Surgical outcome in children undergoing hypospadias repair under caudal epidural vs penile block

Aim and Objective: To evaluate the effect of penile block vs caudal epidural on the quality of analgesia and surgical outcome following hypospadias repair. Background: Intraoperative penile engorgement because of caudal epidural may result in tension on surgical sutures and alter surgical outcome. Methods: Fifty‐four ASA I and II children were randomly allocated to group P (penile block, 0.25% bupivacaine, 0.5 mg·kg^?1; n = 27) and group C (caudal epidural, 0.25% bupivacaine, 0.5 ml·kg^?1; n = 27), respectively. Quality of analgesia was assessed by visual analog scale (VAS) score recorded at 0, 0.5, 3, 6, 12, 24 h, and once a day for the next 4 days. Duration of analgesia was calculated from the institution of block to the first analgesic demand by child or VAS > 5. Total morphine consumption in the first 48 h and oral paracetamol consumption till 5th day were recorded. Children were regularly followed up in their respective outpatient clinic for early or late complications. Results: In group P, lower mean VAS scores were seen from 0.5 h after surgery till day 3 and analgesia lasted for significantly longer duration (82 min) when compared with caudal epidural, P < 0.001. Incidence of urethral fistula formation after primary hypospadias repair was 19.2%, and all had received caudal epidural. An increase of 27% in penile volume from baseline value was observed 10 min after caudal epidural placement, P < 0.05. Conclusion: Penile block provided better analgesia when compared with caudal epidural in children undergoing primary hypospadias repair. Postoperative urethral fistula formation was more likely in children who received caudal epidural.     

Superior sternal cleft with congenital neck contracture and absent hyoid bone

An extremely rare association of superior sternal cleft with congenital neck contracture, absent hyoid bone, partial pericardial defect and ventricular septal defect in a 3-month-old infant is presented. The neck contracture required release under local analgesia to facilitate endotracheal intubation for general anaesthesia.     

Taiwanese cases of SCA2 are derived from a single founder.

We have assessed the haplotypes at the ATXN2 locus in Taiwanese controls and in individuals with SCA2 ataxia with both ataxic and parkinsonian features. Our intention was to determine whether a different ataxin 2 haplotypes predisposed to the two phenotypes. In fact, our analysis showed that all SCA2 mutations carriers had the same ataxin 2 haplotype: haplotype B, which accounts for only 15% of control haplotypes, implying that there is a common founder for all Taiwanese SCA2 patients.     

Usage of dried blood spots for molecular diagnosis and monitoring HIV-1 infection

The usage of dried blood spots as specimens for diagnosis and monitoring of HIV-1 infection in Thailand was evaluated. EDTA blood samples, which were collected from 100 HIV seronegative and 109 HIV seropositive individuals, were tested on dried blood spots; Whatman, Schleicher and Schuell (S&S) No. 903 and S&S IsoCode filter paper. Nucleic acid was extracted and used as a template for HIV-1 proviral DNA detection by an "in-house" multiplex PCR and a commercial Amplicor HIV-1 PCR test (Roche, version 1.0). HIV-1 RNA qualitative (QL) and quantitative (QT) detection was determined by Nucleic Acid Sequence Based Amplification (NASBA). The average DNA per blood spot recovered from Whatman and S&S IsoCode was not statistically different (p = 0.512) with a range of 218.9+/-46.84 and 225.63+/-88.33 microg, respectively. The concordance of HIV-1 proviral DNA detection by PCR from dried blood spots Whatman and S&S IsoCode was 94% versus 89.4% for sensitivity and 100% versus 100% for specificity. The sensitivity and specificity of HIV-1 RNA QL detection in dried blood spots was 89.7 and 97.5%, respectively. The HIV-1 RNA QT from dried blood spots showed a good correlation in paired dried blood spots and plasma with Pearson correlation, r = 0.817 (R2 = 0.667, P < 0.05). The data showed that dried blood spots could be used for the diagnosis and monitoring of HIV-1 infection.     

