Ultrastructural investigation of the pneumocytes in piglets that live in a trashed environment.

The present study provides the ultrastructure of the pneumocytes types II and I in piglets living in the trash environment. Samples of the lungs of twelve piglets two months old were used. By light microscopy, the pneumocytes type I were squamous and somewhat flattened cells, while pneumocytes type II was cuboidal to spherical projected within the alveolar lumen and characterized by a spherical nucleus and foamy cytoplasm, it contained vacuolated bodies that were polygonal with variable size manly at the poles of the cell. The electron microscopy investigation showed blood air barrier between the endothelial lining of pneumocytes type I and therefore the endothelial lining of blood capillary and their nucleus were irregular in shape varied from nearly irregular triangular to polygon rough endoplasmic reticulum represented at their cytoplasm. The pneumocytes type II were frequently covered by pneumocytes type I extensions and united to them by a tight junction. It had been characterized by a high number of mitochondria within the cytoplasm and vacuolated bodies encircled the nucleus and at the two extremities of the cell. The lamellar vacuolated bodies were connected to the endoplasmic reticulum membranes and therefore the intravascular macrophages were attached to the endothelial cells within the pulmonary capillaries until two months old piglets. The occurrence of the intravascular macrophages could be attributed to the higher resistance to the respiratory diseases of the piglets.

The Role of Monocarboxylate Transporters and Their Chaperone CD147 in Lactate Efflux Inhibition and the Anticancer Effects of Terminalia chebula in Neuroblastoma Cell Line N2-A.

AIMS: In the presence of oxygen, most of the synthesized pyruvate during glycolysis in the cancer cell of solid tumors is released away from the mitochondria to form lactate (Warburg Effect). To maintain cell homeostasis, lactate is transported across the cell membrane by monocarboxylate transporters (MCTs). The major aim of the current investigation is to identify novel compounds that inhibit lactate efflux that may lead to identifying effective targets for cancer treatment. STUDY DESIGN: In this study, 900 ethanol plant extracts were screened for their lactate efflux inhibition using neuroblastoma (N2-A) cell line. Additionally, we investigated the mechanism of inhibition for the most potent plant extract regarding monocarboxylate transporters expression, and consequences effects on viability, growth, and apoptosis. METHODOLOGY: The potency of lactate efflux inhibition of ethanol plant extracts was evaluated in N2-A cells by measuring extracellular lactate levels. Caspase 3- activity and acridine orange/ethidium bromide staining were performed to assess the apoptotic effect. The antiproliferative effect was measured using WST assay. Western blotting was performed to quantify protein expression of MCTs and their chaperone CD147 in treated cells lysates. RESULTS: Terminalia chebula plant extract was the most potent lactate efflux inhibitor in N2-A cells among the 900 - tested plant extracts. The results obtained show that extract of Terminalia chebula fruits (TCE) significantly (P = 0.05) reduced the expression of the MCT1, MCT3, MCT4 and the chaperone CD147. The plant extract was more potent (IC50 of 3.59 ± 0.26 µg/ml) than the MCT standard inhibitor phloretin (IC50 76.54 ± 3.19 µg/ml). The extract also showed more potency and selective cytotoxicity in cancer cells than DI-TNC1 primary cell line (IC50 7.37 ± 0.28 vs. 17.35 ± 0.19 µg/ml). Moreover, TCE Inhibited N2-A cell growth (IG50 = 5.20 ± 0.30 µg/ml) and induced apoptosis at the 7.5 µg/ml concentration. CONCLUSION: Out of the 900 plant extracts screened, Terminalia chebula ethanol extract was found to be the most potent lactate efflux inhibitor with the ability to inhibit chaperone CD147 expression and impact the function of monocarboxylate transporters. Furthermore, TCE was found to have growth inhibition and apoptotic effects. The results obtained indicate that Terminalia chebula constituent(s) may contain promising compounds that can be useful in the management of neuroblastoma cancer.

