International Journal of Methods in Psychiatric Research, 2005; Vol.14, No.3, 158–166

The original article to which this Erratum refers was published in International Journal of Methods in Psychiatric Research, 2005; Vol.14, No.3, 158–166. Copyright © 2005 John Wiley & Sons, Ltd.     

Prospective randomised study of urgent haemorrhoidectomy compared with non-operative treatment in the management of prolapsed thrombosed internal haemorrhoids

OBJECTIVE: To compare the outcome of urgent haemorrhoidectomy with conservative treatment for prolapsed thrombosed internal haemorrhoids. METHODS: A prospective randomised study of 50 patients with prolapsed thrombosed internal haemorrhoids was carried out using clinical and ultrasonic outcome measures. Peri-operative bed occupancy and the presence of symptoms at 6 and 24 months were compared. Endoanal ultrasonic scanning was carried out to investigate anal sphincter integrity in those patients willing to be studied. RESULTS: The median length of hospital stay for the group treated conservatively; 2 nights (range 1-9 nights) was significantly shorter than for the group treated by urgent haemorrhoidectomy; 4 nights (range 1-12 nights, P < 0.01). There was no difference between treatment groups in the number of patients with symptoms at six or 24 months. Urgent haemorrhoidectomy was associated with a significantly higher incidence of endosonographically detected anal sphincter damage in 18 patients: 66%vs 0% (P = 0.009). CONCLUSION: Conservative treatment for prolapsed thrombosed internal haemorrhoids is associated with shorter in patient stay and less anal sphincter damage compared with operative treatment.     

Early experience with a novel plaque excision system for the treatment of complex coronary lesions.

The use of directional coronary atherectomy (DCA) in current practice has been limited. The SilverHawk System is a newly developed plaque excision device that aims to overcome the drawbacks of prior DCA platforms. The device was evaluated in a porcine coronary model and in a series of patients. Procedural variables along with outcomes were reviewed. Quantitative angiography (QCA) was performed and excised tissue fragments were weighed and examined histologically. In porcine cases, pretreatment MLD increased from 0.51 +/- 0.26 to 2.36 +/- 0.59 mm postdebulking and 19.9 +/- 7.6 mg of tissue was retrieved. In human cases, pretreatment MLD increased from 0.8 +/- 0.4 to 2.2 +/- 0.5 mm postdebulking and 15.2 +/- 7.8 mg of tissue was retrieved without complications. These data show that the SilverHawk System may offer significant utility in treating a wide variety of complex coronary lesions.     

The efficacy of nasal septal surgery.

Nasal septal deformity is a frequent clinical entity, and septoplasty comprises one of the most common procedures performed by otolaryngologists today. Its efficacy seems intuitive, however the literature reveals relatively few papers confirming its utility. In this study, all patients undergoing septal reconstruction (excluding septorhinoplasty) at three major teaching hospitals in Vancouver during the years 1988 to 1990 were reviewed retrospectively in a two-pronged study. Information was collected concerning symptoms, physical findings and surgical technique. In the second phase, patients were contacted by telephone in a blinded fashion. Data was collected concerning patient satisfaction regarding various parameters including initial and ultimate symptom resolution, acceptance of nasal packing and postoperative complications. The following conclusions may be drawn: 1) Septoplasty was successful in relieving nasal obstruction in 70.5% of patients. 2) Turbinate surgery including outfracturing appears to significantly improve the outcome of surgery. 3) Rhinitis, including allergy, congestion, postnasal drip and rhinorrhea did not significantly affect success in relieving nasal obstruction. 4) Nasal packing did not significantly affect the outcome, but was the most frequently complained of aspect of the surgery. Therefore, we do not feel nasal packing is necessary.     

Detection of Candida in concentrated oral rinse cultures by real-time PCR

The incidence of oral candidosis has increased in recent years, largely as a result of the emergence of human immunodeficiency virus infection and the more widespread use of immunosuppressive chemotherapy. This development has been associated with a need for more reliable methods for the detection of Candida. The present study assessed the performance of a real-time PCR and two block-based PCRs for the detection of Candida in 193 concentrated oral rinse culture (CRC) specimens. A total of 102 CRC specimens were positive by culture for Candida; and 96, 90, and 75 of these were also positive by real-time, N18-specific, and internal transcribed spacer (ITS)-specific PCRs, respectively. The five false-negative results by the real-time PCR were all non-Candida albicans positive by culture. Of the 91 culture-negative CRC specimens, 20, 41, and 44 were positive by the real-time PCR and the N18- and ITS-specific PCRs, respectively. All three PCRs detected fungal DNA in 8 culture-negative CRC specimens, with a further 30 being positive by two of the three PCRs. A total of 32 CRC specimens were Candida free by all methods. In summary, a real-time PCR that provides a sensitive, specific, and rapid alternative technique for detection of Candida in the mouth is described.     

