TLR8 and TLR7 are involved in the host's immune response to human parechovirus 1

Toll-like receptors (TLR) have a key role in regulating immunity against microbial agents. Engagement of TLR by bacterial, viral or fungal components leads to the production and release of inflammatory cytokines. In this study we show that mainly TLR8 and also TLR7 act as the host sensors for human parechovirus 1, a single-stranded RNA (ssRNA) virus. Furthermore, we see that the viral ssRNA genome is detected in endosomal compartments by these TLR, which activate signalling that lead to the synthesis of pro-inflammatory molecules by the host.     

Single-stage medial plateau elevation and metaphyseal osteotomies in advanced-stage Blount’s disease: a new technique

PurposeSurgical treatment in advanced-stage infantile Blount’s disease with medial plateau (MP) depression is challenging. Several osteotomies and fixation methods have been described with no established benchmark. We conducted this study to evaluate the efficacy and safety of a new single-stage technique for acute medial condyle elevation and metaphyseal osteotomies with internal fixation.MethodsA prospective case series of 19 consecutive patients (21 knees) with severe infantile Blount’s disease underwent a single-stage MP elevation and metaphyseal osteotomies, with internal fixation. The mean age was 10.3 years (8.2 to 13.6) and the mean follow-up was 5.1 years (3.2 to 8.3). The outcome measures included clinical and radiological parameters and patient-reported pediatric outcomes data collection instrument (PODCI) score.ResultsThe mean PODCI score improved significantly from 50% to 88%. The mean internal tibial torsion improved from -27° to 11°. All cases maintained full knee extension, no limitation in flexion range of movement and no signs of instability or lateral thrust gait. All the radiographic parameters improved significantly; the mean tibiofemoral angle improved from -29° to 7°, the metaphyseal-diaphyseal angle improved from 33.4° to 4.7° and the angle of depressed MP improved from 38.3° to 2.4° (p < 0.001). At the latest follow-up, no cases of deformity recurrence were identified, the final limb-length discrepancy was < 1 cm in all patients.ConclusionSingle-stage MP elevation and metaphyseal osteotomies with internal fixation significantly improved the clinical and radiographic parameters and PODCI score in advanced infantile Blount’s disease and precluded the use of external immobilization, with no evidence of deformity recurrence.Level of evidenceIV     

Synthesis of some heterocycles of potential biological activity

A convenient method for the preparation of imidazobenzimidazole3, imidazoimidazole5, imidazotriazole6 and pyrano [2, 3-c] oxazole7 derivatives is described. This depends on interaction of 2-methyl-4-arylidene-2-oxazolin-5-ones1 with o-diamines, thiosemicarbazide and/or ethylcyanoacetate. The effect of alcoholic potassium cyanide on oxazolinone1 was studied. Antibacterial activity of the obtained products was studied.     

An epizootic of Rift Valley fever in Egypt in 1997

An epizootic of Rift Valley fever (RVF) occurred in Egypt between April and August 1997. The signs among infected cattle and sheep were high fever, icterus, bloody diarrhoea and abortion. Aborted sheep foetuses and sera from the affected herds were collected in the Aswan and Assiut Provinces, Upper Egypt, for virological and serological examination. A cytopathic effect was detected in Vero cell cultures 48 h after inoculation with the foetal liver and spleen suspensions. The same suspensions caused paralysis and mortalities two to three days post intracerebral injection in mice. The isolated virus was identified using an agar gel precipitation test (AGPT) and a direct fluorescent antibody technique. Serological examination revealed that all tested sheep (57) and cattle (93) gave positive results to serological tests, using a complement fixation (CF), serum neutralisation (SN) and indirect immunofluorescence assay; while only 48 (84.2%) out of 57 sheep sera and 69 (74.2%) out of 93 cattle sera gave positive results using an AGPT. Titration of the serum samples indicated that SN is more sensitive than CF. Importation of infected ruminants, especially camels from the Sudan, is the principal source of infection. Aswan, the nearest Egyptian province to the Sudan, is the focus of RVF virus infection in Egypt. As a result of high insect populations, the epizootics of RVF have usually occurred during the summer in Egypt. Reoccurrence of epizootics from time to time indicates failure of the applied RVF vaccination programme in Egypt.     

