A case of Amyand hernia at the Central Hospital of Yaounde and review of the literature.

INTRODUCTION: Amyand's hernia is defined as an inguinal hernia, containing the appendix in the hernia sac. It is a rare form of hernia. Its management is increasingly codified. CLINICAL HISTORY: A 5-year-old patient with a non-remarkable past history was brought for consultation with an intermittent inguino-scrotal swelling and discomfort. Clinical examination revealed a non-tender inguino-scrotal swelling with positive transillumination. A conclusion of a communicating hydrocele was made; hence, an indication for surgery. Per operatively, we had as findings the appendix present within, and linked to the hernia sac. We performed an appendectomy and a high ligation of the hernia sac. The post-operative evolution was favourable. Anatomopathological analysis revealed a catarrhal appendix. CONCLUSION: Amyand's hernia remains a rare pathology that can be seen in children with a persistent peritoneo-vaginal canal. Dissection of the hernia sac must be carried out carefully since it is most often discovered intraoperatively and accidental injury to the appendix, which is attached to the wall of the hernia sac can lead to serious complications.

Vaccine potentials of an intrinsically unstructured fragment derived from the blood stage-associated Plasmodium falciparum protein PFF0165c.

We have identified new malaria vaccine candidates through the combination of bioinformatics prediction of stable protein domains in the Plasmodium falciparum genome, chemical synthesis of polypeptides, in vitro biological functional assays, and association of an antigen-specific antibody response with protection against clinical malaria. Within the predicted open reading frame of P. falciparum hypothetical protein PFF0165c, several segments with low hydrophobic amino acid content, which are likely to be intrinsically unstructured, were identified. The synthetic peptide corresponding to one such segment (P27A) was well recognized by sera and peripheral blood mononuclear cells of adults living in different regions where malaria is endemic. High antibody titers were induced in different strains of mice and in rabbits immunized with the polypeptide formulated with different adjuvants. These antibodies recognized native epitopes in P. falciparum-infected erythrocytes, formed distinct bands in Western blots, and were inhibitory in an in vitro antibody-dependent cellular inhibition parasite-growth assay. The immunological properties of P27A, together with its low polymorphism and association with clinical protection from malaria in humans, warrant its further development as a malaria vaccine candidate.

Expression and mutation patterns of p53 in benign and malignant salivary gland tumors.

The expression and mutation patterns of p53 were studied in a series of 68 benign pleomorphic adenomas and 237 malignant salivary gland tumors. p53 overexpression (nuclear staining exceeding 10%) was detected in 20% of the malignant salivary gland tumors, with the highest prevalence observed in polymorphous low grade adenocarcinoma, squamous cell carcinoma, and carcinoma ex pleomorphic adenoma and the lowest in adenoid cystic carcinoma and acinic cell carcinoma. In contrast, none of the 68 benign pleomorphic adenomas had nuclear staining exceeding 10%. SSCP and nucleotide sequence analysis of exons 4 to 9 of p53 in 19 malignant tumors revealed 9 mutations in 7 tumors. Our findings indicate that p53 may be a useful marker to help discriminate between benign and malignant salivary gland tumors.

Regeneration of calvarial defects by a composite of bioerodible polyorthoester and demineralized bone in rats.

A study was performed to evaluate regeneration of defects in rat calvaria either unfilled or filled with a bioerodible polyorthoester only, demineralized bone only, or a composite of both. At 4 weeks, histological and radiographic studies showed that defects filled with a composite of bioerodible polyorthoester and demineralized bone or demineralized bone alone were bridged by bone. Unfilled defects or defects filled with polyorthoester only did not heal. The polyorthoester caused slight inflammation that subsided by 3 weeks, and only traces of the filler could be detected at 4 weeks. The polyorthoester provided local hemostasis when used either alone or in composites with demineralized bone. The composite implant was moldable, easily contoured, and technically easier to use than demineralized bone alone.

The effect of a composite of polyorthoester and demineralized bone on the healing of large segmental defects of the radius in rats.

The effect of a composite of demineralized bone mixed with polyorthoester on the healing of large segmental defects in the rat radius was studied. Sixty male Wistar rats were divided into four groups, A through D, and an osteoperiosteal diaphyseal defect of 50 per cent of the length of the bone was made in the right radius of each rat. In Group A, the defect was filled with polyorthoester and demineralized bone; in Group B, demineralized bone; and in Group C, polyorthoester. No material was implanted in the defects in the Group-D rats. The rats were killed fifty days postoperatively. The formation of bone in the defects was quantified with computer-assisted measurements of the area on radiographs. The host-tissue response was evaluated with light microscopy. Defects that had been filled with the composite of polyorthoester and demineralized bone or with demineralized bone alone showed regeneration of bone corresponding to 93.6 and 77.6 per cent of the area of the defect, respectively. Defects that had no implant or that had been filled with polyorthoester alone showed significantly less formation of bone. No inflammation was seen with light microscopy, and only traces of the polyorthoester could be detected in the defects that had been filled with the composite or with polyorthoester alone.

