Intrabiliary rupture of the hydatic cyst complicated with acute pancreatitis

Acute pancreatitis is a rare complication of hydatidosis, and only few reports were published previously. We report a case of a 17-year-old man, with recurrent liver hydatid cyst, who presented with severe upper abdominal pain, vomiting, jaundice. Amylase and bilirubin were elevated. Abdominal CT scan showed a cystic lesion in the dome of the liver and a diffusely swollen pancreas. At endoscopic retrograde cholangiopancreatography (ERCP) the common bile duct was dilated with fragments of hydatid membrane. A sphincterotomy was performed and hydatid membranes were extracted, after which the patient made an uneventful recovery and the level of amylase and bilirubin normalized. After two weeks a new episode of hydatid rupture occurred with clinical presentation of cholangitis. Emergency surgery was performed, which consisted of cystectomy, suture of intracavitary bile fistula, omentoplasty, choledochotomy with extraction of the hydatid membranes and common bile duct drainage. There were no relapses during 5 years follow-up. This case report highlights that ERCP and sphincterotomy are considered the procedures of choice in acute pancreatitis induced by biliary rupture of the hydatid cyst and surgical treatment is considered to be the only definitive treatment of the hydatic cystic lesion of the liver with intrabiliary rupture.     

Colonic angiodysplasia in a chronic renal failure patient

An important cause of intestinal bleeding in patients with chronic renal failure is angiodysplasia. In retrospective reports up to 19-32% of patients had bleeding from angiodysplastic lesions. These are usually multiple, have a high tendency of rebleeding (25-47%) and are often located in the stomach and duodenum, but can affect the colon and the jejunum as well. Bleeding from angiodysplastic lesions is usually low grade and stops spontaneously in more than 90% of patients, but some times may be life threatening necessitate therapeutic interventions to achieve hemostasis. We report a case of an 18-year old female with renal failure on CAPD who presented a massive lower gastrointestinal bleeding and imposed emergency surgery.     

Nosocomial infections--study about the implementation level of preventive measures in the dental office

Nosocomial infection occurs in the hospital and other medical offices and expresses any disease, that affects the patient due to hospital admission or the received care, the activity of the medical personnel, no matter that symptoms appear or not in the hospital or outside. In the performed study we proposed to investigate the implementation level of the measures of nosocomial infections prophylaxis in dental office. The study consisted in a transversal epidemiologic inquiry through a specific questionnaire applying in a sample of 50 patients treated for dental diseases in the dental office. The items refer to the implementation level of the prophylaxis measures in the dental office. The obtained results revealed a proper patients' addressing at dental office and some deficiencies of the personnel medical activity in dental office, such as : does not wear the surgery gloves and mask, does not use the salvo vacuum for patients protection. Also, we find out a deficient medical education referring to hygiene conditions in dental office. In conclusion, there are deficiencies of the prophylaxis measures in dental office.     

Untersuchungen zum Mechanismus der serologischen Luesreaktionen

Zusammenfassung Durch Verwendung von künstlichen serologischen Systemen zeigen die Verff., daß einige unspezifische Veränderungen der serologischen Syphilis-Reaktionen durch Erhöhung der Konzentration der totalen Proteine oder Gammaglobuline hervorgerufen werden können, die allerdings nur die Flockungsreaktionen beeinflussen.Die Erhöhung der Konzentration von normalen Lipoiden in solchen Systemen, hat Veränderungen nur der Komplementbindungsreaktionen zu Folge, wohingegen die Hyperkonzentration von aus syphilitischen Sera gewonnenen Lipoiden besonders deutlich die Komplementbindungsreaktion, in viel geringerem Maße auch die Flockungsreaktionen positiviert.Durch Kombination der Wirkung der Syphilislipoide mit derjenigen der Gammaglobuline erzielt man deutliche Positivierungen sowohl der Komplementbindungsreaktion als auch der Flockungsreaktionen, die bis zur Notierung +++ oder ++++ ansteigen.Durch diese Untersuchungen wird die Hypothese der lipoproteischen Zusammensetzung der syphilitischen Reagins bestätigt.Die Tatsache, daß die Komplementbindungsreaktion durch lipoproteische Komplexe, die Flockungsreaktionen hingegen durch Gammaglobulin positiviert werden, spricht für die Dualität der Antikörper dieser beiden Reaktionsmethoden.     

Contributions to the study of Salmonella. Immunological specificity of proteins separated from Salmonella typhi

Rabbits were immunized with live organisms and with proteins separated by various methods from Salmonella typhi (acetone-treated cells); anti-extract and antibacterial sera were investigated in agglutination and gel diffusion tests with various antigens.

