ASO Visual Abstract: The Landmark Series—Minimally Invasive Pancreatic Resection

Annals of Surgical Oncology -     

Observations on the recent epizootic of bovine ephemeral fever in Saudi Arabia

Observations of the epizootic of bovine ephemeral fever which occurred in Saudi Arabia during 1996 are presented. The investigations included the collection of epidemiological data from affected farms and the testing of sera for antibodies to the virus. The authors report a mean morbidity rate of 50% and a mean case fatality rate of 0.3%. Of the infected cattle, 4% were affected by recumbency, the majority of these recovered (89%). The clinical signs observed in affected cattle were uniform throughout the region concerned. The features of the outbreak, obtained through field investigations, were considered in relation to the ecological and meteorological conditions which were prevalent at the time. The outbreak occurred during the summer months (May to October) in the central and eastern regions of Saudi Arabia, with the initial infection reported at the Al-Ahsa oasis. Farms which were subsequently affected were all reported to possess areas of stagnant water suitable for the reproduction of the vectors of the disease (Culicoides spp. and mosquitoes). To conclude, the authors discuss precautions to prevent future outbreaks of bovine ephemeral fever in Saudi Arabia.     

Post-traumatic endophthalmitis: causative organisms and visual outcome

PURPOSE: Post-traumatic endophthalmitis makes up a distinct subset of intraocular infections. The purpose of the present study was to identify the causative organisms and record the visual outcome after infectious endophthalmitis in eyes with penetrating trauma. METHODS: We reviewed 18 consecutive cases of culture-positive endophthalmitis that developed after penetrating ocular trauma. All cases were treated with pars plana vitrectomy and intravenous and intraocular antibiotics. RESULTS: The 15 males and 3 females ranged in age from 4 to 43 years (mean 25.1 +/- 11 years). Nine (50%) had intraocular foreign bodies. A single species was isolated in 16 cases, and multiple organisms in two. Staphylococcus epidermidis and gram-negative organisms were the most frequent and were cultured either alone or in association with other organisms in respectively five (27.7%) and four cases (22.2%). Clostridium perfringens was isolated in three cases (16.6%). Bacillus was not found as a cause of endophthalmitis. Final visual acuity was better than 20/400 in eight cases (44%). In five cases (27.7%), the eye was saved but visual acuity was counting fingers. Two eyes (11%) had no light perception. The remaining three eyes (16.6%) were enucleated or eviscerated. Clostridium perfringens was isolated from two eyes and Aspergillus niger from one. Postoperative retinal detachment developed in four eyes, which were successfully operated. CONCLUSIONS: Organisms isolated in this series were similar to those in previous reports of post-traumatic endophthalmitis from other parts of the world, except that the frequency of Clostridium perfringens isolation was high and no Bacillus species were cultured. In view of its devastating outcome, post-traumatic endophthalmitis must be treated promptly with vitrectomy and intravitreal antibiotics.     

Basement membrane thickening in the placentae from diabetic women

A light microscopy study was carried out on 48 placentae. Seventeen placentae were obtained from non-diabetic mothers while the other 31 placentae were from both women with controlled diabetes and women who had an abnormality of the glucose tolerance test. All the women delivered at 38-40 weeks of gestation. Placentae from diabetic patients showed immaturity of the villi, hypertrophy of the capillaries and thickening of the basement membrane of the trophoblastic villi (3.2 +/- 0.35 microns) and the amniotic membrane (1.8 +/- 0.3 microns). Focal fibrinoid necrosis, an increase in the number of Hofbauer cells and dilatation of villi capillaries were also commonly observed in placentae from diabetic mothers, and the normal cuboidal cells lining the amniotic membrane tended to become tall columnar (17.6 +/- 6.3 microns) with distally located nuclei. Similar findings were observed in patients who had a potentially abnormal glucose tolerance test, which suggests the possibility of primary lesion in origin. Therefore, control of hyperglycemia may only partially prevent the development of placental abnormalities.     

Pfeiffer syndrome: oral healthcare management and description of new dental findings in a craniosynostosis

Pfeiffer syndrome is a rare fibroblast growth factor receptor‐related craniosynostosis with variable clinical presentations. We describe new dental findings of hypodontia, microdontia, dilacerations, and radicular dentin dysplasia in a 19‐year‐old girl, and discuss the oral health management.     

The effects of topically applied polyNIPAM-based nanogels and their monomers on skin cyclooxygenase expression,ex vivo

Stimulus-responsive nanogels have potential as carriers for drugs targeting the skin. It is important to estimate the biocompatibility of such materials with the skin since they are directly in contact upon application and may induce irritation or inflammation. In the current work, blank (drug-free) polyN-isopropylacrylamide (polyNIPAM), poly(NIPAM copolymerized butyl acrylate) [poly(NIPAM-co-BA)], and poly(NIPAM copolymerized with 5% w/v acrylic acid) [poly(NIPAM-co-AAc)(5%)] nanogels were dosed onto freshly excised full-thickness porcine ear skin and the effects on the expression of cyclooxygenase-2 (COX-2) determined ex vivo by Western blotting. Modulated COX-2 expression was indicative that the material had penetrated the skin and keratinocytes of the viable epidermis. The poly(NIPAM-co-BA) nanogel was found to exert a proinflammatory response when applied topically, as reflected by 67% higher COX-2 expression relative to the control treatment (p = 0.0035). The data obtained for the poly(NIPAM-co-AAc)(5%) nanogel, on the other hand, indicated no significant modulation in the expression of COX-2 (p = 0.1578), suggesting the particles are compatible with skin. This was even the case in the presence of co-administered aqueous citric acid solution. Overall the data support the use of the multi-responsive poly(NIPAM-co-AAc)(5%) nanogel for triggered or controlled topical drug delivery applications.