Impact of zinc on sexual maturation of female sickle cell anemia (SCA) children in Enugu,Southeast Nigeria

Adolescence is an important developmental period of childhood. Good health and adequate nutrition consisting major food constituents and trace elements like zinc are fundamental for optimal sexual maturation. To determine the relationship between zinc levels and pattern of breast and pubic hair development, as well as menarcheal age of female SCA children aged 6–18 years and their matched controls with hemoglobin genotype AA. Cross sectional, case-control study. Information on biodata, age at menarche, medical and drug history as well as 24-hour dietary recall was documented using interviewer administered questionnaire. Sexual maturation was assessed using Tanner staging and zinc levels determined using Atomic absorption spectrophotometer. Eighty-one subjects were compared with 81 controls. There was significant delay in the mean age of attainment of various Tanner stages of breast and pubic hair in the subjects. Mean age of 14.81 ± 1.07 years at menarche in subjects was significantly higher than 12.62 ± 1.18 years in controls (p = 0.001). Serum zinc of 58.01 ± 10.58 µg/dl in subjects was significantly lower than 68.37 ± 8.67 µg/dl in controls (p = 0.001). Serum zinc levels were found to have a significant positive relationship with stages of sexual maturation and mean age at menarche. Reduced serum zinc in children with SCA was associated with delayed sexual maturation.     

Rationale Nachsorge des nicht-muskelinvasiven Harnblasenkarzinoms

best practice onkologie - Die Nachsorge des nicht-muskelinvasiven Harnblasenkarzinoms (NMIBC) stellt eine nicht abschließend gelöste Herausforderung an den Urologen dar. Dabei muss sich...     

Introduction of Haemophilus influenzae type B conjugate vaccine into routine immunization in Ghana and its impact on bacterial meningitis in children younger than five years

This report shows the impact of a pentavalent vaccine that includes Haemophilus influenzae type b (Hib) conjugate vaccine on bacterial meningitis in children younger than 5 years in Ghana. A review of the first 3 years of a pediatric bacterial meningitis surveillance program, started in August 2001 in Accra, Ghana, was undertaken. There was a significant reduction, P = 0.042 and 0.017, in percentage of purulent meningitis in children younger than 1 year, comparing the first year when the vaccine was introduced, to the second and third years, respectively.     

Zytostatikaextravasate

Extravasation of systemic chemotherapy agents is a much-feared adverse event in oncology patients. Extravasation into the soft tissues can lead to severe ulceration and functional impairment of the extremities. The incidence of extravasation reported in the literature is 0.1–6%. The proper maintenance of intravenous lines, immediate discontinuation of the infusion, application of local cooling or warming for specific extravasations, and the use of antidotes to some, to prevent the local toxic effects of the extravasated agents, are the basis of adequate management. This review focuses on the etiology, pathomechanism, and prevention of the extravasation of systemically administered chemotherapy agents and its conservative and surgical management, all with reference to the current literature available.     

K562 human leukemia cell passages differ in embryonic globin gene expression

K562 is a human leukemia cell line inductible by a variety of agents for the synthesis of embryonic and fetal hemoglobins. We compared early and late passages to determine whether a change has occurred in globin synthetic pattern. Clone LA4, derived from passage 199 which had been frozen by Lozzio in 1973, was compared with clone RA6, derived from a line received from Rutherford in 1979. Globin synthetic pattern was determined by incubation with [³]leucine, separation of globins by Triton-X100 polyacrylamide gel electrophoresis, and analysis by fluorography. For RA6, hemin-induced synthesis was greatest for zeta globin but minimal for epsilon globin, whereas for LA4 it was greatest for epsilon globin but minimal for zeta globin. Both lines are pseudotriploid with three No. 11 and three No. 16 chromosomes. However only RA6 has a translocation involving the short arm of chromosome 11 which contains the locus of the beta globin gene cluster. However, translocation-associated deletion does not simply explain the deficient inducibility of epsilon synthesis because ^Gγ and ^Aγ globins, whose genes are linked to the epsilon gene, are similarly inducible in the two lines.     

Rolle der Immunzytologie in der Abklärung von Patienten mit schmerzloser Makrohämaturie

Objective

Gross hematuria is a highly worrisome episode in a patient’s history mainly due to the fact that the prevalence of bladder cancer is significant in this group of patients. In this prospective study the role of immunocytology in the evaluation of patients with gross hematuria was investigated.

Materials and methods

Ucyt® is an immunocytological assay based on microscopic detection of tumor-associated antigens on urothelial cells. The study included 103 consecutive patients with a first episode of painless gross hematuria without prior transitional cell carcinoma. Urine samples were obtained from all patients and examined cytologically and immunocytologically.