Transdermal Permeability of N-Acetyl-D-Glucosamine

Transdermal permeation of N-acetyl-D-glucosamine (NAG), a metabolite of glucosamine was examined. Glucosamine salts are nutraceuticals used in the oral treatment of osteoarthritis. Sparse information is available regarding glucosamine and NAG transdermal or percutaneous transport and absorption. Permeability of NAG in various enhancer suspensions was evaluated by using shed snakeskin as a model membrane via Franz-type cell diffusion studies. Negligible permeability was observed for NAG in neat solutions of known membrane permeation enhancers ethanol, oleic acid, isopropyl myristate, and isopropyl palmitate, as well as from saturated solutions of NAG in water or phosphate buffer. Permeability measurements obtained from saturated solutions of NAG in DMSO and phosphate buffer solutions containing ethanol at 2%, 5%, 10%, 25%, and 50% demonstrated excellent permeation. Permeability coefficients of the phosphate buffer/ethanol solutions at 5%, 10%, and 25% were about threefold larger in value as those for saturated DMSO solution, whereas the 2% and 50% solution values were lower.     

Screening for C9ORF72 repeat expansion in FTLD

In the present study we aimed to determine the prevalence of C9ORF72 GGGGCC hexanucleotide expansion in our cohort of 53 frontotemporal lobar degeneration (FTLD) patients and 174 neurologically normal controls. We identified the hexanucleotide repeat, in the pathogenic range, in 4 (2 bv-frontotemporal dementia (FTD) and 2 FTD-amyotrophic lateral sclerosis [ALS]) out of 53 patients and 1 neurologically normal control. Interestingly, 2 of the C9ORF72 expansion carriers also carried 2 novel missense mutations in GRN (Y294C) and in PSEN-2(I146V). Further, 1 of the C9ORF72 expansion carriers, for whom pathology was available, showed amyloid plaques and tangles in addition to TAR (trans-activation response) DNA-binding protein (TDP)-43 pathology. In summary, our findings suggest that the hexanucleotide expansion is probably associated with ALS, FTD, or FTD-ALS and occasional comorbid conditions such as Alzheimer's disease. These findings are novel and need to be cautiously interpreted and most importantly replicated in larger numbers of samples.     

In vitro anti-Helicobacter pylori activity of aqueous extract from Persian Oak testa

Objective: Growing problem of antibiotic resistance in Helicobacter pylori, as a common cause of chronic gastritis and even stomach cancer, demands searching for novel candidates of herbal sources. This study is aimed at assessing the antimicrobial activity of aqueous extract obtained from Quercus brantii var. persica seed coat(Testa) on H. pylori isolated from gastric biopsy specimens.Methods: Such specimens were collected from 100 patients presenting with endoscopic gastroduodenal findings. Testa extracts were prepared from Persian Oak forests in the province of Kohgiluyeh and BoyerAhmad, IRAN. H. pylori isolates were obtained by a series of standard bacteriology tests and cell culture,then were confirmed by PCR. The activity of testa extracts towards 25 H. pylori isolates was assessed by well diffusion method, microdilution assay, and a disk diffusion assay in vitro. Results were analyzed statistically by one-way ANOVA analysis.Results: Aqueous extract of testa demonstrated an antimicrobial activity with zone diameters of inhibition ranged from 0 mm to 40 mm. Its inhibitory activity increased simultaneously with increasing extract concentration. The lowest MIC and MBC were both recorded as 2 μg/m L. Anti-H. pylori activity of testa extract was approximately close to tetracycline and metronidazole and less than amoxicillin. A potent extract of testa possessed significant inhibitory activity(P 0.05).Conclusion: Testa extract is suggested as a natural therapeutic source against the gastric H. pylori infection. However, evaluating the in vivo activity of this extract is necessary too.     

3D carbon nanofiber microelectrode arrays fabricated by plasma-assisted pyrolysis to enhance sensitivity and stability of real-time dopamine detection

In this paper, we have fabricated 3D carbon nanofiber microelectrode arrays (MEAs) with highly reproducible and rich chemical surface areas for fast scan cyclic voltammetry (FSCV). Carbon nanofibers are created from negative photoresist by a new process called dual O₂ plasma-assisted pyrolysis. The proposed approach significantly improves film adhesion and increases surface reactivity. We showcase our sensor’s compatibility with FSCV analysis by demonstrating highly sensitive and stable FSCV dopamine measurements on a prototype 4-channel array. We envision with proper surface fuctionalization the 3D carbon nanofiber MEA enable sensitive and reliable detection of multiple neurotransmitters simultaneously.