Outpatient-based injection laryngoplasty for the management of unilateral vocal fold paralysis - clinical outcomes from a UK centre.

OBJECTIVE: To assess voice outcomes in patients undergoing vocal fold injection (VFI) augmentation laryngoplasty in a clinic-based setting. METHODS: A prospective study of patients with unilateral vocal cord palsy undergoing Radiesse(®) vocal cord augmentation. We used the ten-item voice handicap index (VHI-10) as a postal survey before and after the intervention. RESULTS: A total of 43 patients were referred to our ENT clinic from June 2011 to October 2014 with unilateral vocal cord palsy. The majority were referred from the oncology department with mediastinal tumours. Fifteen patients died of malignant disease. Twenty-one patients responded to our survey. VHI-10 scores were analysed using one-way analysis of variance (anova), and the results suggest a sustained improvement before and after the intervention (pre-injection versus 3 months post-injection P < 0.01; pre-injection versus 6 months post-injection P < 0.033). CONCLUSION: This is the largest case series of patients who had a local anaesthetic vocal cord injection with calcium hydroxylapaptite using the trans-thyrohyoid approach. Early data would suggest that the results are similar to injections performed under general anaesthesia when performed by an experienced laryngologist. VFI in a clinic-based (awake) setting has the distinct advantage of providing instant feedback of vocal fold closure and voice outcome during the procedure, avoiding general anaesthesia with its inherent risks and cost and also the limitations of difficult exposure.

Risky road-use behaviour among students at the University of Benha, Egypt.

Road traffic injuries constitute 45% of deaths due to injury in Egypt. The aim of this cross-sectional study was to identify and investigate risky behaviours regarding road use among university students in Benha. A self-administered questionnaire was completed by 953 students. Of the respondents 19.3% reported not complying with pedestrian road traffic safety rules, while among drivers, 39.4% had no driving licence, 44.5% did not use a seat-belt and 63.5% exceeded the legal speed limits. In binary logistic regression analysis, substance use (OR 18.3; 95% CI: 9.10-23.3) and having peers with similar behaviours (OR 2.53; 96% CI: 1.15-5.55) were significant predictors of not following road traffic safety rules as a pedestrian. Exceeding the legal traffic speed limits as a driver was significantly associated with male sex (OR 5.13; 95% CI: 1.98-13.3), peer pressure (OR 8.70; 95% CI: 3.90-17.1) and substance use (OR 3.30; 95% CI: 1.58-13.7). Unsafe road-use behaviours that may cause unintentional injuries are prevalent among University of Benha students. Health education sessions and training courses for students on appropriate road behaviours may be warranted.

Computed tomography and sectional anatomy of the head cavities in donkey (Equus asinus).

The purpose of this study was to describe the computed tomographic (CT) anatomy of normal donkey head cavities to be used as a basis for interpretation of CT images of donkey. Six adult donkeys' heads of undetermined sex were used in this study. The donkey heads were divided into three regions-nasal, orbital, and cranial-to show the morphology of the following cavities: nasal cavity, paranasal sinuses, orbital cavity, oral cavity, pharyngeal cavity, especially the guttural pouch, cranial cavity and temporomandibular joint. The donkey head had six pairs of sinuses: three paranasal (the frontal, maxillary and sphenopalatine sinuses) and three nasal (dorsal, middle and ventral conchal) sinuses. The maxillary sinus was subdivided into rostral and caudal compartments by a thin incomplete bony septum that was identified and labeled according to cheek teeth landmarks. The topographic description and relationship between the nasal, oral, orbital, cranial, temporomandibular joint, pharyngeal cavities and paranasal sinuses were demonstrated. The articular disc, articular surface and joint capsule of the temporomandibular joint were indicated easily in our CT and cross sectional images.

Anatomic reference for computed tomography of paranasal sinuses and their communication in the Egyptian buffalo (Bubalus bubalis).

