Drain-free neck dissection: the use of Artiss fibrin sealant.

OBJECTIVE: To study the safety and efficacy of Artiss fibrin sealant in lateral neck dissection, focusing on drain retention time, length of hospital stay and post-operative complications. METHODS: A retrospective review was conducted of patients who underwent neck dissection in a UK hospital over a 12-month period. RESULTS: Twenty-three patients were identified; 13 patients had Artiss and a drain, 10 patients had Artiss only. All drains were removed by post-operative day 2. No post-operative fluid collections or complications were recorded. Patients who had Artiss only without a drain were discharged on post-operative day 1. CONCLUSION: The use of Artiss reduced the drain retention time and hospital stay, with no post-operative complications. Neck dissection can be safely undertaken with no drain, and can potentially be carried out as a day-case procedure, with the application of Artiss. These findings benefit patients and the National Health Service by improving the patient journey and reducing overall costs.

Cross-reaction of antigen preparations from adult and larval stages of the parasite Setaria equina with sera from infected humans with Wuchereria bancrofti.

Crude antigenic preparations from Setaria equina were used in ELISA and Western blotting to examine cross-reaction with human sera from areas endemic for bancroftian filariasis. Sera from normal subjects from non-endemic areas were included as negative controls. Cross-reaction was found between S. equina antigens and antibodies in the sera of Wuchereria bancrofti-infected patients, with the highest levels observed between sera of chronic infected patients and Setaria spp. crude female worm surface antigen (CFSWA). In the absence of active transmission of Setaria spp. infection, CFWSA is useful to detect chronic W. bancrofti infection before patients become symptomatic, particularly when chronic patients are known to be amicrofilaraemic. In the presence of active S. equina infection, antigens from the adult and microfilaraemic stages showed the highest degree of cross-reaction with human sera.

Setaria equina: in vivo effect of diethylcarbamazine citrate on microfilariae in albino rats.

Although diethylcarbamazine citrate (DEC) is successful drug in eliminating human filariasis, yet, its mode of action is still debatable. Herein, the effect of DEC to treat albino rats infected with the animal filarial parasite Setaria equina was tested. Microfilarial (mf) counts and sections from liver, lung, kidney as well as spleen were investigated at different time points after treatment by light microscopy. After 45 and 300min of treatment, a significant decrease in blood mf was observed accompanied by adherence of degenerated mf to both kupffer cells and leukocyte in liver sections. In lung sections, loss of sheath was observed at 45min, while degeneration was observed at later time points. In kidney sections, more mf counts and less matrix were observed in the glomeruli at all time points after treatment. Degenerated mf were observed in spleen sections only at, late time point, 480min after treatment. In conclusion, one of the possible mechanisms by which DEC reduces blood microfilarial count is trapping larvae in organs and killing them through cellular adherence.

Influence of process parameters in electrical discharge machining on H13 die steel.

H13 die steel is characterized by its high hardness and need for special surface features that are obtained by nontraditional machining processes. Electrical discharge machining (EDM) is used to machine hard materials and to produce complicated shapes. In this work, different EDM process parameters are investigated on H13 die steel. Several experiments are conducted to study the effect of three process parameters: peak current (Ip), pulse on-time (Ton) and electrode material on the machining process of H13 die steel. The machining process is evaluated by material removal rate (MRR), electrode wear ratio (EWR%) and surface roughness (SR) as indicators of the process efficiency in terms of quality and cost. Taguchi method was used to investigate the significant effect of process parameters on the performance measurements and the optimal parameters of the EDM process. For analysis and explanations Minitab version 17 software was used. Different process parameters were experimentally investigated and statistically analyzed and the results showed that the copper electrode leads to the highest MRR and lowest EWR%; whereas the brass electrode leads to the lowest SR.

Novel growth of aluminium nitride nanowires.

This work describes novel growth of aluminium nitride (AIN) nanowires by nitridation of a mixture consists of aluminium and ammonium chloride powders (Al:NH4Cl = 1.5:1 weight ratio) at 1000 degrees C for 1 h in flowing nitrogen gas (1 l/min). XRD analysis of the product showed the formation of pure hexagonal AIN. SEM micrographs of as-synthesized product revealed the growth of homogeneous AIN nanowires (phi 40-150 nm). No droplets were observed at the tips of obtained nanowires which suggests that they were grown mainly by a vapor-phase reactions mechanism. Thermodynamic analysis of possible intermediate reactions in the operating temperatures range illustrates that these nanowires could be grown via spontaneous vapor-phase chlorination-nitridation sequences.

