Centre-based statistics of cleft lip with/without alveolus and palate as well as cleft palate only patients in Aden, Yemen.

OBJECTIVE: The purpose of the study was to report the types and patterns of cleft lip with/without cleft alveolus and palate as well as cleft palate only as seen in Aden, Yemen. DESIGN AND SETTING: Retrospective, centre-based study conducted at the Cleft Lip and Palate Centre, Aden University, Yemen. MATERIAL AND METHODS: Statistical evaluation of the data from all cleft patients who were registered at or referred to this centre during the years 2005-2011. RESULTS: A total of 1110 cleft patients were seen during the period studied (2005-2011). Amongst these there were 183 (16.48%) with a cleft lip and 144 (12.98) with a cleft of lip and alveolus, 228 (20.54%) had a cleft palate, and 555 (50%) had a combination of cleft lip, alveolus, and palate. The clefts were found more often in males than in females (56.5% boys versus 43.5% girls). This difference was statistically significant (p ≤ 0.001). Statistically significant sex differences were also noted when evaluating the various cleft types. Isolated cleft palates were found most often in females. Among the cleft palate cases there were 102 (9.2%) with a cleft soft palate only. The ages of the patients were between one day and 40 years. Two hundred and one children (18%) had a positive family history of clefts. Among the risk factors considered in this study, consanguineous marriages among cousins were found most frequently (in 48% of the cases). In contrast to this, only 10% of the mothers had reported to have been taking medication directly prior to or during the first trimester of their pregnancy. On average the mothers were neither very young nor very old. CONCLUSION: The prevalence rate of orofacial cleft types among this Yemeni sample was similar to prevalence rates previously reported in white Caucasians. The present study did neither find many cases with medication before, nor during, pregnancy; there were few young or very old mothers; and the incidence of positive family histories was similar to those found in other studies on clefts. However, consanguineous marriages were encountered quite often.

Bacteriology swabs in primary total knee arthroplasty.

OBJECTIVE: An early detection of possible periprosthetic infection may lead to an earlier and potentially less invasive treatment of infected total knee arthroplasty TKA). The purpose of the present study was to evaluate retrospectively our current, affordable clinical practice of intra-operative swab taking during primary TKA. METHODS: A total of 206 primary TKA were analysed retrospectively for intra-operative bacteriology swabs and subsequent periprosthetic infection. All bacteriology swabs were obtained in a standardized manner including a tissue sample. Data was statistically evaluated concerning standard descriptive statistics and using the chi-square test. RESULTS: Bacteria were identified in 43.4% with coagulase-negative staphylococci being the most frequently isolated pathogens (52.2%). Regarding the contingency tables and chi-squared tests, generally no association was found between positive intra-operative swabs and subsequent periprosthetic infection as well as all other parameters investigated (timing of the antibiotic prophylaxis and pre-operative laboratory results). CONCLUSIONS: Bacteriology swabs during primary total knee arthroplasty are no adequate measure to predict subsequent periprosthetic infections, even if augmented with a tissue sample.

Functional and esthetic outcome after bony lateral wall decompression with orbital rim removal and additional fat resection in graves' orbitopathy with regard to the configuration of the lateral canthal region.

PURPOSE: To investigate whether en bloc resection of the lateral orbital wall, including the orbital rim, during lateral wall decompression surgery in patients with Graves' orbitopathy (GO) potentially influences the esthetic and functional aspects of the lateral canthal region. METHODS: Lateral wall decompression was performed in 30 orbits of 18 patients using an upper lidcrease approach involving complete removal of the lateral orbital wall combined with additional orbital fat resection. Patients undergoing surgery before January 2010 were evaluated retrospectively for exophthalmos, vertical lid aperture, lagophthalmos and eye motility. Patients undergoing surgery after January 2010 were evaluated prospectively in addition for horizontal lid aperture, pupillary distance, lateral movement of the lateral canthus, and the disease-specific GO-QOL questionnaire, including subjective and objective assessments of the appearance of the lateral canthal region. RESULTS: A mean exophthalmos reduction of 3.0 mm was achieved, accompanied by a significant reduction in vertical lid aperture but without significant influence on horizontal eye movements. GO-QOL scores disclosed significant improvements with regard to both visual and psychosocial functioning. Although 3 out of 18 patients reported some temporal hollowing, this was confirmed objectively in only one patient. CONCLUSIONS: Our analysis did not demonstrate any impairment of lateral canthal stability or motility functions. Slight scar retraction was objectively confirmed in only one patient, allaying concerns about significant temporal hollowing. Given the good overall esthetic and functional results of this surgical technique, we advocate lateral wall decompression with resection of the orbital rim in GO patients with mild-to-moderate exophthalmos.

A novel sialyl Le(X) expression score as a potential prognostic tool in colorectal cancer.