The purpose of this work was to present an anatomic reference for computed tomography (CT) for the paranasal sinuses of adult buffalo fit the use of anatomists, radiologists, clinicians and veterinary students. CT images with the most closely corresponding cross sections of the head were selected and studied serially in a rostral to caudal progression from the level of the interdental space to the level of the nuchal line. The anatomical features were compared with the dissected heads and skulls. The paranasal sinuses of buffalo comprise dorsal conchal, middle conchal, maxillary, frontal, palatine, sphenoidal (inconstant, small and shallow when present), lacrimal and ethmoidal that were identified and labelled according to the premolar and molar teeth as landmarks. The topographic description of all the compartments, diverticula, septa and communication of the paranasal sinuses in buffalo has been presented. The relationship between the various air cavities and paranasal sinuses was easily visualized.

Morphological characteristics of the vallate papillae of the one-humped camel (Camelus dromedarius).

In this study, the morphology of the vallate papillae of camel was investigated using gross, light and scanning electron microscopy as well as immunohistochemistry. Vallate papillae were arranged along an identical line on each side of the lingual torus and revealed remarkable individual differences. However, each papilla - round or flat, small or large, single or paired - was surrounded by a prominent groove and an annular pad. Based on our findings, postnatal development and formation of new papillae occur in camel. Microscopically, taste buds were constantly observed along the medial wall epithelium, and in the papillary wall epithelium on both sides of the secondary groove apparently separating the vallate papillae. In addition, an aggregation of taste buds was occasionally observed at the bottom of the lateral wall epithelium. Using SEM, we observed several pits and microplicae on the surface of papillae as well as distinct taste pores on the peripheral parts of the dorsal surface. We demonstrated immunoreactivity of α-gustducin only in mature taste buds. We conclude that the morphological features and microstructure of vallate papillae are a characteristic feature in camel compared to other ruminants. These features might have evolved to assist the camel in the manipulation and tasting of thin organic stiff plants that grow in its environment and therefore might have related to the feeding habits of the animal.

Division of tongue tie: review of practice through a tertiary paediatric otorhinolaryngology service.

OBJECTIVES: Recent NICE guidance declared that evidence regarding surgical division of tongue tie was adequate to support the use of the procedure, provided that normal arrangements are in place for consent, audit and clinical governance. This work aimed to carry out a retrospective review of those patients who have previously undergone tongue tie division through a tertiary paediatric otorhinolaryngology service. We further aimed to identify the referral patterns, indications for, and outcomes following, division. METHODS: A retrospective chart review of all patients attending for division of tongue-tie between January 2010 and June 2011, inclusive. RESULTS: A total of 48 patients underwent division of tongue-tie over the study period. The median age of patients at the time of operation was 16 months (range 3-192). Delayed speech or articulation problems (27%), and parental concern (23%) were the most common reasons for referral. Overt difficulty with feeding was responsible for referral in just 4 cases. All cases were performed under general anaesthetic as day-case procedures; 7 patients had a second procedure performed at the same time. No complications, either early or late, were recorded across this cohort. CONCLUSIONS: Tongue-tie division is a safe procedure with minimal associated morbidity. Whilst the primary indication cited in the literature is that of feeding difficulty, it appears that the majority of division is performed for other reasons.

Macro-microscopic study on the toepad of ostrich (Struthio camelus).

The ostrich foot has four toepads, two on the 3rd digit, one on the 4th digit and one at metatarso-phalangeal joint. Previous studies have not detailed the histo-morphological structure of these toepads. In this study, we have described the macroscopic and microscopic structures of the toepad of ostrich (Struthio camelus). Numerous papillae with different direction, length and thickness have been observed grossly on the ventral surface of each toepad. Histological examinations have revealed that the epidermis of the ostrich toepad, similar to other digitigrades, consists of an outer stratum corneum and an inner stratum germinativum (which is subdivided into basal, intermediate and transitional layers). The stratum corneum has several layers of flattened horny cells. The nuclei of basal cells have several mitotic figures. The cytoplasm of the stratum germinativum cells has multiple lipid droplets and multigranular bodies (in transitional cells only). Scanning electron microscopic examination revealed presence of collagen fibers in mid and deep dermis of each toepad. These fibers run parallel and connect to each other by very thin fibrils which are branched, crossed with each other in an oblique direction. Such arrangement of these collagen fibers, thin fibrils and presence of digital cushion are likely to be responsible for the protection of the underlying soft tissues and absorption of concussion.