Eosinophilic oesophagitis: a systematic review for otolaryngologists.

BACKGROUND: Eosinophilic oesophagitis is a chronic, immune/antigen-mediated oesophageal disease, only recently, but increasingly, recognised in the world literature. It is diagnosed and managed primarily by medical gastroenterologists and allergy specialists, and is a distinct disease entity, affecting both children and adults. Few studies have been published in otolaryngology journals, although otolaryngologists will encounter patients with undiagnosed eosinophilic oesophagitis. Patients may present with dysphagia, bolus obstruction or with other ENT disorders, such as atopic rhinitis, reflecting the underlying systemic allergic disorder. OBJECTIVE: This paper systematically reviews the evidence base published on the epidemiology, clinical presentation, diagnosis, treatment and prognosis of eosinophilic oesophagitis, particularly as it relates to otolaryngology practice.

Cell culture-derived HCV cannot infect synovial fibroblasts.

Worldwide 170 million individuals are infected with hepatitis C virus (HCV), up to 45 million of whom are affected by arthropathy. It is unclear whether this is due to viral infection of synovial cells or immune-mediated mechanisms. We tested the capacity of primary synovial fibroblasts to support HCV propagation. Out of the four critical HCV receptors, only CD81 was expressed to any significant extent in OASF and RASF. Consistent with this, pseudotyped HCV particles were unable to infect these cells. Permissiveness for HCV replication was investigated by transfecting cells with a subgenomic replicon of HCV encoding a luciferase reporter. OASF and RASF did not support replication of HCV, possibly due to low expression levels of miR-122. In conclusion, primary human synovial fibroblasts are unable to support propagation of HCV in vitro. HCV-related arthropathy is unlikely due to direct infection of these cells.

Evaluation of a stage-specific proteolytic enzyme of Schistosoma mansoni as a marker of exposure.

Cercarial elastase (CE) is one of the first proteins released in the host by invading schistosome cercariae. An enzyme-linked immunosorbent assay (ELISA)-formatted immunoassay has been developed to detect antibodies to the stage-specific CE antigen of Schistosoma mansoni as marker of exposure. We have evaluated this test system as an epidemiologic tool, using well-characterized sera collected from S. mansoni- and S. haematobium-infected subjects residing in endemic areas and from control subjects living in nonendemic areas in Egypt. Urine, stool specimens, and blood samples were collected from a sample of 272 endemic subjects randomly selected to represent different age groups in the range of 2-20 years of age. Of 47 S. mansoni-infected subjects, 41 (87.2%) had anti-CE IgG antibodies. Of 52 S. haematobium-infected cases, 38 (73.0%) had IgM antibodies to CE and 43 (82.7%) had IgG antibodies to CE. Of 173 egg-negative people in the endemic area, 84 (48.6%) were IgM positive and 99 (57.2%) were IgG positive. The mean IgM and IgG antibody levels were similar in the infected groups but were significantly lower in the egg-negative group (P = 0.001). All sera from young children (2-3 years of age) were uniformly ELISA negative. The prevalence of IgM and IgG antibodies to CE in children less than six years of age were significantly lower than in other age groups. There was no significant difference in prevalence rates of IgM and IgG anti-CE antibodies between subjects having other parasites present in the endemic area (Ascaris lumbricoides, Entrobius vermicularis, Hymenolepis nana, H. diminuta, Trichostrongylus spp., and Entamoeba histolytica) and those without any parasitic infection. All nonendemic sera (58), including those with other helminth infections, were uniformly ELISA negative for antibodies to CE. These findings suggest that antibodies to elastase indicate exposure, but not necessarily active schistosome infection.

Blockage of skin invasion by schistosome cercariae by serine protease inhibitors.

