A novel monoclonal antibody with catalytic activity against beta human chorionic gonadotropin

In this study, we report for the first time, production of monoclonal antibody (MAb) against beta human chorionic gonadotropin (hCG) with proteolytic activity. MAb "7D9" was raised in Balb/C mice using purified human chorionic gonadotropin. Immunoblot analysis and enzyme-linked immunoabsorbent assay (ELISA) showed that this MAb reacts with beta hCG. The epitope for this antibody appears to be located in the C-terminal of beta chain as suggested by the absence of cross-reaction with other glycoprotein hormones such as FSH, TSH and LH. Our data reveal that this MAb is very unstable and has autodegradation characteristics. Zymogram analyses also show that 7D9 MAb has a high level of hydrolytic activity against different substrates such as casein and gelatin. This proteolytic activity can be inhibited by EDTA. These findings demonstrate the proteolytic character of 7D9 MAb and consequently explain its instability.     

Pediatric fractures of the foot and ankle

Distal tibial physeal injuries are common in children, accounting for 10% to 40% of all injuries to skeletally immature patients. This article describes the classification, treatment, and complications of distal tibial fractures, fractures of the talus and calcaneus, midfoot and tarsometatarsal injuries, metatarsal fractures, and fractures of the phalanges in children.     

Atypical Basal Ganglia germ cell tumor presenting as cerebral and brainstem hemiatrophy

We describe a 20-year-old male patient with a germ cell tumor of the basal ganglia who presented with progressive hemiparesis and hemisensory loss. Initial computed tomography and magnetic resonance imaging showed ipsilateral cerebral and brain stem hemiatrophy predominantly in the left basal ganglia and thalamus, whereas no mass or enhancement was depicted. Single photon emission computed tomography revealed mild hypoactivity of the left cerebral hemisphere. Stereotactic biopsy was performed after a mass lesion became apparent, allowing histologic verification of germ cell tumor to be established.     

Community attitudes and social distance towards the mentally ill in South Sudan: a survey from a post-conflict setting with no mental health services

Purpose

This study investigates attitudes and social distance towards the mentally ill in a post-conflict, low-income country.

Methods

A cross-sectional community survey (n = 1,200) was conducted in South Sudan. Associations between various sociodemographic variables and attitudes toward/social distance from the mentally ill were investigated.

Results

The regression analysis showed that lower levels of education were positively associated with social distance, and Christian or Muslim beliefs, compared with traditional beliefs, were negatively associated with social distance. Familiarity with mental illness or psychological distress was not significantly associated with social distance. Participants who endorsed community-oriented attitudes (rather than hospital/drug-oriented attitudes) about health care for the mentally ill were more likely show a decreased social distance. Participants who believed that the mentally ill were dangerous had higher scores on the social distance scale.

Conclusions

A high level of stigma towards the mentally ill exists in South Sudan, especially in the rural areas. Alongside efforts to build up mental health services in South Sudan, the existing stigma needs to be addressed. Information regarding the role of the community both in preventing mental illnesses and in service delivery should be prioritised.     

The human error: delayed diagnosis of intravascular loss of guidewires for central venous catheterization

We report three recent cases in which there was intravascular loss of the entire guide wire. In one case, this loss was discovered more than three months after the patient's procedure. In another case, the loss was detected one month later, and in the third case, four days was the interval of the loss. We discuss the problems of human error and failure of diagnosis, both of which were responsible for serious sequelae.