Acute hepatitis B virus infection by genotype F despite successful vaccination in an immune-competent German patient.

BACKGROUND: Hepatitis B Virus (HBV) infection is a leading cause of chronic hepatitis and liver cirrhosis worldwide, and efficient protection can usually be achieved by vaccination that is based on recombinant HBsAg protein from HBV genotype A and D. RESULTS: Here we report the case of a fully immune-competent German patient that acquired a symptomatic acute HBV infection during adulthood despite a complete and formally successful vaccination, which had resulted in anti-HBs titers considered protective. Further phylogentic analysis identified an infection with the rare genotype F of HBV, possibly acquired in Spain, without apparent aberrations in the immunodominant 'a' determinant domain of the envelope gene. However, sequence comparisons revealed that all reported genotype F isolates display marked differences from the other genotypes in this domain which serves as an epitope for humoral immune responses. CONCLUSIONS: The rare HBV genotype F, as detected in this immune-competent, previously vaccinated patient, has marked sequences differences in the envelope/polymerase gene. Therefore, current HBV vaccines based on genotype A and D may not result in full protective immunity towards viral strains from genotype F.     

Genotype characterization and phylogenetic analysis of hepatitis B virus isolates from Iranian patients

Hepatitis B virus (HBV) is one of the major causative agents of acute and chronic liver disease worldwide and is believed to be responsible for a million deaths annually. Eight genotypes of HBV, A to H, have been described on the basis of similarity of the complete genomes sequence. Although, it is reported that the predominant HBV genotype in the Mediterranean area and the middle east is genotype D, there are no reports on HBV genotypes prevalent in Iran. In this study, the C and S regions of HBV from 26 chronic hepatitis B Iranian patients were amplified and sequenced. Phylogenetic analysis revealed that all Iranian HBV isolates sequences were classified into genotype D with bootstrap values of 100%, 73%, and 100% (1,000 replicates each) for S, C, and preS2 regions, respectively. The mean percent intra-distance of S and C regions were 0.8% and 2.3%, respectively. The mean percent inter-distance of S and C regions between Iranians and genotype D isolates were 1.7% and 3.0%, respectively, and the range of mean percent nucleotide distance of S and C regions between Iranians and the other reference isolates were 7.9%-17.5% and 4.8%-14.7%, respectively. Thirteen out of 23 HBV C region sequences showed nucleotide "A" at position 1896 (precore mutant) in C region. Nucleotide 1858 showed presence of "T" in all isolates. No insertion or deletion was found in both regions. SimPlot and BootScanning analyses did not show any recombination between Iranian isolates and other genotypes in both regions.     

Diminished expression of the α5β1 integrin (fibronectin receptor) by invasive clones of a human follicular thyroid cancer cell line

Altered adhesion plaques have been observed in transformed cell lines and are associated with enhanced metastatic potential. The prototypical adhesion plaque is formed by 51 fibronectin receptors (FnRs) interacting with the cellular actin network. We have found differences in the actin networks of noninvasive (FTC-133) and invasive (FTC-236, FTC-238) clones of a human follicular thyroid cancer cell line. Furthermore, thyroid-stimulating hormone (TSH) induces stress fibers in FTC-133. In order to investigate differences in adhesion plaques, expression of fibronectin (FN) and its receptor by these cells was analyzed. For these studies FTC-133, FTC-236, and FTC-238 were cultured in serum-depleted DME-H21 medium for 24 hours before the addition of TSH 30 mU/ml. No quantitative differences were noted in FN expression on Western blot in either the conditioned medium or cellular extracts. Western blots and immunohistochemical studies indicated that TSH induced secretion of FN only in FTC-133. Flow cytometry with an 5 antibody demonstrated a 52% and 45% reduction (p<0.01) in expression of FnR by FTC-236 and FTC-238, respectively, compared to FTC-133; this finding was supported by immunohistochemistry results. TSH treatment did not alter FnR expression. From these studies, we conclude that invasive clones of FTC decrease their expression of FnRs without changing their expression of FN. Furthermore, TSH treatment may promote FN secretion by FTC-133, although it does not seem to affect FnR or absolute FN expression. The diminished expression of FnR adhesion plaques may enhance metastatic potential in some follicular thyroid cancers.