Invasion of skin by schistosome cercariae is facilitated by a serine protease secreted from the acetabular cells of cercariae in response to skin lipid. Specific inhibitors of the protease, when applied to human skin in formulations designed to retain the inhibitor on and in the upper stratum corneum layers, block cercarial invasion of human skin. Both peptide-based, irreversible inhibitors and non-peptide, reversible inhibitors block cercarial invasion when applied in a propylene glycol:isopropyl alcohol (3:1) formulation in vitro. Arrest of cercarial invasion could be achieved even after immersion of treated skin in water for 2 hr. Peptide-based irreversible inhibitors in the presence of three different Topicare Delivery Compounds optimized arrest of cercarial invasion. The three Topicare Delivery Compounds applied alone prevented 80-100% of cercarial invasion. With inclusion of the inhibitor, there was 97-100% inhibition in vitro. The optimal formulation with inhibitor was then applied to the tails of BALB/c mice, and the mice were exposed to 120 cercariae by tail immersion. With the carrier lotion alone, there was a 50% reduction in worm burden and a 70% reduction in egg burden. When inhibitor was included, an 80% reduction in worm burden and a 92% reduction in egg burden was observed.

Effect of pyridoxine on the blood-retina barrier in experimentally induced hyperglycemia in rats.

We studied the effects on the blood-retina barrier of pyridoxal S phosphate, the biologically active form of vitamin B6 (pyridoxine), in 23 male Long-Evans rats in which hyperglycemia had been induced by means of intraperitoneal injection of streptozocin. Twelve rats were treated with pyridoxine, and 11 rats served as the control group. Vitreous fluorophotometry was used to quantitatively evaluate the effect of pyridoxine. The procedure was done before and 2 weeks after the induction of hyperglycemia, readings being taken 5 and 60 minutes after injection of the dye. In both groups the mean vitreous fluorescein levels after hyperglycemia was induced were significantly higher than those before hyperglycemia was induced (p less than 0.05). The mean levels before hyperglycemia was induced were not significantly different between the two groups. The mean level 60 minutes after injection of the dye after hyperglycemia was induced was lower in the treated group than in the untreated group, although not significantly so. The incidence of lens opacities at 5 weeks was higher in the untreated group than in the treated group (p less than 0.01). We conclude that administration of pyridoxine to hyperglycemic rats for 5 weeks has no significant effect on the permeability of the blood-retina barrier.

Morpho-Physiological and Biochemical Criteria of Acanthamoeba spp. Isolated from the Egyptian Aquatic Environment.

BACKGROUND: The free-living amoebae Acanthamoeba spp., have been recognized as etiologic agents of amoebic encephalitis, keratitis, otitis, lung lesions and other skin infections mainly in immuno-compromised individuals. In this study, morpho-physiological and biochemical characterization of Acanthamoeba strains isolated from the Egyptian aquatic environment were surveyed. METHODS: Some Acanthamoeba species were cultivated on non-nutrient agar. Isolated strains of Acanthamoeba were identification based on the morphology of trophic and cyst forms in addition to temperature and osmo-tolerance assays. Biochemical characterization of the isolated amoeba strains was performed using quantitative assay as well as qualitative determination of proteolytic activity in zymograph analysis. RESULTS: Potentially pathogenic Acanthamoeba species were isolated from all of the examined water sources. Colorimetric assays showed protease activity in the heat-tolerant isolates of Acanthamoeba. All pathogenic isolates of Acanthamoeba exhibited higher protease activity than did the non-pathogenic ones. The zymographic protease assays showed various banding patterns for different strains of Acanthamoeba. CONCLUSION: The incidence and prevalence of the pathogenic Acanthamoeba species in the aquatic environment using parasitological and biochemical diagnostic tools will provide baseline data against which the risk factors associated with waterborne transmission can be identified.

Characterization of an avian influenza virus H5N1 Egyptian isolate.