BACKGROUND: Treatment decisions in colorectal cancer subsequent to surgery are based mainly on the TNM system. There is a need to establish novel prognostic markers based on the molecular characterization of tumor cells. Evidence exists that sialyl Le(X) expression is correlated with an unfavorable outcome in colorectal cancer. The aim of this study was to establish a simple sialyl Le(X) staining score and to determine a potential correlation with the prognosis in a series of advanced colorectal carcinoma patients. METHODS: In order to implement routine use of sialyl Le(X) immunohistology, we established a new, easily reproducible score and defined a cutoff which discriminated groups with better or worse outcome, respectively. We then correlated sialyl Le(X) expression of 215 UICC stage III and IV patients with disease-free and cancer-related survival. RESULTS: A five-stage score could be established based on automated immunohistochemical stainings. Using a statistical model, we calculated a cutoff to discriminate between weak and strong staining positivity of sialyl Le(X). Patients with strong positive specimens had a worse cancer-related survival (P = 0.004) but no difference was observed for disease-free survival (P = 0.352). CONCLUSIONS: These results demonstrate a strong correlation between high sialyl Le(X)-expression in colorectal carcinomas and cancer-related survival. Our highly standardized and easy-to-use staining score is suitable for routine use and hence it could be recommended to evaluate sialyl Le(X)-expression as part of the standard histopathological analysis of colorectal carcinomas and to validate the score prospectively based on a larger population.

Experiments on the mechanism of underwater hearing.

CONCLUSION: The findings suggest that underwater sound perception is realized by the middle ear rather than by bone conduction, at least in shallow water conditions. OBJECTIVE: To prove whether underwater sound perception is effected by bone conduction or by conduction via the middle ear. METHODS: Five divers, breathing through snorkels, were tested in a swimming pool, to determine whether a sound was louder when the acoustic source placed was in front of the head in comparison with a lateral application facing the ear region. The second experiment investigated whether sound perception is influenced by ear protection plugs in underwater conditions. Also, the effect of a 5 mm thick neoprene hood was determined, with and without an additional perforation in the ear region. RESULTS: Sounds were louder when applied from a position laterally facing the ear, louder without than with a protection plug, louder without than with a neoprene hood on, and louder when the neoprene hood had a perforation in the region of the ear than with an intact hood.

Effect of alcohol consumption on whole-body protein turnover in healthy adults.

The aim of the study was to investigate the whole-body protein turnover, either before or after continuous, moderate ethanol-induced oxidative stress by red wine consumption over a relatively short period in healthy volunteers. Ten healthy adults received an individual regular diet over 20 days. After 10 days, the subjects consumed 0.4 ml ethanol kg(-1) day(-1) as red wine together with dinner over a 10-day period. After 8 and 18 days, respectively, a (15)N-labelled yeast protein was administered in a dosage of 4.2 mg kg(-1) body weight. Urine and faeces were collected over 48 h, respectively. The (15)N-enrichment was measured by isotope ratio mass spectrometry, whereas the protein flux rates were calculated by a three-compartment model. The whole-body protein turnover without/with red wine consumption amounted to 3.73±0.6 and 3.49±0.6 g kg(-1) day(-1) (not significant), respectively. Moderate alcohol consumption does not induce significant short-term changes in the whole-body protein turnover of healthy adults.

Gene expression profiling of peripheral blood mononuclear leukocytes from psoriasis patients identifies new immune regulatory molecules.

In the present report gene expression profiling of peripheral blood mononuclear cells (PBMC) from psoriasis patients suffering from severe generalized disease was performed comparing diseased stage with cured stage. By this means, 18 genes were identified which showed differential expression. The most significant differences were found for IL-8, annexin A3, cycloxygenase-2 (COX-2), cell cycle regulator G0S2, and pre-B cell enhancing factor (PBEF), all of which showed upregulation in the diseased stage. Microarray data were confirmed by real-time RT-PCR. Further analyses using support vector machines identified three pairs of genes (IL-8 - CDKN1C/p57, cyclooxygenase-2 - NR1D2, and desmocollin-2 - CDKN1C/p57) which allowed an accuracy of disease stage prediction of 86%, based on gene expression patterns. Taken together, this is the first large-scale gene expression study of psoriasis PBMC identifying candidate genes that might contribute to psoriasis immunopathogenesis. The genes identified in the present report and the molecular mechanisms underlying their regulation might serve as future targets for therapeutic intervention in psoriasis.

Differentiation of adrenal adenomas from metastases with unenhanced computed tomography.

OBJECTIVE: To investigate whether the diagnostic accuracy of unenhanced computed tomography (CT) regarding the differentiation of adrenal adenomas from adrenal metastases is increased by applying a combination of morphologic criteria instead of only measuring the density values of the tumor. PATIENTS AND METHODS: Unenhanced CT scans of 56 patients with an adrenal mass and a history of an extra-adrenal malignancy were analyzed for size, attenuation, contour, and structure characteristics of the adrenal tumor. Coefficients yielded by multiple logistic regression analysis were used for the construction of an additive total score (score S) that included several diagnostic criteria. The reliability of the total score and all parameter combinations was tested by receiver operating characteristic (ROC) analysis. The nature of the adrenal lesion was determined by follow-up CT (40 patients), percutaneous biopsy (15 patients), or surgery (1 patient). Twenty-four of the neoplasms were adenomas, and 32 were found to be metastases. RESULTS: The score of the combined CT parameters showed the largest area under the ROC curve. The highest predictive power indicated by the model was calculated at a cutoff value of 7.05, with a sensitivity of 100% and a specificity of 96.8% for the detection of metastases. At 6.85 points as the cutoff value, the scoring system still maintained a sensitivity of 95.8% and a specificity of 96.9%. CONCLUSION: The differentiation between adrenal adenomas and metastases is improved by applying our scoring system compared with any single parameter alone. The total score is obtained by adding 10% of the density values to the size in centimeters, plus 2 if the contour of the lesion is blurred and plus 1 if the structure is inhomogeneous. By setting the threshold at 7 points, all but 1 lesion were classified correctly.