Sentinel lymph node biopsy (SLNB) in management of N0 stage T1-T2 lip cancer as a "same day" procedure.

Current management of N0 stage lip Squamous Cell Carcinoma (SCC) are prophylactic neck dissection, radiotherapy, or "watch and see" policy. The aim is the evaluation of the role of sentinel lymph node biopsy (SLNB) in their management based upon actual and not hypothetical presence of cervical lymph node (CLN) micrometastases as a same day procedure. Fourteen patients between November 2003 and August 2005 were included, nine men and five women, median age:57 years, (range 34-65 years). SLNB using preoperative lymphoscintigraphy and intra-operative localisation with patent blue and radioactive Tc(99m) Human Serum Albumin was performed. The median follow-up period was 26 months. Successful patent blue localisation in 13/14 whilst successful radio-localisation in all patients. Micrometastases were detected in 1/14 whom underwent therapeutic neck dissection. No local recurrence or regional lymph node involvement were detected. SLNB is a technically feasible and accurate approach for detection of CLN micrometastases in N0 stage lip SCC using the triple diagnostic localisation technique as a same day procedure.

Vaginal reconstruction with a greater omentum-pedicled graft combined with a vicryl mesh after anterior pelvic exenteration. Surgical approach with long-term follow-up.

Resection of anterior vaginal wall that occurs with some cases of anterior pelvic exenteration leaves the patient with a small and narrow vagina. This affects their sexual life leading to major psychologic problems, especially in young women. The aim of this study is to evaluate a new technique of vaginal reconstruction following anterior pelvic exenteration with clinical and cytohistologic follow-up. Between March 2002 and November 2004, ten sexually active female patients underwent vaginal reconstruction after radical cystectomy that required en bloc removal of the anterior vaginal wall, with a pedicle graft of greater omentum combined with a vicryl mesh. The mean age of the patients was 38 years. The mean operative time of the reconstructive procedure was 50 min. There were no complications regarding the reconstructive procedure. On follow-up, the neovagina accepted two fingers easily and showed a pink-colored smooth lining. Seven patients reported successful attempts of sexual intercourse. It was concluded that reconstruction of vagina after anterior pelvic exenteration in sexually active women can be done safely with the use of vicryl mesh combined with a pedicled omental graft. It is a simple, reliable, and not time-consuming technique. The long-term follow-up was very beneficial in detection of complete healing, postoperative infections, and hormonal activity of the graft and recurrence of malignancy.

Role of recombinent interleukin-12 as an adjuvant on vaccine-induced immunity in murine Schistosoma mansoni infection.

In the present work, the role of recombinent Interleukin-12 (rIL-12) as an adjuvant to soluble worm antigen preparation (SWAP) in protection against primary murine S. mansoni infection, using certain immunization protocol, was studied. A highly significant statistical increase in resistance (P<0.001) was observed between the group immunized with SWAP and rIL-12 (group I) and those immunized with SWAP only (group II), when each was compared to the infection control group (group III). Moreover, resistance to challenge infection was higher in group I (73.6%) than in group II (66.1%). In comparison to group III, histopathological examination of liver sections of groups I and II showed marked reduction in granuloma sizes, with more reduction in group I to the extent that some ova were seen without cellular reaction around them. Liver necrosis and fibrosis were detected only in the infection control group. In contrast to group III, sections in the small intestine did not show any granulomatous reaction in groups I and II. rIL-12, when administered with SWAP could inhibit mesangial cells proliferation in the kidney glomeruli of mice in group I. However, minimal mesangial cells proliferation was observed in the kidney sections from mice in group II, when compared to the prominent proliferation seen in group III. rIL-12 has a prominent role when administered as an adjuvant to SWAP, against primary murine S. mansoni infection and for preventing granulomatous reaction, decreasing worm burden and increasing resistance to infection.

Chemotherapy of Schistosomiasis present and past.

The primary objective of chemotherapy is to cure individual patient by eradication of the infection. This eradication leads to cessation of egg deposition which is the main pathogenic agent for the patient and community. The present generation of antischistosomal drugs provides physicians and public health practitioners with flexible, well tolerated, convenient, highly efficient tools for control of schistosomal morbidity in human, in contrast old generation of antischistosomal drugs were not so.

Hypertension in elderly Egyptians

Global census studies reveal that the elderly are the most rapidly growing population group in both industrialized and less industrialized nations. During 1991 and 1992, three major interventional trials dealt with hypertension in older subjects and the value of antihypertensive treatment in the elderly. These were the American Systolic Hypertension in the Elderly Program [SHEP], the Swedish Trial in Old Patients with Hypertension [STOP-Hypertension], and the British Medical Research Council Trial on treatment of hypertension in older adults. All three trials showed that therapy for hypertension in the elderly reduces the risk of stroke and cardiovascular events. In 1993 evidence from the Egyptian Hypertension Project highlighted hypertension as a national public health problem that must be addressed. Guidelines for primary prevention among all sectors of the community are discussed

Cerebral atrophy: a schistosomiasis manifestation?

Preliminary studies with sonography indicated that a reduced brain mantle index and dilated ventricles were frequently seen in patients with chronic Schistosoma mansoni infection. Computerized tomography (CT) was used to confirm our earlier observations and to obtain more accurate measures. Brain scans of 25 patients with chronic S. mansoni infection showed mild to moderate degrees of cortical atrophy in 9 cases (36%) and central atrophy in 3 (12%). The remaining 16 subjects and 10 controls showed normal brain scans. The present study is the first report documented by CT showing a significant correlation between chronic S. mansoni infection and cerebral atrophy.

An outbreak of Newcastle disease in a pheasant flock in Iraq.

A highly virulent strain of Newcastle disease virus (NDV) was isolated from pheasants in an unvaccinated private imported flock in the Rathwania area near Baghdad, Iraq, which was suffering from ND. The virus was propagated in 9-day-old specific pathogen-free chicken embryos. It was characterised by the following tests: intracerebral pathogenicity index (ICPI), intravenous pathogenicity index (IVPI), mean death time (MDT), haemagglutinin stability at 56 degrees C and mammalian erythrocyte agglutination. The ICPI, IVPI and MDT for the virus were: 1.89, 2.63 and 64 hours respectively. The stability of its haemagglutinin at 56 degrees C was 120 minutes. It agglutinated chicken and pheasant but not bovine, equine and human type "O" erythrocytes.