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PubMed2006

The clinical picture of hepatitis C virus as a concomitant infection with fascioliasis.

Hepatitis C and human fascioliasis are two of the most important public health problems locally and internationally. Each one has its own complications regarding spreading to man, clinical picture, laboratory and serologic diagnosis, treatment and prevention. Concomitant human infection with both magnified the complications. Clinically, both diseases (HCV and fascioliasis) have their own broad signs and symptoms. In concomitant infection, the clinical pictures of both showed some variations. The most common feature in fascioliasis and HCV patients was easy fatigability in 78.6% and the lowest was 7.18% for each of tympanic abdomen, tender colon, tender right upper quadrant, itching, arthritis, epi-gastric pain, and right quadrant pain. The eosinophilia % ranged from 5-24 and the haemoglobin ranged from 7-11.1 gm/dl. In patients with fascioliasis alone, the most come feature was pallor in 96.15% and the lowest was 3.85% for each of splenomegaly, ascites and itching. Eosinophilia % ranged from 1 to 22 and haemoglobin ranged from 6-12 gm/dl. In general, the double infection with both HCV and fascioliasis magnified the laboratory and clinical pictures of such patients.

Adolescent↗
PubMed2006

Infection of Blastocystis hominis in primary schoolchildren from Nakhon Pathom province, Thailand.

A study was conducted to evaluate the infection status of Blastocystis hominis in children from four public schools in Phuttamonthon district, Nakhon Pathom province, Thailand during November to December 2004. A total of 814 faecal specimens were used for B. hominis cultivation using Jones' medium. Mixed infections with other intestinal parasites were also examined by formalin ethyl acetate concentration method. It was found that 13.51% (110 of 814) of the children examined were infected with B. hominis. Mixed infections with other intestinal protozoa and helminths were observed in 10.91% (12 of 110) of B. hominis positive specimens. There were Giardia lamblia cysts (4.55%), Trichomonas hominis trophozoites (1.82%), Entamoeba histolytica cysts (0.91%), Endolimax nana cysts (0.91%), Strongyloides stercoralis larvae (0.91%), hookworm eggs (0.91%), and Trichuris trichiura eggs (0.91%). Of the children positive for B. hominis, there was no significant differences between sex (P > 0.05) and showed no correlation between age and the percentage of infection. The different infection rates among four schools indicated the involvement of hygienic factors which promoted the infection of this common intestinal protozoan. Variation in size of B. hominis was found in culture medium, which might indicate to the presence of different strains of B. hominis infection.

Adolescent↗
PubMed1991

[Evaluation of cerebral hemodynamics by transcranial Doppler in anesthesia and reanimation].

Doppler technics are widely used for the investigation of the peripheral flows. The main objective of the method is to detect and quantify the vascular disease (stenosis, arterio-venous malformation) at the level of the carotid bifurcation or on the intracranial vessels. The spectral analysis provides informations on the velocity profile, and allows to quantify systolic, diastolic, and mean frequencies from which the usual haemodynamic parameters are determined. In case of vasospasm, the maximal frequency increases significantly (> 3 kHz). The amplitude of the diastolic flow is related to the vascular resistance. Vascular disease or distal vessel compression make the resistance increase; on the contrary vasodilation decreases the vascular resistance. The Doppler index R = S-D/S, with S and D the systolic and diastolic amplitude is generally accepted to change in proportion with the vascular resistance. The blood flow volume can be evaluated from the mean Doppler frequency, the vessel diameter, and the angle theta between the vessel and the Doppler beam. In case of intracranial arteries the diameter cannot be accurately measured by echography. Nevertheless if the diameter does not change and the angle theta remains constant, the variations of the mean frequency represent the blood flow volume changes. If there is a vasospasm, this method cannot be used, and the only possibility to evaluate the cerebral blood flow changes is to measure the variations of the common carotid blood flow or carotid mean frequency. The haemodynamic parameters are used in anesthesiology or in intensive care.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗
PubMed1989

Problems with patients' compliance in peptic ulcer therapy.

The problem of patient compliance in peptic ulcer therapy is difficult to approach, especially because very few studies in the recent literature have focused on this aspect. Even when discussed, it is of marginal or secondary importance. We lack precise definitions and validated measurement techniques. Analysis of the data now available does not allow the validation of the theoretical parameters currently thought to influence compliance: psychological factors, disease factors, and treatment factors. Nevertheless, it seems, from a review of the studies, that despite the imperfect methodology commonly used, the variations in treatment regimens do not play an important role in patient compliance. This impression needs to be confirmed by new, specific prospective studies.

