Stress experienced by mothers of Malaysian children with mental retardation

OBJECTIVE: To compare parenting stress among Malaysian mothers of children with mental retardation and a control group, and to determine factors associated with stress. METHODOLOGY: Seventy-five mothers of children with mental retardation aged 4-12 years and 75 controls (those without disabilities who attended the walk-in paediatric clinic) participated in the Parenting Stress Index (PSI). Intelligence quotient (IQ) and Child Behaviour Checklist (CBCL) scores, together with sociodemographic data, were entered into a multiple stepwise regression analysis, using the PSI as the criterion. RESULTS: Mothers of children with mental retardation scored significantly higher than control subjects in both the child-related domain (difference between means 26.1, 95% confidence interval 19.6-32.5) and parent-related domain (difference between means 15.0, 95% confidence interval 7.9-22.1) of the PSI. The total child behaviour scores from the CBCL (P < 0.01), IQ scores (P < 0. 01) and sibship size (P < 0.01) were associated with child-related domain scores. For the parent-related domain, CBCL (P < 0.01) and IQ scores (P = 0.01) remained important factors but Chinese ethnicity (P < 0.01) and maternal unemployment (P < 0.01) were also significant predictors of stress. CONCLUSION: A large proportion of mothers of children with mental retardation experienced substantial parenting stress, especially Chinese and unemployed mothers, and this warrants appropriate intervention.     

转小鼠TNFα基因大鼠脑缺血时细胞凋亡、c-JUN、p-JUN与p-JNK表达的研究

目的：探讨肿瘤坏死因子α（TNFα）过度表达时对细胞凋亡、c-JUN、p-JUN与p-JNK表达的影响。方法：采用线栓法制作大鼠大脑中动脉闭塞模型,用TNFct、TUNEL、c-JUN、p-JUN与p-JNK免疫组化染色观察SD大鼠与转小鼠TNFQ基因大鼠缺血1h再灌注24h时的细胞凋亡、c-JUN、p-JUN与p-JNK的表达。结果：与SD大鼠相比,转小鼠TNFα基因大鼠缺血1h再灌注24h后．脑组织凋亡细胞显著增多,c—JUN、p-JUN与p-JNK过度表达显著,以上指标变化均显著高于SD大鼠。结论：TNFα的过度表达加剧缺血性脑损伤,其机制可能为c-JUN、p-JUN与p-JNK的过度表达。     

The development of colon innervation in trisomy 16 mice and Hirschsprung’s disease

AIM To study the colon innervation of trisomy16 mouse, an animal model for Downssyndrome, and the expression of protein geneproduct 9.5 (PGP 9.5) in the stenosed segmentof colon in Hirschsprungs disease (HD).METHODS Trisomy 16 mouse breeding;cytogenetic analysis of trisomy 16 mice; andPGP 9.5 immunohistochemistry of colons oftrisomy 16 mice and HD were carried out.RESULTS Compared with their normallittermates, the nervous system of colon intrisomy 16 mice was abnormally developed.There existed developmental delay of muscularplexuses of colon, no submucosal plexus wasfound in the colon, and there was 5mmaganglionic bowel aparting from the anus intrisomy 16 mice. The mesentery nerve fiberswere as well developed as shown in their normallittermates. Abundant proliferation of PGP 9.5positive nerve fibers was revealed in thestenosed segment of HD colon.CONCLUSION Trisomy 16 mice could serve asan animal model for Hirschsprung s disease foraganglionic bowel in the distal part of colon.Abundant proliferation of PGP 9.5 positive fibersresulted from extrinsic nerve compensation,since no ganglionic cells were observed in thestenosed segment of the colon in HD. HD has agenetic tendency.     

Sarcoidosis of the skin – A dermatological puzzle: important differential diagnostic aspects and guidelines for clinical and histopathological recognition

Sarcoidosis of the skin may have an extremely heterogeneous clinical presentation, so that the definitions of ‘great imitator’ and ‘clinical chameleon’ have long been used. There is, in fact, a large group of skin diseases that can enter the differential diagnosis with cutaneous sarcoid manifestations, either clinically or/and pathologically. As the clinical consequences and the prognosis of these groups of diseases are often very different, it is important to correctly plan the diagnostic workup. The diagnostic process in this case often presents a challenge as no single test is sufficiently specific, so that a certain diagnosis can be only made in the presence of a compatible clinical and radiographic picture, along with histopathological evidence of non‐necrotizing, epithelioid cell granulomas, and exclusion of other potential aetiologies. For practical reasons, four main groups of skin conditions capable of mimicking sarcoidosis can be identified: (i) transmissible, infectious diseases; (ii) allergic and immunological manifestations of various aetiologies; (iii) granulomatous diseases of various aetiologies; and (iv) lymphomas and pseudolymphomas. The aim of this article is to describe the main clinical and histopathological findings of such disease entities, and to discuss the role of those features (morphological, pathological and laboratory) that can help distinguish them from sarcoidosis of the skin.     