The results show that the determinant groups of polysaccharides are not the sole factors involved in O agglutination of the bacteria. Apart from large amounts of H agglutinins and precipitins, anti-extract sera, containing no antibodies to polysaccharides, have been found to contain O agglutinating and precipitating antibodies.

In tests performed with extracts containing the whole bacterial antigen complex, the antibodies precipitated from antibacterial sera by polysaccharides were found to account for about one-third to one-half of the total antibody content of these sera.

Antibacterial sera absorbed with polysaccharide still contain O agglutinins which may be removed by subsequent saturation with protein.

Gel diffusion tests illustrate the results obtained.

The proteins separated from veronal buffer extracts by precipitation with trichloracetic acid are immunologically identical with the protein separated from the bacteria by means of dilute hydrochloric acid. From the serological and physicochemical points of view they behave like the flagellins isolated by Ada, Nossal, Pye and Abbot (1964) from flagella.

As in the case of flagellins, attempts to purify the proteins isolated from the bacterial organisms did not result in separation of the factors involved in O and H agglutination. The peptide determinants involved in both types of agglutination may well coexist on the same molecule.

     

Influence of organic solvents and pH on some characteristics of influenza virus A(H1N1). Note 1. Influence of organic solvents on the spectral characteristics of fluoresceine isothiocyanate-conjugated influenza virus A(H1N1)

The fluorescence of fluoresceine isothiocyanate (FITC)-conjugated influenza virus A(H1N1) was enhanced following addition of ethanol, acetone or dimethylsulfoxide (DMSO) and decreased after addition of dioxane; light scattering values increased in the presence of any of these organic solvents. The effect of the organic solvents could be correlated with the excess values delta epsilon of the dielectric constant. Out of the four organic solvents it was DMSO that caused the slightest changes in the fluorescence and light scattering of the FITC/virus system.     

Pseudomyxoma peritonei presenting with inguinal hernia

Pseudomyxoma peritonei (PMP) is rare being characterized by intraperitoneal accumulation of mucinous ascites produced by neoplastic cells, mostly originating from a perforated appendiceal adenoma. The clinical signs of the disease are variable, and preoperative diagnosis is often difficult. We describe the clinical case of a 67-year-old patient referred to our unit one month after a left inguinal hernia repair, presenting clinical signs compliant with PMP. Surgical cytoreduction, peritonectomy, appendectomy, and greater omentectomy with perioperative intraperitoneal chemotherapy were performed. The patient was disease free for a 15 month period when he died apparently due to a cardiac event. We advocate that in all cases of gelatinous fluid in a hernia sac PMP must be suspected, thus histological investigation is mandatory as well as abdominal computed tomography (CT) in order to confirm the diagnosis.     

Risk assessment induced by knapsack or conventional motor sprayer on pesticides applicators and farm workers in cotton season

Fakous Province in the Sharkia Governorate constitutes one of the largest agricultural areas in Egypt. The majority of people in this province rely on subsistence agriculture. In the cotton cultivation season the continuous application of pesticides is commonly used to increase agricultural productivity, using different types of spraying equipment. In this study a cohort of 210 intensive agricultural pesticide applicators and farm workers from Sawada and Akyad Elkepplia villages in Fakous Province were assessed according to the type of spraying equipment they used. Conventional motor (300l/feddan or 0.42ha) and knapsack motor sprayer (20l/feddan) were commonly used by farmers. Contamination on applicators was detected on head, body (thorax/abdomen) and legs at different percentages according to the spraying tools. The recorded results revealed that contamination with pesticides due to knapsack motor sprayers 0.76% on head, 4.8% on body and 5.8% on legs; however, conventional motor sprayers induce contamination of 3.6% on head, 23.7% on body and 29.1% on legs. Several criteria for estimating pesticide contamination by previous delivery systems were used. The most important reference biomarker was serum acetyl cholinesterase (AchE) depression. Sprayers showed changes in serum glucose levels as well as reduced erythrocytic glutathione levels (GSH). However, an increase in both total serum protein and albumin was recorded also, alongside elevation in lipid peroxidation biomarker malondialdehyde (MDA). Changes in serum biochemistry regarding enzymes reflecting cytotoxicity were also recorded, such as inhibition of alanine aminotransferase (ALT) and glutathione-S-transferase (GST). An increase in aspartate aminotransferase (AST) and glutathione reductase (GR) was observed particularly in conventional motor sprayers. Changes in enzymes activities found in this study are linked to the adverse health effects related to chronic pesticide toxicity that may lead to pathophysiological diseases, cancer or neurodegenerative disorders, which warrants further investigation.