Humans↗
PubMed1989

[Endoscopic treatment of gallstones: new technics].

Since endoscopic papillotomy and extraction of stones out of the bile duct have become established procedures, the therapeutic approach to choledochlithiasis has fundamentally changed. 80 to 90% of all stones can be extracted by this method. New techniques can be applied for larger stones or for anatomical variations of the common bile duct. Mechanical lithotripsy, a technique by which further 80 to 90% of the remaining stones can be extracted, has been perfected for clinical use. In addition, laser lithotripsy, guided by choledochoscopy, is an elegant alternative for treating large solitary concrements. Extracorporal shock wave lithotripsy, too, is a valuable technique in certain cases. Applying these new techniques has further improved therapeutic results. Despite all this progress, however, it should not be forgotten that, besides the surgical removal of bile duct stones, the condition of choledocholithiasis can, especially in old people, run a mild and uneventful course.

Ampulla of Vater↗
PubMed1987

Globin gene-associated restriction-fragment-length polymorphisms in southern African peoples.

The combination of polymorphic restriction-enzyme sites in the 3' region of the beta-globin gene cluster shows very little variation in southern-African Bantu-speaking black and Kalahari !Kung San populations. The sites of the 5' region, on the other hand, show marked variation, and two common haplotypes are present--the "Negro" type (- - - - +) and the "San" type (- + - - +)--in frequencies of .404 and .106, respectively, in the Bantu-speakers and .262 and .405, respectively, in the San. Twenty of 23 beta s-associated haplotypes in southern-African Bantu-speaking black subjects were the same as that found commonly in the Central African Republic (CAR)--i.e., the "Bantu" type--a finding providing the first convincing biological evidence for the common ancestry of geographically widely separated speakers of languages belonging to the Bantu family. The (-alpha) haplotype has a frequency of .21 in the Venda, .07 in both the Sotho-Tswana and the Nguni, and .06 among the !Kung San. These data are interpreted in the light of Plasmodium falciparum malaria selection and population movements in the African subcontinent.

Africa, Southern↗
PubMed1977

Pathology of cardiomyopathy. An autopsy analysis of twenty-five cases.

Pathology of twenty-five autopsied causes of cardiomyopathy is presented. Twenty cases were those of congestive cardiomyopathy. The ages varied between eleven and sixty-eight years and there were nine females and eleven males. The heart weights ranged between 240 gm and 600gm. Thrombi in the heart were encountered in 60% cases. Five cases conformed to endomyocardial fibrosis. The age ranged between twelve and forty years and all were males. Three cases out of five had severe left inflow tract involvement. Only one case showed predominant right sided involvement. No cases of hypertrophic cardiomyopathy were encountered. There appears to be a higher incidence of EMF in the Southern parts of India as compared to the other regions where COCM is most commonly encountered. The variation in the type of cardiomyopathy encountered in different parts of India, may well be related to dietary, climatic conditions or infections, peculiar to that area.

Adolescent↗
PubMed1987

Evaluation of the neck veins.

In spite of numerous technical advances in cardiovascular diagnosis, the bases for determination of the need for diagnostic tests and therapy and for evaluation of the response to therapy often remain the history and bedside physical findings. The complete cardiovascular examination includes evaluation of the arterial pulsations, the precordial pulsations, and cardiac auscultation. The correct interpretation of the jugular venous pulse is an integral part of the examination. The jugular venous pulsations reflect the systolic and diastolic hemodynamics of the right atrium and, in the absence of obstruction of the tricuspid valve, of the right ventricle as well. When correctly interpreted, the jugular venous pulsations provide information about right ventricular hemodynamics and important clues to the diagnosis. Instead of trying to find the classically described A and V waves in normal people, one should look for the systolic collapse of the normal jugular venous pulse. When one is thoroughly familiar with the normal variations, the few common abnormalities are easy to appreciate.

Cardiomyopathies↗
PubMed1985

Generation of troponin T isoforms by alternative RNA splicing in avian skeletal muscle. Conserved and divergent features in birds and mammals.