Gastroesophageal junction of Anatolian shepherd dog; a study by topographic anatomy, scanning electron and light microscopy.

The aim of this study was to cast a spotlight on the topography and to point out the clinical importance of the gastroesophageal junction (GEJ) in Anatolian Shepherd dogs. Nine Anatolian Shepherd dogs were used to study the morphology of the GEJ. The esophagus was appeared has a portion within the thoracic cavity while no portion of the esophagus presented within the abdominal cavity that documented the absence of the intra-abdominal portion in all studied dogs. The topographic anatomy, scanning electron and light microscopic examinations revealed that the gastroesophageal junction was located at the level of the phrenico-esophageal ligament (PEL) inside the esophageal hiatus. Our results were distinguished the morphology of the esophageal and gastric cardiac mucosa at the level of the gastroesophageal junction by the scanning electron micrographs. The light microscopical examination was explained the PEL attached to the esophageal side in one dog and to the gastric cardiac side in three dogs.

Laparoscopic anatomy of caprine abdomen and laparoscopic liver biopsy.

This study was carried out on apparently healthy adult non pregnant female Baladi goats to provide normal laparoscopic anatomy of the abdomen and to assess feasibility of laparoscopy for liver biopsy. Following preparation of animals, equipment and instruments, the primary port and laparoscope was placed on the umbilicus and 360° scan was performed for orientation and exploration of the abdominal cavity. Secondary ports were placed under direct laparoscopic observation to allow insertion of accessory instruments for tissue grasping, coagulation and severing. The obtained results cleared that ventral laparoscopic approach and tilting and rotating the animal during laparoscopic procedures provided better exposure of internal abdomen. Laparoscopy provided a comprehensive description of cranial and caudal abdominal regions. Laparoscopic liver biopsy required two secondary ports; one assisting port inserted in right subcostal area and one operating port inserted subxiphoid. The procedure was safe, practical and easily performed.

Role of sphingosine 1-phosphate receptor expression in eosinophils of patients with allergic rhinitis, and effect of topical nasal steroid treatment on this receptor expression.

OBJECTIVE: Recent research has indicated that sphingosine 1-phosphate plays a role in allergy. This study examined the effect of allergen challenge on the expression of sphingosine 1-phosphate receptors on the eosinophils of allergic rhinitis patients, and the effect of steroid treatment on this expression. STUDY DESIGN: A prospective, non-randomised study. METHODS: The study had three parts. Firstly, sphingosine 1-phosphate receptor expression on the eosinophils of allergic rhinitis patients and control patients was determined. Secondly, sphingosine 1-phosphate receptor expression was quantified pre- and post-allergen challenge, before and after a short course of fluticasone propionate; all patients underwent symptom scoring and peak nasal inspiratory flow measurement pre- and post-allergen challenge, both before and after steroid or saline treatment. Thirdly, the effect of sphingosine 1-phosphate on eosinophil migration was examined. RESULTS: The eosinophils of both allergic rhinitis patients and controls expressed sphingosine 1-phosphate1, 3, 4, and 5. Eosinophils from all allergic rhinitis patients demonstrated up-regulation in sphingosine 1-phosphate expression after allergen challenge. These changes were statistically very significant for sphingosine 1-phosphate1, 4, and 5, and moderately significant for sphingosine 1-phosphate3. Sphingosine 1-phosphate receptor expression up-regulation was abolished in the steroid-treated group after allergen challenge; however, the saline-treated group showed no change in sphingosine 1-phosphate receptor expression after allergen challenge. Peak nasal inspiratory flow scores were significantly diminished after allergen challenge prior to treatment, but not after a course of topical nasal steroids. Sphingosine 1-phosphate induced eosinophil chemotaxis was increased following allergen challenge in allergic rhinitis subjects. CONCLUSIONS: Local intranasal steroid therapy acts directly to block allergen-induced up-regulation of sphingosine 1-phosphate receptors on the peripheral eosinophils of allergic rhinitis patients, and this is coincident with post-challenge peak nasal inspiratory flow measurement improvements. These observations support the idea that such an increase in sphingosine 1-phosphate receptor expression is clinically relevant in allergic rhinitis, with potential consequences for eosinophil migration and survival.