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Resumen Se han observado placas adhesivas alteradas en líneas celulares transformadas en asociación con un potencial metastásico incrementado. La prototípica placa adhesiva se forma por la interacción de receptores 5-1 con la trama celular de actina. Hemos encontrado diferencias en las tramas de actina en clones no invasivos (FTC-133) e invasivos (FTC-236, FTC-238) de una línea celular de cáncer folicular de tiroides.Además, la TSH induce líneas de estrés en FTC-133. Con el objeto de investigar las diferencias en las placas adhesivas, se hizo el análisis de la expresión de fibronectina (FN) y sus receptores en tales células.Para estos estudios se hizo el cultivo de FTC-133, FTC-236 y FTC-238, en sueros depletados de DME-H21 por 24 horas anteriores a la adición de 30 mU/ml TSH por 24 horas. No se observaron diferencias cuantitativas en la expresion de FN o en el Western blot ni en los medios condicionados ni en los extractos celulares. Los Western blots y los estudios inmunohistoquímicos indicaron que la TSH induce la secreción de FN sólo en FTC-133. La citometría de flujo con un anticuerpo 5 demostró una reducción de 52% y 45% (p<0.01) en la expresión de FnR por FTC-236 y FT-238, respectivamente, en comparación con FTC-133; este hallazgo fue verificado por inmuno-histoquímica. El tratamiento con TSH no alteró la expresón FnR. Con base en estos estudios, es nuestra conclusión que los clones invasivos de FTC disminuyen la expresión de FnR sin cambiar su expresión de FN. Además, el tratamiento con TSH puede promover la secreciòn de FN por FTC-133, aunque no parece afectar la expresión de FnR o la expresión absoluta de FN. Esta expresión disminuída de las placas adhesivas FnR puede incrementar el potencial metastásico en algunos cánceres foliculares de tiroides.

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Résumé On a observé des altérations des plaques d'adhésion dans certaines lignées cellulaires transformées, et celles-ci semblent être associées à un potentiel métastatique augmenté. La plaque d'adhésion prototypique est formée par des récepteurs 51 de fibronectine (FnR) qui agissent sur le réseau cellulaire d'actine. Nous avons trouvé une différence entre les réseaux d'actine des clones noninvasifs (FTC-133) et invasifs (FTC-236, FTC-238) des lignées cellulaires dans le cancer folliculaire de la thyroïde chez l'homme. La TSH induit des fibres de stress dans le FTC-133. Afin d'évaluer les différences dans les plaques d'adhésion, l'expression de la fibronectine (FN) et de son récepteur ont été analysées. Pour ces études, les clones FTC-133, FTC-236 et FTC-238 ont été mis en culture dans le milieu DME-H21 dépourvu en sérum pendant 24 heures avant l'addition de 30 mU/ml de TSH/24 heures. II n'y avait aucune différence quantitative dans l'expression FN sur Western blot que ce soit sur le milieu ainsi conditionné ou sur les extraits cellulaires. Les Western blots et les études immunohistochimiques ont indiqué que la TSH n'induisait la sécrétion de FN que dans la lignée FTC-133. La cytométrie de flux avec l'anticorps 5 a démontré une réduction respectivement de 52% et de 45% (p<0.01) dans l'expression de FnR par les clones FTC-236 et FTC-238, comparé au FTC-133. Cette donnée a été confirmée par l'immunohistochimie. A partir de ces études, nous concluons que les clones d'invasion de FTC diminuent leur expression en FnR sans changer leur expression de FN. De plus, un traitement par la TSH peut induire la sécrétion de FN par le clone FTC-133 alors qu'il ne semble pas influencer le FnR ou l'expression FN. L'expression diminuée des plaques d'adhésion FnR semble potentialiser les métastases dans certains cancers de la thyroïde.

     

A report of the first three cases of diffuse panbronchiolitis in Malaysia

Three cases of diffuse panbronchiolitis (DPB) occurring in two Malaysian Chinese patients and one Malay patient are reported. They had similar clinical, radiological and physiological features which are characteristic of DPB. The diagnosis in one of the cases was confirmed histologically by transbronchial lung biopsy. These could be the first three cases identified in Malaysia.