We describe the isolation and sequence analysis of quail muscle cDNA clones encoding two closely related isoforms of the striated muscle contractile protein, troponin T. The cDNAs represent two troponin T mRNAs that exhibit an unusual sequence relationship. The two mRNAs have identical sequences over hundreds of nucleotides including 3' untranslated regions, but they differ dramatically in a discrete, internally located block of 38 nucleotides. The two alternative sequences of this 38-nucleotide block encode two different but related versions of amino acid residues 230-242, near the C terminus of the protein. These results are consistent with a novel mechanism of troponin T isoform generation by alternative mRNA splicing pathways from a single gene containing two different exons corresponding to amino acids 229-242, as recently proposed by Medford et al. (Medford, R. M., Nguyen, H. T., Destree, A. T., Summers, E., and Nadal-Ginard, B. (1984) Cell 38, 409-421). This proposal was based on analysis of a rat troponin T genomic DNA clone and a cDNA clone corresponding to one of the two alternatively spliced mRNAs. Our analysis of quail troponin T cDNA clones, apparently corresponding to two alternatively spliced mRNA species, provides important new evidence for this novel mechanism of troponin T isoform generation and reveals the differential splicing mechanism to be of great antiquity, antedating the bird-mammal divergence. One of the quail alternative isoform sequences clearly corresponds to one of the rat sequences, but the other quail alternative sequence does not correspond to either of the rat sequences. This result suggests a greater complexity of troponin T gene structure or a greater diversity of troponin T isoform genes than is currently known, and also has implications for the functional significance of the troponin T protein isoform heterogeneity. Comparison of quail and mammal alternative isoform sequences also reveals strongly conserved features which suggest that all the isoform alternative amino acid sequences are variations on a common structural theme.

Amino Acid Sequence↗
PubMed1982

Dimensions of effective preclinical teaching.

The purpose of this study was to identify the factors underlying dental students' evaluations of preclinical instruction. Ninety sophomore students in academic year 1979-80 and 74 sophomore students in academic year 1980-81 rated five preclinical instructors in a fixed prosthodontic technique course. At the end of the course, prior to final examinations, students received a 24-item evaluation instrument designed to assess preclinical teaching behavior. All items were rated on a 5-point scale, with response options ranging from no agreement to strong agreement. Factor analytic techniques were used to identify common sources of variation among items. Results indicate that 22 of the 24 items correspond to two underlying, stable dimensions that summarize preclinical teaching effectiveness, teaching style, and orientation toward students. The discussion compares teaching effectiveness dimensions identified in dental education studies with dimensions identified in studies of college instruction.

Education, Dental↗
PubMed1994

Present status of computerized tomography and angiography in the diagnosis of cerebral thrombophlebitis cavernous sinus thrombosis excluded.

In order to evaluate the contribution of computerized tomography (CT) to the diagnosis of cerebral thrombophlebitis, a series of 28 cases was reviewed and compared with data from the literature. In an examination carried out 4 to 5 days of its constitution the thrombus may be directly visualized as a spontaneous hyperdensity. This early but very transient sign, called "cord sign", can easily be overlooked, which explains why it was found in only 5 of our 28 cases and in 2% of the largest series of the literature. The thrombus thereafter becomes hypodense and can be intensified by peripheral contrast enhancement which produces the classical "delta sign". This sign is more frequent: 13/28 in our series and 16 to 30% in published cases. It is usually found in the superior sagittal sinus and must be distinguished from anatomical variations which are common at that level. These two direct signs acquire a greater value when associated with such indirect signs as diffuse or localized cerebral oedema (12 to 52%) and venous ischaemia (22 to 59%). Venous ischaemia is characterized by its strong bleeding potential (more than 50% of the cases) and by its usually favourable course; these two elements and its site differentiate it from arterial ischaemia. Finally, venous stasis is responsible, in 5 to 19% of the cases, for intense enhancement of the tentorium cerebelli; this sign is not specific but easy to evidence and of great value when associated with a direct sign. Dilatation of cortical veins, found in 4 of our 28 cases, also seems to be an interesting sign which, to our knowledge, has not yet been mentioned in the literature. Since in 3.6 to 26% of the cerebral thrombophlebitis the CT scan is normal, a negative CT examination does not rule out this disease, and in many cases the exploration must be rapidly completed by angiography or MRI. Because it is non-invasive and very sensitive to flows, MRI has become the key examination to assert the diagnosis. Angiography is now restricted to those cases where cases where MRI cannot be performed promptly or to certain, purely cortical thrombophlebitis which might pass unnoticed at MRI. When carried out and interpreted cautiously, angiography always shows the venous thrombosis, its exact size and its suppletive network. The results of this study show that MRI alone can diagnose cerebral thrombophlebitis in most patients, that CT well done and interpreted often provides useful but seldom sufficient indices, and that angiography should be reserved for difficult cases.

