Hepatitis E virus genotype 3f sequences from pigs in Thailand, 2011–2012

Phylogenetic analysis of partial ORF1 and ORF2 genes of Hepatitis E virus (HEV) strains from pigs in Thailand during 2011–2012 was performed. The result indicated that the current Thai strains belonged to the genotype 3 subgroup 3f, which were similar to the previous HEVs circulating in humans in Thailand.     

Does Extralaryngeal Branching Have An Impact on the Rate of Postoperative Transient or Permanent Recurrent Laryngeal Nerve Palsy?

Background  This prospective study assessed the prevalence of the extralaryngeal branching of the recurrent laryngeal nerve (RLN) and its impact on the incidence of postoperative transient or permanent RLN palsy. Methods  Total or hemithyroidectomy was performed in 115 patients, with a total of 195 RLNs displayed. The RLN extralaryngeal branches were routinely identified and preserved. The postoperative course of each patient was evaluated. Outcomes of patients with and without branching RLN were compared. Results  In all, 36 of 195 (18.5%) nerves showed extralaryngeal branching: 27 cases (25.5%) on the right and 9 on the left side (10.1%; p = 0.0088).Trifurcation of the RLN was identified in two dissections (1%). Bilateral bifurcations were observed in 3 of 80 (3.7%) patients. We reported four (2.1%) unilateral permanent RLN palsies, eight cases of unilateral transient nerve palsy (4.1%), and one bilateral transient RLN injury (0.6%). The comparative analysis of postoperative outcomes between branched and nonbranched RLNs revealed that the anatomical variation was more frequently associated both with unilateral permanent RLN palsy (relative risk, 13.25; 95% confidence interval, 1.42–123.73; p = 0.0204) and unilateral transient RLN palsy (relative risk, 7.36; 95% confidence interval, 1.84–29.4; p = 0.0061). The only case of bilateral transient RLN injury was associated with a nonrecurrent inferior laryngeal nerve. Conclusions  Branched RLNs represent a risk factor both for transient and permanent nerve palsy after surgery. Awareness of this anatomical variation and its routine investigation are essential during thyroid surgery to limit its relevant impact on postoperative RLN injury rate.     

Neurological and psychiatric disorders in primary hyperparathyroidism: the role of parathyroidectomy

The clinical presentation of primary hyperparathyroidism (pHPT), previously constantly characterized by bone and renal diseases, has been changing during last years. Several Studies report psychic and behavioural symptoms mostly vague and aspecific, particular in elderly patients, such as asthenia, anxiety, depression, irritability, mood swings, amnestic and cognitive disturbances, severe psychosis. In case history hereby reported 11.8% of the patients affected by pHPT (16 out of 136 cases operated from 1983 to October 2006) who underwent to parathyroidectomy, presented only neuro-cognitive and/or psychiatric symptoms. A relevant association has been found between clinical presentation and age: patients showing neuro-cognitive and psychiatric disturbances were older compared to those suffering from the classical bone and kidney disease. No significant correlation neither with serum calcemia nor with PTH serum levels and severity of the symptomatology was demonstrated A statistically significant reduction of the anxious-depressive disturbances one month post surgery has been found (p < 0.05), and an improvement, though not significant, of the neuro-cognitive and psychiatric alterations was registered (p > 0.1). The Authors believe neuro-cognitive or psychic manifestations is not to be neglected, mainly in geriatric patients: frequently the aspecific symptomatology is not referred as hypercalcemia due to pHPT Neuro-psychic symptomatology should be considered an indication for surgical treatment.     

Production, characterization, and functional analysis of newly established CD99 monoclonal antibodies MT99/1 and MT99/2

The leukocyte surface molecule CD99 is an integral membrane glycoprotein encoded by the E2/MIC2 gene. This molecule is broadly expressed on cells of the hematopoietic system and displays two surface forms, a long 32 kDa form and a short 28 kDa form. While the complete function of the CD99 molecule is unclear, it has been reported to be involved in regulation of cell adhesion, migration, and apoptosis. Thus, several CD99 monoclonal antibodies (MAbs) have been generated for biochemical and functional studies of the CD99 molecule. In the present study two CD99 MAbs, MT99/1 and MT99/2, were produced. The MAbs recognized different epitopes of the CD99 molecule. MAb MT99/1, but not MT99/2, was appropriate for biochemical characterization. Binding of MAb MT99/1 with its epitope led to the induction of cell adhesion and apoptosis. The generated MAbs can be used for future study of the function and mechanism of the CD99 molecule, including its role in the immune system, and may have application in tumor diagnosis and treatment.