Screening of some food poisoning bacteria in sausage and hamburger meat

Microbial investigation of 30 samples of sausage meat and 30 samples of hamburger meat, freshly prepared, were collected randomly from different markets in Alexandria city, to determine the bacteriological status of these products. The average counts/gm of total bacteria, total coliforms and fecal coliform in sausage meat were 1.33 x 10(7), 9.16 x 10(5) and 1.11 x 10(3) respectively, and in hamburger samples were 8.47 x 10(5), 2.63 x 10(3) and 1.35 x 10(3) respectively. Shigella, Escherichia coli, Staphylococcus aureus and Proteus spp were isolated with various percentages, whereas Salmonella spp was isolated from sausage only. The public health importance of the isolated microorganisms are fully discussed.     

Pelvic and lower extremity arterial imaging: diagnostic performance of three-dimensional contrast-enhanced MR angiography

OBJECTIVE: The diagnostic performance of a three-dimensional MR angiography-based strategy was assessed with regard to its ability to characterize the arterial vasculature from the aortic bifurcation to the lower extremity runoff vessels. A single-injection, two-station protocol in combination with a lower-extremity vascular coil was used. SUBJECTS AND METHODS: Both conventional digital subtraction angiography and three-dimensional contrast-enhanced MR angiography with a dedicated peripheral vascular coil were performed in 61 patients with suspected peripheral vascular disease. In a prospective analysis, one reviewer evaluated the digital subtraction angiographic images and a second reviewer evaluated the MR angiographic images; both were unaware of the results of the other imaging technique. Each vascular segment (29 segments per patient) was evaluated for the presence of occlusive vessel disease. The following grading system was applied: 0, normal; 1, vessel irregularity with a luminal reduction of less than 10%; 2, mild stenosis (lumen reduction, 10-49%); 3, severe stenosis (lumen reduction, 50-99%); and 4, occlusion (lumen reduction, 100%). In 11 patients surgical graft patency was assessed. RESULTS: MR angiography provided an image quality comparable with that of digital subtraction angiography. Overall sensitivity and specificity for MR angiography were 92% and 96.6%, respectively, for the detection of hemodynamically significant disease and 92.3% and 99.4%, respectively, for the detection of occlusions. CONCLUSION: Two-station contrast-enhanced three-dimensional MR angiography with a dedicated lower-extremity vascular coil proved effective enough to consider it as a noninvasive alternative to digital subtraction angiography in the assessment of the pelvic and lower extremity arterial vasculature.     

Physical activity combined with massage improves bone mineralization in premature infants: a randomized trial.