Results

Clinical assessment by physical examination, laboratory tests, endoscopy, and imaging modalities yielded urothelial cancer in 22 cases (21%). Further diagnoses were BPH (30%), inflammation (10%), urolithiasis (7%), and“further conditions” (16%). In 17 patients the reasons for hematuria were not determined. For cystoscopy, immunocytology, and conventional urine cytology a sensitivity of 89 (excluding UUT), 86, and 45% was observed. Specificity was 94, 82, and 89%, respectively. Two and three bladder tumors were not detected by cystoscopy and immunocytology, respectively.

Conclusions

The combination of cystoscopy and immunocytology yielded 100% sensitivity, while combining cystoscopy and cytology only marginally improved the sensitivity of cystoscopy alone. Since sensitivity appears to be of key relevance in the assessment of patients with gross hematuria, the authors suggest the addition of a sensitive noninvasive test to the diagnostic armamentarium in this situation.     

Groin exploration for nonpalpable testes: laparoscopic approach

Purpose: Diagnostic laparoscopy (DL) is the technique of choice for exploration of nonpalpable testes (NPT). Nevertheless, groin exploration is necessary to evaluate the cord and gonadal structures entering the internal ring. This retrospective analysis evaluates our hypothesis that hypoplastic cord structures entering the internal ring predicts absence of a viable testicle and a laparoscopic groin exploration in these cases can reduce the number of unnecessarily performed open groin exploration (OGE). Materials: A retrospective review was performed of 23 boys with 26 NPTs who were operated on from June 1998 to October 2000 to evaluate our protocol for NPT using DL and OGE. Results: Of 26 NPTs in 23 boys, 3 bilateral intraabdominal testis were detected (2 Fowler Stephens; 1 standard orchidopexy). Twenty cord structures entered the internal ring. Three appeared normal at DL with a viable testis followed by an orchidopexy. Seventeen were hypoplastic without patent processus. During LGE no viable testis was detected: blind-ending cords, no biopsy (n = 4); testicular regression syndromes (n = 3), early fetal regression (n = 6), no residual testicular structures (n = 4). Conclusions: This experience confirms the authors' hypothesis and criteria for LGE in all cases. The authors conclude that LGE is a helpful tool in the diagnostic workup of NPT to avoid unnecessary OGE and is a further step in the minimally invasive approach to all kinds of findings of NPT.     

Arrest and extravasation of neoplastic cells

Summary The morphological aspects of the arrest and extravasation of malignant cells of human origin (K-562 cell line) in the lungs of athymic (nude) and asplenic-athymic (lasat) mice were studied by electron microscopy examination of serial sections. The specimens were obtained at sequential stages after the sc inoculation into newborn mice of 10⁷ malignant cells. K-562 cells (10⁵) were also injected iv into control groups of nude and lasat mice to assess the influence of the route of inoculation on the in vivo behavior of K-562 cells. Our results demonstrated that K-562 cells were arrested and proliferated within the pulmonary capillaries without the participation of platelets or fibrin. The neoplastic cells extravasated by attrition and penetration of the endothelium (rather than by diapedesis) and continued to proliferate in the interstitial tissue of the lung, developing into neoplastic nodules. Following iv injection, K-562 cells induced the formation of platelet-tumor cell aggregates within the pulmonary capillaries. However, under these conditions, the neoplastic cells did not adhere to the endothelium nor did they proliferate or extravasate. These aggregates were flushed out by the circulation, restoring the permeability of the capillaries.Supported by Biomedical Research Support Grant FR 5541 and by grant number CA 18185-06 from the National Cancer Institute, DHHS     

Thyroglossal duct cysts in paediatric patients: early operative intervention reduces rate of complications

BACKGROUND: Thyroglossal duct cysts arise from mucus production in an incomplete regressed thyroglossal duct. Often they are only noticed in case of infection or secondary fistulation. The operative management is a Sistrunk procedure. METHOD AND PATIENTS: In a retrospective study we analyse 26 patients aged 0,3 - 10 years with histological confirmed thyroglossal duct cysts, 13 of these (50 %) had signs of infection. In 15 patients the cyst was primarily cored out, in 11 patients the core out followed a primarily incision and drainage. RESULTS: 5 patients (19 %) developed recurrent cysts. Patients with signs of infection or incomplete resection of hyoid bone had a high risk of developing recurrence. CONCLUSIONS: We propose an early operative treatment for thyroglossal duct cysts with a complete Sistrunk procedure.