The highly pathogenic influenza virus H5N1 that infected chickens in Egypt in 2006 was characterized at immunologic and molecular levels. Cloacal swabs from chicken were analyzed by rapid antigen detection and RT-PCR using H5- and N1-specific primers, which confirmed the presence of an H5N1 influenza virus in infected chickens. Sequencing results revealed 100% homology of both genes with previously published sequences of H5N1 isolates from Egypt and the Middle East. The virus was isolated and propagated in MDBK cells in culture. Host cells showed a substantial cytopathic effect within 2 days of infection, which increased dramatically by the fourth day. Plaque infectivity titers of virus harvested from cell culture were initially 10(5)PFUs/ml and increased to 10(8)PFUs/ml after two additional passages and ultrafiltration. Formaldehyde treatment completely inactivated the virus, and MDBK cells inoculated with the killed virus showed no cytopathic effect. Two days after chickens were immunized with the killed virus, their sera showed that the killed Egyptian isolate was highly immunogenic. Western blot analysis showed that sera had antibodies reacting to four viral peptides: hemagglutinin (61.5kDa), RNA-binding protein (56kDa), neuraminidase (50kDa), and 45-kDa protein. In a challenge infection, the vaccine protected immunized chickens from death and reduced viral shedding.

Enzyme-linked immunosorbent assay with worm vomit and cercarial secretions of Schistosoma mansoni to detect infections in an endemic focus of Burkina Faso.

Cercariae and adult Schistosoma mansoni were used to prepare, respectively, cercarial secretions (CS) and worm vomit (WoV). These were used as antigens in an enzyme-linked immunosorbent assay (ELISA) to test the IgG-reactivity of sera obtained in an S. mansoni-endemic area of Burkina Faso. Among the egg-excreting individuals (n = 240), 94.6% reacted positively with WoV, but only 62.9% with CS, thus suggesting a high diagnostic sensitivity of WoV, but not of CS. Among those individuals without detectable eggs in two Kato-Katz thick smears from different stool specimens (n = 215), the respective percentages of positive IgG reactivity were 78.1% and 63.3%. These positive reactions in the absence of detectable eggs are interpreted in terms of limited sensitivity of parasitological stool examinations. Optical density values in ELISA with CS, but not with WoV, correlated negatively with age, which may reflect decreasing exposure to cercariae in older individuals.

Biochemical comparison of the serine protease (elastase) activities in cercarial secretions from Trichobilharzia ocellata and Schistosoma mansoni.

We report on serine protease activity in cercarial secretions (CSs) from the bird parasite Trichobilharzia ocellata. Using a colorigenic substrate, the biochemical properties of this enzyme were studied and its activity was compared to the homologous one in CSs from the human parasite Schistosoma mansoni. The specific serine protease activity was always 2- to 3-fold higher in CSs from T. ocellatacompared to S. mansoni. The enzyme has its optimal activity at pH 10.5, is Ca2+-dependent (inhibition with EDTA) and has a trypsin-like (inhibition with anti-pain) serine proteinase activity (inhibition with PMSF and aprotinin). The K(m) value of the serine protease from T. ocellatawas higher than that of S. mansoni, and the K(i) values for several inhibitors were generally lower for the enzyme of T. ocellatathan that of S. mansoni except for EDTA. The enzyme activities from both parasites had a molecular weight of 30 kDa in gelatin-SDS-polyacrylamide gels. The intensity of the gelatin digestion bands was stronger with the T. ocellata than with the S. mansoni enzyme.

Comparative study on the levels of alpha-fetoprotein (AFP) in different pathological cases.

The research represents a trial to demonstrate the changes which probably took place in AFP levels as a tumor marker among pregnant egyptian women suffering from bilharzial and cancerous infestations. It was found that combination of schistosomal infection with pregnancy leads to obvious high significant increase in AFP in late pregnancy (6-8 months) compared to unpregnant patients. Although the combination between bilharzial infestation and early pregnancy leads to increase in AFP level, the differences were non significant compared to unpregnant ones. There is an extremely significant increase in AFP levels among urinary and intestinal schistosomal pregnant patients compared with healthy pregnant women which was higher in intestinal infection and more pronounced in early pregnancy than late ones. Malignancy in combination with pregnancy caused markable greatly significant increase compared to unpregnant patients, and the increases were slightly higher in bladder than colonic cancerous cases and their AFP levels were gradually increased with progress of both pregnancy and malignancy. In combination of malignancy with pregnant schistosomal infested women to study the effect of schistosomal infection the detected increase in AFP was statistically non significant at early pregnancy and malignancy, turned to significancy at late ones either in bladder or colonic cases.