BACKGROUND: Osteopenia of prematurity is a known source for morbidity in preterm infants. Premature infants have shown favorable outcomes in response to massage and physical activity. Whether such intervention can stimulate bone formation or decrease bone resorption is yet to be determined. OBJECTIVE: To test the hypothesis that massage combined with physical activity can stimulate bone formation and ameliorate bone resorption in premature infants. DESIGN/METHODS: A prospective double-blinded randomized trial was conducted at the Neonatal Intensive Care Unit of Ain Shams University in Cairo, Egypt. Thirty preterm infants (28 to 35 weeks' gestation) were randomly assigned to either control group (Group I, n=15) or intervention group (Group II, n=15). Infants in the intervention group received a daily protocol of combined massage and physical activity. Serum type I collagen C-terminal propeptide (PICP) and urinary pyridinoline crosslinks of collagen (Pyd) were used as indices for bone formation and resorption, respectively. PICP and Pyd were measured at enrollment and at discharge for all subjects. t-Test, ANOVA and linear regression analysis were used for statistical analyses. RESULTS: There was no difference between groups I and II in gestational age (32.1+/-1.8 vs 31.5+/-1.4 weeks) or birth weight (1.429+/-0.148 vs 1.467+/-0.132 g). In the control group, serum PICP decreased over time from 82.3+/-8.5 to 68.78+/-14.6 (p<0.01), while urinary Pyd increased from 447.7+/-282.8 to 744.9+/-373.6 (p<0.01) indicating decreased bone formation and increased bone resorption, respectively. In the intervention group, serum PICP increased over time from 62.5+/-13.8 to 73.84+/-12.9 (p<0.01). Urinary Pyd also increased over time from 445.7+/-266.5 to 716.8+/-301.8 (p<0.01). In a linear regression model including gestational age and intervention, serum PICP increased significantly in the intervention group (regression coefficient 18.8+/-4.6, p=0.0001) while urinary Pyd did not differ between groups (regression coefficient=5.6+/-114.3, p=0.961). CONCLUSIONS: A combined massage and physical activity protocol improved bone formation (PICP) but did not affect bone resorption (Pyd). Pyd increased over time in both groups, possibly due to continuous bone resorption and Ca mobilization.     

Label-free metabolic imaging of non-alcoholic-fatty-liver-disease (NAFLD) liver by volumetric dynamic optical coherence tomography

Label-free metabolic imaging of non-alcoholic fatty liver disease (NAFLD) mouse liver is demonstrated ex vivo by dynamic optical coherence tomography (OCT). The NAFLD mouse is a methionine choline-deficient (MCD)-diet model, and two mice fed the MCD diet for 1 and 2 weeks are involved in addition to a normal-diet mouse. The dynamic OCT is based on repeating raster scan and logarithmic intensity variance (LIV) analysis that enables volumetric metabolic imaging with a standard-speed (50,000 A-lines/s) OCT system. Metabolic domains associated with lipid droplet accumulation and inflammation are clearly visualized three-dimensionally. Particularly, the normal-diet liver exhibits highly metabolic vessel-like structures of peri-vascular hepatic zones. The 1-week MCD-diet liver shows ring-shaped highly metabolic structures formed with lipid droplets. The 2-week MCD-diet liver exhibits fragmented vessel-like structures associated with inflammation. These results imply that volumetric LIV imaging is useful for visualizing and assessing NAFLD abnormalities.     

Sutureless Scleral Tunnel Trabeculectomy: Evaluation of Feasibility and Effectiveness versus Conventional Trabeculectomy for Management of Primary Open Angle Glaucoma

Purpose: To evaluate the intraocular pressure-lowering effect of sutureless scleral tunnel trabeculectomy with Mitomycin-C (MMC) compared to the standard trabeculectomy with MMC in patients with primary open angle glaucoma (POAG). Methods: This was a masked, randomized, controlled comparison trial involving 34 eyes of 34 patients with bilateral POAG. Patients were randomized to receive sutureless sclera flap trabeculectomy with MMC or conventional trabeculectomy with MMC. The main outcome for comparison was the IOP-lowering effect of both procedures. Complete surgical success was considered if the patient’s IOP was <22 mmHg and the IOP were lowered by more than 20% with the use of maximum two anti-glaucoma medications. Results: All surgeries passed uneventfully without intraoperative complications and all patients showed significantly (p<0.05) lower IOP on the first postoperative day compared to their respective preoperative IOP with non-significant (p>0.05) difference between both study groups. All patients, irrespective of operative procedure, maintained significantly (p<0.05) lower IOP compared to their respective preoperative IOP until the end of 12 months’ follow-up. There were no recorded serious postoperative complications in either groups, like wound leaks or endophthalmitis. Conclusion: Sutureless scleral tunnel trabeculectomy exhibits potential as an alternative to conventional trabeculectomy surgery. Over 12 months of follow-up, sutureless sclera flap trabeculectomy was safe and effective with an IOP-lowering effect comparable to that achieved with the conventional technique, but with increased rate of postoperative transient hypotony.