Improvement of wound tissue repair by chitosan films containing (–)‐borneol,a bicyclic monoterpene alcohol,in rats

The aim of this study was to investigate the wound‐healing activity of (–)‐borneol (BOR) incorporated in chitosan film on healing protocol in rodents. To assess the BOR wound‐healing potential, male Wistar rats were subjected to a full‐thickness excisional wound. The animals were divided into three groups: dressed with chitosan‐based film (QUIN); dressed with chitosan‐based film containing 0·5% BOR (QUIBO05); or dressed with chitosan‐based film containing 1% BOR (QUIBO1). Dressing the wound areas and histological analysis were performed on the 3rd, 7th, 14th, and 21st days. The myeloperoxidase (MPO) activity was assessed on the third and seventh days after surgical procedures. Wounds dressed with chitosan‐based film containing BOR reduced significantly the MPO activity (P < 0·001), showed significantly larger wound retraction rates (7 days, P < 0·05), improved the granulation reaction, and also provided better collagenisation density and arrangement during wound healing. It is suggested that BOR modulates the wound‐healing process and is a promising compound to be used in wound care. This product may be quite useful in improving wound healing and could be a new biotechnological product with healing properties and clinical application. Further ongoing studies will enable us to understand the precise mechanisms whereby BOR improves the wound‐healing process.     

Does autologous blood transfusion during liver transplantation for hepatocellular carcinoma increase risk of recurrence?

AIM: To analyze outcomes in patients who underwent liver transplantation(LT) for hepatocellular carcinoma(HCC) and received autologous intraoperative blood salvage(IBS). METHODS: Consecutive HCC patients who underwent LT were studied retrospectively and analyzed according to the use of IBS or not. Demographic and surgical data were collected from a departmental prospective maintained database. Statistical analyses were performed using the Fisher's exact test and the Wilcoxon rank sum test to examine covariate differences between patients who underwent IBS and those who did not. Univariate and multivariate Cox regression models were developed to evaluate recurrence and death,and survival probabilities were estimated using the Kaplan-Meier method and compared by the log-rank test.RESULTS: Between 2002 and 2012,158 consecutive patients who underwent LT in the same medical center and by the same surgical team were identified. Among these patients,122(77.2%) were in the IBS group and 36(22.8%) in the non-IBS group. The overall survival(OS) and recurrence free survival(RFS) at 5 years were 59.7% and 83.3%,respectively. No differences in OS(P=0.51) or RFS(P=0.953) were detected between the IBS and non-IBS groups. On multivariate analysis for OS,degree of tumor differentiation remained as the only independent predictor. Regarding patients who received IBS,no differences were detected in OS or RFS(P=0.055 and P=0.512,respectively) according to the volume infused,even when outcomes at 90 d or longer were analyzed separately(P=0.518 for both outcomes).CONCLUSION: No differences in RFS or OS were detected according to IBS use. Trials addressing this question are justified and should be designed to detect small differences in long-term outcomes.     

Down综合征16三体小鼠胃的神经发育观察

目的　研究Dow n 综合征动物模型16 三体和正常同窝鼠支配胃的神经发育。方法　采用16三体鼠培育,同窝鼠胚胎龄(em bryonic days, ED)13～18 天细胞遗传学分析,蛋白基因产物9.5(proteingene product 9.5, PGP9.5)免疫组化等方法对16 三体小鼠胃的神经发育进行了研究。结果　正常同窝鼠,胎龄13 天(ED13)来源于外胚层神经嵴的神经母细胞迁移并进驻胃壁;ED14 神经元发出突起,形成原始神经网络;ED15 形成简单排列的肌间神经丛,开始出现早期的神经节;ED16 有分布规则的肌间神经丛;ED17 神经母细胞进驻粘膜下层,形成粘膜下神经丛;ED18 完整的胃神经丛形成,即粘膜下浅、深神经丛和肌间神经丛。与正常同窝鼠比较,16 三体鼠胃神经系发育迟缓,ED14 胃壁始有散在分布神经元。此后,胃神经系的发育与分化均较正常延迟,至ED18 仅有肌间神经丛。根据胃神经系的发育程度和PGP9.5 免疫反应强度作半定量分析及秩和检验,16 三体鼠胃神经的发育明显落后于它们正常的同窝鼠,两者比较有显著性差异(P< 0.05)。结论　16 三体小鼠是公认的Dow n 综合征动物模型,它除了有多系统和多器官的畸型外,还发现有小鼠胃神经丛发育迟缓,粘膜下神经丛缺失。     

Differentiation of viable and nonviable myocardium by the use of three-dimensional tagged MRI in 2-day-old reperfused canine infarcts

BACKGROUND: To limit ischemic myocardial injury, it is important to differentiate viable from infarcted myocardium. Three dimensional (3D) tagged MRI has the ability to quantify myocardial 3D deformation and strain (noninvasively and precisely), and can achieve a true comparison of contraction not only from region to region, but also at different levels of function. In this study, we investigated whether regional strain mapping obtained by 3D-tagged MRI can differentiate between viable but stunned myocardium and nonviable myocardium. METHODS AND RESULTS: We examined 7 dogs 2 days after a 90-minute closed-chest left anterior descending coronary artery occlusion followed by 48 hours of reperfusion. 3D-tagged MR images spanning the entire left ventricle were acquired both at rest and during dobutamine infusion (5 microg. kg-1. min-1 IV). Regional blood flow was measured with radioactive microspheres and used to define risk regions. Infarcted regions were defined as 2,3,5 triphenyltetrazolium chloride negative regions. Strains in infarcted regions were greatly impaired compared with remote regions (P<0.001) and remained unchanged during dobutamine stress. Risk regions showed a dysfunction at rest, with improved function during dobutamine infusion. Receiver operating characteristics analysis showed that radial strain was more accurate for identifying viable regions. CONCLUSIONS: When coupled with a stress test, 3D strain mapping by the use of tagged MRI is a sensitive and noninvasive method for characterizing ischemic injury. Regional strain can be used to differentiate between viable but stunned and nonviable myocardium within the postischemic injured myocardium.