Inhibition of heterotopic osteogenesis in rats by a new bioerodible system for local delivery of indomethacin.

A study was done to evaluate the effect of a system for the local delivery of indomethacin on demineralized bone-induced formation of heterotopic bone in the abdominal muscles of rats. Two separate investigations were conducted on a total of forty-eight Wistar rats. In both series, two types of implants were used: polyorthoester and demineralized bone (Group A, the control group) and polyorthoester with 5 per cent indomethacin and demineralized bone (Group B, the experimental group). In the first series, host-tissue responses and osteoinduction were evaluated histologically at two, three, and four weeks after the implantation. In the second series, the formation of bone was quantified on the basis of uptake of 85Sr at four weeks after the implantation. The polyorthoester system for the local delivery of indomethacin significantly inhibited demineralized bone-induced heterotopic formation of bone, as demonstrated by light microscopy and by uptake of 85Sr. The polyorthoester, with or without the drug, caused little tissue reaction and was resorbed almost completely at four weeks.

Hemangiopericytic meningioma with extracranial spread to multiple sites without intracranial recurrence.

This report describes a hemangiopericytic meningioma with extracranial metastases in a 46-year-old man. Metastases developed in his right femur 2 1/2 and 4 1/2 years post operation; he received radiotherapy both times. Now 5 years after the primary operation the patient is alive but shows signs of a subcutaneous tumor in the area of the right posterior iliac crest, most likely metastatic tumor tissue. The case is discussed with special attention paid to the path tumor spread.

Guided tissue regeneration and local delivery of insulinlike growth factor I by bioerodible polyorthoester membranes in rat calvarial defects.

Thirty 8-week-old male Wistar rats were randomly allocated into three groups of 10 rats each. A 5-mm defect in the left parietal bone was made in each rat. In the defects of the first group of rats, no implant was used (control group). In the second group, polyorthoester membranes were placed in the defects without active substance. In the third group, polyorthoester membranes were placed with insulinlike growth factor I. The rats were sacrificed 6 weeks postoperatively. Bone formation in the defects was quantified by computer-assisted measurements of the area of the residual defect on radiographs. Host-tissue response was evaluated by light microscopy. The area of residual bone defect was greatest in the control group, less for the defects with polyorthoester membrane without active substance, and least for the defects with polyorthoester membranes with the growth factor. During histologic evaluation, no inflammation was seen, and only traces of the polyorthoester were detected in the defects with polyorthoester membrane with or without the growth factor.

Central mucoepidermoid tumour of the mandible. Report of 2 cases.

Central mucoepidermoid tumour is an uncommon tumour within the jawbones. The onset is insidious and the first symptom is usually swelling. The radiographic appearance resembles a multiocular cyst or ameloblastoma. Two new cases are presented, and their diagnosis, histopathology and treatment are discussed. The prognosis is fairly good after adequate surgical treatment.

Arthroscopy of the rabbit temporomandibular joint.

Arthroscopy of the rabbit temporomandibular joint was evaluated experimentally on 22 rabbits. A small arthroscope with so-called "Selfoc"-system was employed. The reaction to arthroscopy was analyzed clinically. Macroscopic dissection and histology were then employed to detect possible pathological changes in the joints at periodic intervals. The established criteria for evaluation of postoperative reactions were erythema, suppuration, weight changes and chewing capacity. The results of this study indicate that the rabbit temporomandibular joint may be arthroscoped with subsequent minor reversible changes. It also seems feasible to assume that temporomandibular joint arthroscopy in humans runs a low risk for postoperative complications.

Congenital epulis in the newborn.

Neoplasms in the oral cavity are generally recognized during the routine examination of the newborn. Lesions arising on the alveolar processes of the jaws may interfere with nursing and respiration. This paper reviews the congenital epulis (CE) in the newborn. A case of CE arising on the maxillary alveolar process is reported. Due to the indication for removal of these benign tumours in the neonatal period they should be recognized as early as possible.

Melanotic neuroectodermal tumour of infancy arising in the maxilla.

