Identification of Human Case of Avian Influenza A(H5N1) Infection,India

A 11-year-old boy with acute myeloid leukemia was brought for treatment of severe acute respiratory infection in the National Capital Region, New Delhi, India. Avian influenza A(H5N1) infection was laboratory confirmed. Complete genome analysis indicated hemagglutinin gene clade 2.3.2.1a. We found the strain to be susceptible to amantadine and neuraminidase inhibitors.     

Intraspinal MDL28170 microinjection improves functional and pathological outcome following spinal cord injury

Although calpain (calcium-activated cysteine protease) inhibition represents a rational therapeutic target for spinal cord injury (SCI), few studies have reported improved functional outcomes with post-injury administration of calpain inhibitors. This reflects the weak potency and limited aqueous solubility of current calpain inhibitors. Previously, we demonstrated that intraspinal microinjection of the calpain inhibitor MDL28170 resulted in greater inhibition of calpain activity as compared to systemic administration of the same compound. In the present study, we evaluated the ability of intraspinal MDL28170 microinjection to spare spinal tissue and locomotor dysfunction following SCI. Contusion SCI was produced in female Long-Evans rats using the Infinite Horizon impactor at the 200-kdyn force setting. Open-field locomotion was evaluated until 6 weeks post-injury. Histological assessment of tissue sparing was performed at 6 weeks after SCI. The results demonstrate that MDL28170, administered with a single post-injury intraspinal microinjection (50 nmoles), significantly improves both locomotor function and pathological outcome measures following SCI.     

A three‐dimensional measurement approach for the morphology of the femoral head

The hip joint is one of the most frequent sites of osteoarthritis. Advances in diagnosis and clinical treatment have progressed dramatically in the last few decades; however, there are limitations associated with the lack of reliable measures for quantifying hip joint morphology. Current diagnostic measures of the hip are performed with pre-determined measures, typically lengths and angles, on 2D radiographic planes. The current measurement techniques do not utilize the inherent 3D nature of CT and MR imaging and do not necessarily quantify the relevant clinical pathologies. A valid and reliable measurement modality that measures the surface geometry of the femoral head is necessary for early diagnosis and treatment of hip disease. The purpose of this study was to establish a method to quantify femoral head morphology using a three-dimensional model. A novel measurement approach was applied to 45 cadaveric femurs (23 right; 22 left; nine female, 17 male) and their digitally reconstructed 3D CT models. The mean difference between the cadaveric and digital measures was −2.04 mm with 95% confidence limits (CI) of 13.67 mm and −17.75 mm, respectively. The digital measurement approach was found to have excellent intraobserver reliability (ICC = 0.99, CI 0.98–0.99) and interobserver reliability (ICC = 0.98, CI 0.93–0.99). This valid and reliable novel digital measurement approach enables quantification of the 3D surface geometry of the femoral head and is able to measure individual variations and potentially detect abnormalities. This method may be used to assist future studies to establish valid diagnostic measurements for femoral head and head–neck junction pathologies.     

Adherence syndrome following inferior oblique anteropositioning – a case report

Introduction: We report a case of inferior oblique (IO) muscle adherence with fat adherence, which developed following unilateral IO anteriorization (IOAT).

Methods: A 14-year-old child with V pattern left exotropia, bilateral IO overaction, bilateral dissociated vertical deviation (DVD), and strabismic amblyopia (OS) underwent recess/resect procedure along with IOAT. He developed consecutive esotropia and drooping of upper eyelid with marked limitation of levoelevation (?4). Differential diagnoses of antielevation syndrome and adherence syndrome were considered.

On surgical exploration, forced duction test (FDT) was positive for elevation, left inferior oblique (LIO) muscle insertion was found anterior to the inferior rectus (IR) insertion along with fat adhesions which were released and IO muscle was reattached 3 mm behind and 2 mm lateral to IR insertion, along with advancement of left lateral rectus.

Results: Following resurgery, the patient had six prisms left esophoria and a hypotropia 9 prisms, with minimal limitation of levoelevation (?1). One month later, it was seen that the hypotropia had increased to 18 prism diopters and limitation of elevation was ?2.

Conclusions: Adherence syndrome is a rare and severe complication of IO weakening procedures. The initial postoperative improvement achieved in elevation and hypotropia in primary position was not maintained over subsequent follow-ups.     

Modifiable risk factors to reduce renal cell carcinoma incidence: Insight from the PLCO trial

Introduction

Identify modifiable factors contributing to renal cell carcinoma in the PCLO to target disease prevention and reduce health care costs.

Interfraction accumulation of seroma during accelerated partial breast irradiation: preliminary results of a prospective study

PurposeTo quantify and characterize the process of seroma accumulation during accelerated partial breast irradiation using multicatheter balloon brachytherapy.Materials and MethodsTwenty-two patients were treated using the Contura Multilumen brachytherapy catheter to a dose of 34 Gy in 10 fractions over 5 treatment days. Serial aspirations of the vacuum port of the catheter were performed at the time of CT simulation and before each treatment. Volume and characteristics of fluid drawn were recorded. Univariate analysis was performed to evaluate various factors predictive of seroma formation.ResultsMedian patient age was 59.5 years, body mass index was 31, and volume of surgical specimen was 62.4 cm³. Median time from breast conservation surgery to placement of Contura catheter was 18.5 days. Pericatheter seroma, typically scant with a median volume of 0.75 mL, was noted in 91% of patients at CT simulation. A total of 203 aspirations were performed with a median-aspirated seroma volume of 4.05 mL. There was no significant correlation between the volume of seroma and histology (invasive vs. in situ), quadrant of location, body mass index, reexcision or reoperation, days from breast conservation surgery to balloon placement, or the volume of specimen removed. Radiation treatment factors, including balloon volume, balloon to skin distance, and planning target volume evaluation, also did not correlate with aspirated seroma.ConclusionsInterfraction seroma accumulation has a variable pattern of development with no discernible predictors of occurrence. Routine pretreatment aspirations via vacuum port may potentially improve dosimetric reproducibility for a minority of patients.