Cavernous Sinus↗
PubMed1996

Improved rapid detection of the PML/RARalpha fusion gene in acute promyelocytic leukemia.

Acute promyelocytic leukemia (APL) is a medical emergency which requires rapid diagnosis and tailored treatment. Detection of the PML/RARalpha fusion gene in APL blasts is critical to start promptly the specific therapy with all-trans retinoic acid (ATRA). APL lacking this genetic lesion have been reported as being ATRA resistant. Reverse-transcription polymerase chain reaction (RT-PCR) has been extensively used to detect the PML/RARalpha cDNA. The reported PML/RARalpha amplification techniques are laborious and time consuming, and include conventional RNA extraction, cDNA synthesis and a two-round (nested) PCR. We hereby describe a few variations of the commonly adopted RNA extraction and PML/RARalpha RT-PCR protocols which allow a molecular diagnosis of APL to be carried out in less than 5 h. Processing of small volumes of leukemic cell lysate (0.5 ml) in a microfuge allows extraction of good quality RNA in 1 h. After reverse transcription to obtain cDNA, a 'hot start' PCR procedure was adopted which enabled us to amplify clearly visible and specific products after a single (not nested) amplification round. The PML/RARalpha fusion gene was detected in the blasts of six consecutive APL at diagnosis, and an APL-tailored protocol including ATRA was started in each case within 6 h of admission. On repeated experiments, the assay proved highly specific and sensitive for the rapid detection of all PML/RARalpha transcript types. Our data should encourage the use of this rapid procedure for the diagnosis of both typical APL and, particularly, less typical cases awaiting urgent therapeutic intervention.

Base Sequence↗
PubMed1977

Electrophoretic variation in the partial deficiency of hypoxanthine-guanine phosphoribosyltransferase.

Mutant hypoxanthine-guanine phosphoribosyltransferase from four patients with a partial deficiency of this enzyme has been studied by isoelectric focusing. The isoenzymes found in these hemolysates were different from the normal isoenzymes and were different from each other. These observations suggest that electrophoretic variation is a common occurrence in this disorder and they support the existence of structural gene mutations with genetic heterogeneity in this X-linked hyperuricemia.

Blood Protein Electrophoresis↗
PubMed1998

Pharmacokinetic analysis for assessing developmental toxicity of a new synthetic acetolactate synthase inhibitor, LGC-40863, in rats.

Effects of O-[2,6-bis[(4,6-dimethoxy-2pyrimidinyl)oxy]benzoyl]oxime (LGC-40863) on dams and embryonic development were examined at p.o. doses of 500, 1000 and 2000 mg/kg/day on days 6 to 15 of gestation in rats. No significant maternal or embryonic toxicity was observed at any of the doses. However, external fetal anomalies including brachycephaly, microcephaly, micrognathia, agnathia, lordosis and edema were observed at an incidence of 2.2% at the lowest dosage level but not at higher dosages. Because these malformations are not common as spontaneous variations in rats, we carried out a toxicokinetic study to clarify whether the fetal anomalies at 500 mg/kg are related to LGC-40863. During multiple p.o. administrations of LGC-40863 at the same doses used in the developmental toxicity study, LGC-40863 was not detected in the systemic circulation. Moreover, 3 months of multiple dosing did not alter its plasma level. In the pregnant rats receiving 500 mg/kg on 10 consecutive days of gestation, LGC-40863 was also undetectable. However, after i.v. administration, high levels of the drug were found in plasma, and these could be described by a two-compartment model. These results demonstrate that the bioavailability of LGC-40863 is negligible. To investigate a possible relevance of metabolite(s) to the fetal anomalies, we examined excretion of radioactivity after p.o. doses of 500 and 2000 mg/kg of LGC-40863 spiked with [14C]LGC-40863. For both doses, cumulative recovery up to 72 hr was approximately 80% and 9% in feces and urine, respectively, indicating dose linearity in the elimination kinetics. Overall, these toxicokinetic data suggest that the fetal anomalies observed at 500 mg/kg are not associated with LGC-40863 but are spontaneously generated. In conclusion, LGC-40863 had neither significant maternal nor developmental toxicity at any of the doses tested for p.o. exposure.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Community-based heart health promotion: perceptions of facilitators and barriers.

