Cerebral Contusion: An Investigation of Etiology, Risk Factors, Related Diagnoses, and the Surgical Management at a Major Government Hospital in Cambodia.

INTRODUCTION: Cerebral contusions are a common type of injury among the Cambodian population, mostly due to road traffic accidents. This article aims to assess various aspects around brain contusion focusing on the condition at admission, residing province, mechanism and time of injury, age and sex distribution with differing helmet wearing, and alcohol consumption patterns. Hospitalization-related data such as treatment and outcome were analyzed. METHODS: This was a retrospective analysis of 406 cases who have been admitted during the period between May 2013 and May 2016. RESULTS: Two hundred and ninety-five (75.51%) of the patients came from rural areas, 312 (76.84%) were male (mean age 31.17 ± 12.90 years for males and 38.5 ± 16.29 years for females). The average hospital stay amounted to 10.51 ± 6.67 days. One hundred and eight two cases (52.29%) happened between 4.00 and 11.00 p.m. Three hundred and nineteen (79%) of the injured patients were motorcycle drivers and 18% pedestrians. Male patients had an alcohol involvement in 135 (49.45%) (females in 5 [6.25%]) cases and 26 (10%) wore a helmet (females in 5 [6.25%]). Surgery was performed in 82 cases, specifically craniotomy and craniectomy +/- elevation of a depressed skull fracture. Two hundred and ninety-six (73.09%) patients showed related second diagnosis, mostly subdural hematoma in 96 (32.43%) and epidural hematoma in 63 (21.28%) cases. Fifty patients (13.16%) had a Glasgow Coma Scale of 3-8. 92 (24.21%) of 9-12 and 238 (62.63%) of 13-15 on admission. Most of the patients were discharged with an improved status 324 (91.52%) according to the Glasgow Outcome Scale 4 or 5. CONCLUSION: The severity and resulting neurologic impairment of cerebral contusions show the importance of more in-depth research and prevention programs.

A peptide vaccine based on a B-cell epitope on the VP1 protein of enterovirus 70 induces a strong antibody response.

Enterovirus 70 (EV70) is the causative agent of acute hemorrhagic conjunctivitis (AHC), for which no effective vaccine is available. This study revealed a high reactivity of the N-terminal region of EV70 VP1 (VP1-1) with an anti-EV70 mouse serum. The analysis of overlapping synthetic peptides of VP1-1 identified a B-cell epitope in this region. The E-peptide (14-ANTVESEIKAELGVI-28) showing the highest reactivity with the anti-EV70 serum induced neutralizing antibodies in mice and reduced the virus titer in the eyes, suggesting that it is a candidate vaccine against AHC caused by EV70.

Development of an in vitro antigen-detection test as an alternative method to the in vivo plaque reduction neutralization test for the quality control of Japanese encephalitis virus vaccine.

Japanese encephalitis virus (JEV) causes diseases that attack the human central nervous system. Traditionally, the quality control for JEV vaccines, in which the plaque reduction neutralization (PRN) titer is measured by the national control laboratories before the vaccine batches are marketed, has required laboratory animal testing. However, classical animal tests have inherent problems, including the very fact that animals are used, ethical issues, and the possibility of error. In this study, JEV antigen was measured in an in vitro assay to assess the feasibility of replacing in vivo assays that measure the PRN titers of JEV vaccines. We constructed a double-sandwich enzyme-linked immunosorbent assay (DS-ELISA) that could detect JEV envelope (E). Initially, monoclonal antibodies (mAbs) directed against the JEV E protein were generated and characterized. We isolated 18 mAbs against JEV E protein, and most were the IgG1 or IgG2a isotype. The mAbs (5F15 and 7D71) were selected as the most suitable mAb pair to detect JEV E protein. DS-ELISA with this pair detected as little as approximately 3 µg/mL JEV E protein and demonstrated a relationship between the amount of JEV E protein and the PRN titer. From these results, we surmise that this DS-ELISA may be useful, not only in terms of measuring the amount of JEV E protein, but also as a substitute for the PRN test for JEV vaccine evaluation.