catalyst. The final ratio of D,L-lactide to epsilon-caprolactone obtained by 1NMR was 60/40. Hydroxyapatite (HA) powder was loaded in the copolymer. The HA/copolymer ratio was 60/40 (w/w). These composites were easily shaped by hand. Animal tests were performed on mature wistar rats (n=30). Defects were created on the proximal, the thickest part of the femur. The bone defects of the first group were filled with polymer/HA composite, the second group filled with only HA and the third group was left empty. Histologic examination of bone tissues showed new bone formation around the yellow-green polymer/HA composite material in the first group of animals whereas no evidence of new bone growth was observed in other groups.     

Pneumatised superior turbinate: a common anatomic variation?

Summary Anatomic variations are important in preendoscopic CT evaluation of the paranasal sinuses. In this study, we investigated whether the superior turbinate could become pneumatised like the middle turbinate, pneumatisation of which is well-known. Images of 52 patients who underwent CT examination prior to endoscopic sinus surgery and who had normally aerated posterior ethmoidal cells and an unobscured nasal cavity were retrospectively evaluated. The patients were 12–68 years old (median age, 35 years); 28 were women and 24 were men. Pneumatisation of the superior turbinates was graded in two groups as minimal or marked. Pneumatisation was evident in 25 patients (48%). 13 unilateral (25%), 8 bilateral (15%) pneumatisations were detected in the group graded as minimal, whereas 1 unilateral and 3 bilateral pneumatisations were present in the markedly (8%) pneumatised group of patients. Superior turbinates were seemingly aerated through the posterior ethmoid cells. The superior turbinates can be pneumatised as the middle turbinate is a not frequent anatomic variation that should be taken into account in preendoscopic CT evaluation of the paranasal sinuses.

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La pneumatisation du cornet nasal supérieur : une variation anatomique courante ?

Résumé Les variations anatomiques sont importantes à connaitre dans le cadre du bilan tomodensitométrique précédant une chirurgie endoscopique des sinus paranasaux. Dans cette étude, nous avons recherché si le cornet nasal supérieur pouvait être pneumatisé comme l'est le cornet nasal moyen, entité anatomique bien connue. Les images de 52 patients ayant eu une tomodensitométrie avant chirurgie endoscopique et montrant des cellules ethmoïdales postérieures normalement pneumatisées et une cavité nasale nonopaque, ont été évaluées rétrospectivement. Les patients, 28 femmes et 24 hommes, étaient âgés de 12 à 68 ans (moyenne : 35 ans). La pneumatisation du cornet nasal supérieur a été classée en deux groupes; minime et prononçée. Cette pneumatisation était patente chez 25 patients (48 %). Treize pneumatisations unilatérales (25 %) et 8 pneumatisations bilatérales (15 %) furent retrouvées dans le groupe présentant une pneumatisation minime alors que 1 pneumatisation unilatérale et 3 bilatérales (8 %) étaient présentes dans le groupe dont la pneumatisation était plus marquée. Les cornets nasaux supérieurs semblaient être aérés par les cellules ethmoïdales postérieures. Les cornets nasaux supérieurs peuvent être pneumatisés, comme le sont les cornets nasaux moyens, avec une fréquence non-exceptionnelle. Cette variation anatomique mérite d'être prise en considération dans le bilan tomodensitométrique précédant toute chirurgie endoscopique des sinus paranasaux.

     

Role of granulocyte colony-stimulating factor in the treatment of mucormycosis

Several problems in the management of life-threatening mucormycosis remain unresolved, necessitating new methods of management. Four patients with histopathologically proven rhinocerebral mucormycosis were treated with high cumulative doses of granulocyte colony-stimulating factor (G-CSF). All had multiple predisposing factors for mucormycosis, particularly leukemia and neutropenia. Two patients refractory to fluconazole therapy were treated with liposomal amphotericin B. The improvement in clinical manifestations was closely related to neutrophil recovery, and all patients were alive at the end of therapy. In addition to surgical debridement and antifungal therapy, G-CSF seems to have played a role in their survival.