Recent consensus on the classification of rhinosinusitis--a way forward for research and practice?

Prior classification of rhinitis was into three categories: acute, subacute and chronic rhinosinusitis. The advantages of this classification were obvious but they were offset by some disadvantages. For example, the previous classification did not take account of the mechanisms underlying the condition or the clinical outcome. Hence, there was a need for evidence-based sinusitis classification guidelines. The American Academy of Otolaryngology-Head and Neck Surgery and other related societies published a classification of the condition and suggested clinical research strategies for patients with rhinosinusitis. The main conclusion was that sinusitis should be divided into four categories: acute (bacterial) rhinosinusitis, chronic rhinosinusitis (CRS) without polyps, CRS with polyps, and allergic fungal sinusitis. The aim of this current paper is to discuss the consensus for nomenclature, outline the proposed classification of different types of rhinosinusitis and to suggest some ways that we may audit these guidelines.

Delayed facial nerve palsy following tympano-mastoid surgery: incidence, aetiology and prognosis.

OBJECTIVE: To establish the frequency of occurrence of delayed facial nerve paralysis following tympano-mastoid surgery in our department and to determine the aetiological factors and long term prognosis. SETTING: Tertiary care academic centre. MATERIALS AND METHODS: A retrospective review of all patients who had undergone tympano-mastoid surgery in our department over the previous five years was carried out. A total of 219 patients were included in the study. Only two patients were identified as having delayed onset facial nerve palsy over this period of time. The patients' medical records were reviewed and the patients clinically assessed. RESULTS: The frequency of delayed onset facial nerve palsy following tympano-mastoid surgery in our series was 0.91 per cent. Facial weakness set in on day eight and day 14 in the two patients. Serological investigations in both patients revealed raised titres of immunoglobulin (Ig) M and IgG to varicella-zoster virus, confirming the presence of varicella-zoster infection. In our experience, the combined use of prednisone and acyclovir was an effective form of treatment for both patients, whose facial nerve function fully recovered within six months of onset. CONCLUSION: The incidence of delayed facial nerve palsy following tympano-mastoid surgery is low. It can occur up to two weeks after the surgery. Our two cases confirm viral reactivation to be an important aetiological factor in the development of delayed onset facial nerve palsy. The overall prognosis for delayed facial nerve palsy following tympano-mastoid surgery appears to be good.

Tonsillectomy--cold dissection vs. hot dissection: a prospective study.

Throughout the years, investigators and surgeons have developed new techniques for tonsillectomy aiming to lessen the postoperative morbidity and complications of tonsillectomy. It is generally accepted that the ideal method should decrease operative time, blood loss, postoperative haemorrhage and morbidity. To compare the technique and post-operative morbidity of two different tonsillectomy methods: cold dissection and bipolar electrodissection. A prospective study including a total of 545 children (Age: 3-16 yrs) undergoing tonsillectomy at The Children's University Hospital in Dublin, Ireland, from January 2003 to December 2003. The incidence of primary, secondary haemorrhage and postoperative pain was compared between both techniques. The overall rate of haemorrhage was 3.6% (20 patients) this included primary haemorrhage in 0.3% (2 patients) and secondary haemorrhage in 3.3% (18 patents). Primary haemorrhage occurred only in the electrodissection technique. As regards to secondary haemorrhage it was higher in the electrodissection technique 2.3% (12 patients) compared to 1% (6 patients) of the cold dissection technique. Patients rated pain to be more severe in the electrodissection technique compared to the cold dissection technique. Cold dissection tonsillectomy technique is still considered to be a safe and effective method with less posoperative morbidity complications as evidenced from our study.