This paper examines factors that facilitate or impede the implementation of heart health activities in Ontario public health departments using survey (n = 262) and depth interview (n = 56) data from Canadian Heart Health Initiative-Ontario Project (CHHIOP). The data were consistent in revealing factors related to leadership, staffing, resources, internal organization, and characteristics of the surrounding community as the primary facilitators or barriers. Diversity within these common themes reflected variation due to external factors in the communities served by the health unit and factors internal to the health unit itself. The findings advance knowledge of the factors that influence predisposition and capacity to undertake community-based heart health promotion in public health departments, and they underscore the challenge of achieving integrated programs among partner agencies.

Attitude of Health Personnel↗
PubMed1995

Hepatitis B virus (HBV) sequence variation of cytotoxic T lymphocyte epitopes is not common in patients with chronic HBV infection.

It has been suggested that immune selection pressure exerted by the cytotoxic T lymphocyte (CTL) response could be responsible for viral persistence during chronic hepatitis B virus infection. To address this question, in the current study we compared the DNA and amino acid sequences of, and the CTL responses to, multiple HLA-A2-restricted CTL epitopes in the hepatitis B virus in several HLA-A2-positive patients with acute and chronic hepatitis. Our results indicate that the CTL response to these epitopes is barely detectable in the majority of patients with chronic hepatitis. Further, we show that the weak CTL response is not secondary in infection by mutant viruses lacking these epitopes, and we show that the CTL response did not select for escape mutants in any of these patients. We conclude that an ineffective hepatitis B virus specific CTL response is the primary determinant of viral persistence in chronic hepatitis and that immune selection of viral variants is not a common event in the majority of patients.

Acute Disease↗
PubMed2006

The relationship between anatomic variations of paranasal sinuses and chronic sinusitis in children.

CONCLUSIONS: Anatomical variations in the nose and paranasal sinuses are common in children. Due to the absence of a definitive relationship between anatomical variations and sinus disease, local, systemic or environmental factors appear to be more significant in pediatric sinusitis than the anatomic variations. OBJECTIVE: Chronic sinusitis is increasing in the pediatric population. Following the initial reports of functional endoscopic sinus surgery (FESS) for children, the majority of patients undergoing this procedure have experienced improved quality of life. Thus, we need to know the precise anatomy and anatomical variations of the nose, as well as the relationship between such anatomy and chronic sinusitis. PATIENTS AND METHODS: To determine the extent and distribution of disease, as well as associated anatomic abnormalities, computed tomography (CT) scans were performed on 113 children with persistent symptoms of sinusitis after failure of medical therapies. RESULTS: The maxillary sinus was the most commonly involved sinus, followed by the ethmoid, sphenoid, and frontal sinuses. There was no relationship between age and severity of sinusitis. Agger nasi cell was the most common anatomical variation, followed by septal deviation, Haller cell, concha bullosa, paradoxical middle turbinate, and Onodi cell. The prevalence of septal deviation increased with age. There was no significant relationship between the sinusitis and anatomic variations.

Adolescent↗
PubMed2004

Genetic variation analysis within and among six varieties of common carp (Cyprinus carpio L.) in China using microsatellite markers.

Five microsatellites were used to study the genetic diversity and genetic structure of one wild and five domestic varieties of common carp in China (the Yangtze River wild common carp, Xingguo red carp, purse red carp, Qingtian carp, Russian scattered scaled mirror carp and Japanese decorative carp). All loci in this study showed marked polymorphism with the number of alleles from 4 to 13. Domestic varieties (except Xingguo red carp) showed less genetic diversity than the Yangtze River wild common carp in terms of allelic diversity. Population differentiation was assessed and each combination of populations displayed significant differentiation (p < 0.05) with the exception of that between the Yangtze River wild common carp and Xingguo red carp. Genetic distance analysis (Nei's standard genetic distance and pairwise F(st) distance) showed that the largest distance was between Russian scattered scaled mirror carp and the Yangtze River wild common carp and the smallest distance was between the Yangtze River wild common carp and Xingguo red carp. However, among six populations Japanese decorative carp displayed the highest level of variability in terms of heterozygosity.

Animals↗