Melanotic neuroectodermal tumour of infancy is an uncommon neoplasm that usually occurs in children aged one year or less. Difficulty in deciding the cellular origin of this tumour has led to numerous names, including congenital melanocarcinoma, melanotic epithelial odontoma, melanotic ameloblastoma, and retinal anlage tumour. Electron microscopy and histochemical studies, however, have now established the neural crest origin. The most frequent site of occurrence is the maxilla followed by the skull, the brain and the mandible. The genital organs are the most frequent extracranial site. We present two cases of melanotic neuroectodermal tumour of infancy arising in the maxilla.

Lipid parameters - significance in patients with endogenous depression.

BACKGROUND: People are aware of the consequences of high serum lipid levels, specifically, total cholesterol. Awareness about harmful effects of very low levels of serum lipids is still lacking. Very low levels of serum lipids lead to psychological consequences. OBJECTIVES: The objective of this study was to show whether there was a significant relationship between serum lipid levels and depression. MATERIAL AND METHODS: Total 70 subjects were included in this study. 40 subjects suffering from depression as assessed with the help of clinical findings and Beck Depression Inventory (BDI) scores were included in the study group, while control group comprised of 30 normal subjects. Lipid profile was done on blood samples obtained after overnight fasting. BDI scores were also obtained in control group using BDI. Co-relation between BDI score and lipid levels was obtained in both the groups. RESULTS: Serum lipid levels were significantly low in study group as compared to control group. There was a significant negative co-relationship between serum lipid levels with depression. Subjects of study group having lower lipid levels specifically Total Cholestrol (TC) (r = -0.78), Low-Density Lipoprotein (LDL) (r = -0.69), TG (r = -0.41) and Very Low-Density Lipoprotein (VLDL)(r = - 0.418), showed higher BDI scores (p<0.05). CONCLUSION: We can conclude that there is a significant relationship between low TC and depression. Similarly, low levels of serum LDL, TG and VLDL also showed significant relationship with depression. Lipid levels below a certain limit are not good as it may cause depression. Patients with low lipid levels should be screened for depression so that if necessary, corrective measures can be taken at the earliest.

The use of a selective serotonin reuptake inhibitor decreases heavy alcohol exposure-induced inflammatory response and tissue damage in rats.

Alcohol intoxication and psychiatric medication overdoses, including antidepressants, are common emergency room events. Heavy alcohol and antidepressant exposure are able to induce changes in cytokines disturbing normal physiology. We examined the inflammatory and physiological effects of selective serotonin reuptake inhibitor (SSRI) medication after heavy alcohol exposure. Rats were randomly divided into Alc (EtOH 5g/kg, intravenous infusion for 3 h), SSRI (paroxetine oral intake) and Alc+SSRI groups. Serum samples were collected to measure blood ethanol, aspartate transferase, alanine transferase, creatine phosphokinase, lactate dehydrogenase, amylase, tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels. Lactate dehydrogenase levels in bronchoalveolar lavage fluid were also examined. Liver, pancreas and lungs were removed after sacrifice and any pathological changes were catalogued. Ethanol infusion resulted in blood levels of ethanol of >100 mg/dL after ethanol infusion. Serum levels of aspartate transferase, alanine transferase, creatine phosphokinase, lactate dehydrogenase, amylase, TNF-α and IL-6 in the Alc+SSRI group were lower than in the Alc group. Moreover, pathological damages to the liver, pancreas and lungs were slightly lower in the Alc+SSRI group than in the Alc group. These findings suggested that SSRI is able to decrease the release of pro-inflammatory cytokines and thereby reduce liver and pancreas damage after heavy alcohol exposure.

Lack of exercise decreases survival and increases organ damage after hemorrhagic shock in rats.

Inflammatory response secondary to hemorrhagic shock (HS) frequently precedes multiple organ failure and death in trauma patients. Researchers have recognized that exercise benefits immune function. However, the effects of exercise on HSinduced death and organ damage are unknown. In this study, the authors aimed to explore the effects of exercise on survival rate and organ injury after HS. Rats were divided into exercise and nonexercise groups. The exercise group received running training 30 min/day five times/week for 4 weeks. After 4 weeks, researchers withdrew 60% of total blood volume in both groups to mimic HS. Levels of blood aspartate transferase (GOT), alanine transferase (GPT), blood urea nitrogen (BUN), creatinine (Cr), lactic acid dehydrogenase (LDH), creatine kinase-myoglobin (CK-MB), blood glucose, and lactate were measured. The survival rate and injury scores for the liver, kidney, and lung were examined 48 hr after HS. Physical activity was measured in surviving rats from the 3rd to the 7th day after HS. Exercise training significantly increased the survival rate (75% for the exercise group vs. 50% for the nonexercise group) after HS and decreased organ injury. In addition, the exercise group was more active than the nonexercise group after HS.