Sequestered disc herniation mimicking psoas abscess: A rare case report

Intervertebral disc herniation is common condition, with majority occurring in lumbar and cervical spine. Most lumbar disk herniations occur within the spinal canal, with approximately 7%-10% identified within the foramen or extraforaminal location. Extraforaminal disc herniation in extreme lateral, retroperitoneal or anterior terms are used when disc material is seen towards anterolateral or anterior to the spine. Disc herniation in these locations is easily mistaken for an abscess or a neoplasm especially when it is not connected to the parent disc (sequestered disc). We describe a case of 60-year male who initially was misdiagnosed as psoas abscess and subjected to invasive investigation which later turned out to be histologically confirmed disc sequestration in the retroperitoneum. Thus, knowledge of this condition is essential in avoiding unnecessary workup and treatment.     

基底动脉尖卒中

儿童卒中常见［１］,在过去２０年里,抗磷脂抗体（ＡＰＬＡ）一直被认为是缺血性卒中的一个重要原因。在所有缺血性卒中中,以大脑中动脉分布区最为常见,而后循环则最为罕见［２］．本文报告１例ＡＰＬＡ引起的儿童基底动脉尖卒中。ｌ 病例报告 患儿,男,８岁,因发热４天突发失明１２小时人院．无癫■、神志改变、头痛或呕吐史．无眼痛或幻视,入院时发热。全身周围血管搏动正常,血压正常．其他检查未见明显异常。患儿间歇出现嗜睡,双侧眼睑下垂伴完全失明。上视麻痹伴左视时水平震颤加重。瞳孔３ｍｍ,对光反射正常。眼底正常．躯干…     

Rapid detection and quantitation of hepatitis B virus DNA by real-time PCR using a new fluorescent (FRET) detection system.

BACKGROUND: The diagnosis of hepatitis B virus (HBV) has until recently been based on traditional serologic methods targeting viral antigens and antibodies to viral proteins. The development of molecular methods allowing for the quantitation of HBV DNA is proving clinically valuable for monitoring therapy and detecting early treatment failures. OBJECTIVES: Here we report a new real-time (LightCycler) quantitative PCR for the detection of HBV DNA based on sequence specific hybridisation probes (designed in-house), targeting the HBV surface antigen. STUDY DESIGN: The assay was evaluated using a 10-fold dilution series of standard HBV DNA [Eurohep standard reference 1, genotype A, HBsAg subtype adw with a unitage of 10(6) WHO. i.u./ml] and 89 clinical serum samples. The performance was measured against a quantified standard HBV DNA working reagent (NIBSC code 98/780) and the sensitivity compared with our conventional thermal-block PCR. RESULTS AND CONCLUSION: Real-time PCR detected HBV DNA in 45% (40/89) and thermal-block PCR in 16% (14/75) of clinical samples. Results for 26 samples were below the detection limit of the thermal-block PCR but could be quantified by real-time (LightCycler) PCR. The LightCycler assay was at least 5 logs more sensitive than thermal-block PCR and could detect HBV in a linear range between 5 and 10(7) i.u. per reaction. The broad generic nature of the PCR primers coupled with the enhanced sensitivity and specificity of the fluorescent hybridisation probes makes this assay potentially valuable for both routine diagnostic and epidemiological work.     

Nodding syndrome in Mundri county,South Sudan: environmental,nutritional and infectious factors

Background

Nodding Syndrome is a seizure disorder of children in Mundri County, Western Equatoria, South Sudan. The disorder is reported to be spreading in South Sudan and northern Uganda.

Objective

To describe environmental, nutritional, infectious, and other factors that existed before and during the de novo 1991 appearance and subsequent increase in cases through 2001.

Methods

Household surveys, informant interviews, and case-control studies conducted in Lui town and Amadi village in 2001–2002 were supplemented in 2012 by informant interviews in Lui and Juba, South Sudan.

Results

Nodding Syndrome was associated with Onchocerca volvulus and Mansonella perstans infections, with food use of a variety of sorghum (serena) introduced as part of an emergency relief program, and was inversely associated with a history of measles infection. There was no evidence to suggest exposure to a manmade neurotoxic pollutant or chemical agent, other than chemically dressed seed intended for planting but used for food. Food use of cyanogenic plants was documented, and exposure to fungal contaminants could not be excluded.

Conclusion

Nodding Syndrome in South Sudan has an unknown etiology. Further research is recommended on the association of Nodding Syndrome with onchocerciasis/mansonelliasis and neurotoxins in plant materials used for food.     

Multipronged evaluation of genotoxicity in Indian petrol-pump workers

Petrol (gasoline) contains a number of toxicants. This study used human biomonitoring to evaluate the genotoxic effects of exposure to benzene in petrol fumes in 100 Indian petrol-pump workers (PPWs) and an equal number of controls. The study was corroborated with in silico assessments of the Comet assay results from the human biomonitoring study. An in vitro study in human lymphocytes was also conducted to understand the genotoxicity of benzene and its metabolites. In a subset of the population studied, higher blood benzene levels were detected in the PPWs (n = 39; P < 0.01) than the controls (n = 18), and 100-250 ppb benzene was also detected in air samples from the petrol pumps. PPWs had higher levels of DNA damage than the controls (P < 0.01). In addition, the micronucleus assay was performed on lymphocytes from a subset of the subjects, and the micronucleus frequency for PPWs was significantly higher (n = 39; 14.79 +/- 3.92 per thousand) than the controls (n = 18; 7.54 +/- 3.00 per thousand). Human lymphocytes were treated in vitro with benzene and several of its metabolites and assayed for DNA damage with the Comet assay. Benzene and its metabolites produced significant (P < 0.05) levels of DNA damage at and above concentrations of 10 microM. The metabolite, p-benzoquinone, produced the greatest amount of DNA damage, followed by hydroquinone > benzene > catechol > 1,2,4,-benzenetriol > muconic acid. This study demonstrates that, using sensitive techniques, it is possible to detect human health risks at an early stage when intervention is possible. possible.     

Interplay between fluoride and abrasivity of dentifrices on dental erosion–abrasion

Objectives

Eroded teeth are more susceptible to toothbrushing wear than sound teeth. We tested the hypothesis that fluoride and abrasivity of dentifrices can interact, modulating the development of erosive–abrasive lesions.

Methods

Human enamel and root dentin specimens were submitted to cycles of demineralization, remineralization and toothbrushing using six dentifrices formulated with three different abrasivity levels: low (L), medium (M) and high (H); with (+F) and without (−F) fluoride. Surface loss was quantified by optical profilometry and compared among groups (α = 0.05).

Results

In dentin, it was ranked: L < M < H, for both +F and −F dentifrices. In enamel, +F dentifrices had similar results; however for −F formulations, M and H did not differ. Fluoride reduced surface loss in enamel, at all abrasive levels. In dentin, the same fluoride effect was observed but only for the low abrasive formulation.

Conclusions

Both fluoride and abrasivity were important modulators of enamel surface loss, while abrasivity had a higher impact than fluoride on dentin.