Neurofibromatosis type 2--the importance of serial imaging of the brain and spinal cord.

Meningiomas and schwannomas are relatively common central nervous system neoplasms, but patients harbouring multiple meningiomas or schwannomas are rare. We present the case of a 27 year-old patient with Neurofibromatosis type 2 with multiple associated intracranial meningiomas and spinal cord neurofibromas at various levels. Patients with Neurofibromatosis type 2 should be followed up for life with serial magnetic resonance imaging of the brain and spinal cord to detect new and recurrent tumours at these sites.

Epidemiology and immunodiagnosis of schistosomiasis haematobium in low endemic area in Egypt.

A survey was performed in Behbeet village in Giza governorate including 370 individuals (172 males and 198 females) representing 10% of the house holds. Clinical, stool, urine and serological tests accompanied by a questionnaire were applied to all participants to find out the prevalence, intensity of infection of S. haematobium, underlying sociodemographic factors, morbidity indicators and the awareness and treatment status among the infected population. It was revealed that the overall prevalence of S. haematobium based on the detection of eggs in urine was 18.1% while the prevalence of antibodies to S. haematobium species specific microsomal antigen was 57.6% detected by enzyme-linked immuno-transfer blot (EITB). The highest age specific prevalence and intensity of infection were detected among school children in the early teenage. Males were at a higher risk of contracting infection than females with a sex ratio of 2.5:1. Occupational and recreational water contact were significantly more frequent among the egg positives than the negative ones. Present history of haematuria and microhaematuria detected by reagent strips had the strongest association with S. haematobium infection followed by leucocyturia and dysuria. Microhaematuria had the strongest negative predictive value (85.7%) in discrimination between egg positive and negative groups while its positive predictive value was the highest (92.9%) when seropositives and negatives were discriminated. Less than half of the infected population were aware of having the disease (43.3% and 41.8% among the egg positives and seropositives, respectively) and lower percentages reported receiving previous treatment for schistosomiasis. No significant differences were detected between groups (P>0.05). Culturally appropriate and effective health education of the population, and training of the staff of rural health units to improve diagnostic and outreach skills are recommended.

An epidemiological study of cancer breast in greater Cairo.

This study was carried out to get a picture of risk factors associated with the occurrence of cancer breast. Three hundred and seventy two females (180 breast cancer patients and 192 controls) were selected from Ain Shams and Benha University Hospitals to be the subjects of this study. The results showed that the important risk factors affecting the development of cancer breast were: parity, age at first birth, age of menarche, age of the patient, family history, number of pregnancies and age of natural menopause. Mostly these factors are interrelated to each other.

Risk factors of gallstone disease in a sample of patients in Benha City.

This study included one hundred cases of gallstone disease diagnosed by ultrasonography and a similar group of matched controls chosen from Benha University and General Hospitals. Both cases and controls were subjected to a specially designed questionnaire, clinical examination, anthropometric measurements, ultrasonography and laboratory investigations to find out some risk factors that may contribute to the development of gallstone disease. Females constituted the majority of cases (87%) while males were a minority (13%). In both sexes, the highest percentages of cases were among patients aged fifty years or more (53.8% and 33.3% for males and females respectively). Bad dietary habits including increased consumption of animal fats and frequent use of snacks between meals, obesity as indicated by body mass index and body fat percent, positive family history of gallstones and liver cirrhosis were found to be significant risk factors in the predisposition to gallstones in the present study. On the other hand, factors suggesting hormonal role in the pathogenesis of gallstones such as age of menarche, duration of menstrual life, age at first pregnancy, multiparity and duration of contraceptive pills use did not show any significant difference between female cases and controls.