[Optimization of loop-mediated isothermal amplification [LAMP] method for detection of herpes simplex virus type 1 and 2]

Type 1 and type 2 herpes simplex [HSV] virus cause infection of central nervous system [encephalitis] in human. The molecular techniques are the best methods for detection of HSV. In this study we evaluated the novel molecular technique of LAMP for detection of HSV-1 and HSV-2. In this experimental study 184 cerebrospinal fluid [CSF] samples were collected from Mofid Hospital. DNA of every sample was extracted by use of Sinagen DNP kit. Based on the HSV DNA polymerase gene, a set of 6 primers were designed and sensitivity and specificity of this method were determined. By adding SYBER Green, LAMP product was identified. The results of LAMP method were compared to those of PCR by chi-square test. Sensitivity of LAMP method determined to be 5 copies/ tube and sensitivity of PCR method determined to be 50 copies/ tube. Both LAMP and PCR methods showed 100% specificity for detection of HSV type 1 and type 2. Among 184 samples, 60 samples were positive by LAMP but 45 samples were positive by PCR method. Sensitivity of LAMP was 10 times higher than that of PCR. Comparison of the results of the two methods by means of chi-square test showed a significant difference [p<0.05]. LAMP method had high sensitivity and specificity for detection of type 1 and type 2 HSV in CSF samples

[Correlation between P53, P63 expression and HPV infection with staging and grading of oral squamous cell carcinoma]

Squamous cell carcinoma is the eighth common cancer and forms 94% of oral malignancies. Nowadays, many molecular and genetic changes have been known to affect tumoral behavior which might be good for drug production and gene therapy. It has been known that mutated P53, overexpression of P63 as an oncogene and HPV infection are correlated with clinicopathological behavior of oral squamous cell carcinoma [OSCC] and it's prognosis and overall survival rate. The aim of this study is to determine the correlation between the expression of P53, P63 and HPV infection with oral squamous cell carcinoma and it's clinical staging and microscopical grading. Forty paraffin blocks with diagnosis of OSCC were collected from the pathology department, Shahid Beheshti School of Dentistry and the Department of general pathology, Taleghani hospital. Immunohistochemical staining was performed with antibodies against P53 and P63 and for detection of high risk types of HPV [HPVI6, 18] polymerized chain reaction [PCR] was used. Spearman correlation test was used for data analyzing. In this analytical cross-sectional study, we found significant correlation between P53 total score and staging [P=0.0001] and P53 total score and grading [P=0.013]. There was also significant correlation between P63 proportional score and grading [P=0.049]. HPV 16 also had significant correlation with P53 total score [P=0.003]. The mean nuclear staining of P53 was 33.04 +/- 25.66% [01=24.94-41.14] and P 63 was 39.25 +/- 19.35 [CI 33.13-45.37]. HPV frequency was 40% [HPV 16=20% and HPV18=7.5%]. There was no significant correlation between P63 and HPV infection [P>0.05]. We concluded that P63 could be a diagnostic marker for grading of OSCC and P53 and P63 expression might have some role in progression of OSCC and its clinicopathological behavior. Presence of HPV especially HPV 16 may be regarded as a risk factor in OSCC

Abnormal brain MRI in a case of acute ataxia as the only sign of abdominal neuroblastoma

Ataxia is a movement disorder that may manifest an acute, intermittent, non progressive or chronic progressive course. Ataxia alone is rare as a paraneoplastic sign, especially if it is due to neuroblastoma [abdominal or chest]. We report an abdominal neuroblastoma in a two-year-old girl presenting with only acute ataxia and abnormal neuroimaging. Brain MRI showed abnormal signal finding in the medulla, pons, corticospinal tract and the periventricular space. In the abdominal CT, a mass was detected in the right adrenal gland with calcification and the histopathologic examination re-vealed neuroblastoma. We suggest in children with acute ataxia, with or without opsoclonus-myoclonus, neuroblastoma should be considered

10 year survey on childhood CNS tumors

Tumors of the central nervous system constitute the largest group of solid neoplasms in children and are second only to leukemia in their overall frequency during childhood. The main purpose of the present study is to determine the incidence, age, sex, location and histological diagnosis of CNS tumors in children, less than 15 years of age, in the Mofid Children's Hospital, in the past 10 years. In this descriptive retrospective study we reviewed the medical records of 143 children with diagnosis of CNS tumors admitted during the past 10 years in neurology and surgery departments of Mofid Children's Hospital between the years 1996 and 2006. During the 10 year study period, CNS tumor was diagnosed in 143 patients; of these tumors, 119 were intracranial and 58 were intraspinal; 51.3% of brain tumors were located in the supratentorial and 48.7% in the infratentorial regions. The most common intracranial neoplasms were astrocytic tumors [36.8%], embryonal tumors [31.1%] and ependymal tumors [13.4%]. Of the intraspinal neoplasms the most frequently noted were embryonal tumors [37.5%], mesenchymal meningothelial tumors [20.8%], followed by astrocytic tumors [16.7%]. The median age at diagnosis was 8.9 +/- 4.1 years with a male to female ratio of 1.4:1 [P<0.5]. The most common intracranial astrocytic and embryonal neoplasms were pilocytic astrocytoma and medulloblastoma/ PNET respectively. Brain tumors in children constitute a diverse group in terms of incidence, distribution and histopathological diagnosis

Malignant giant cell tumor of soft parts in lumbosacral region

Giant cell tumor of soft parts is a rare neoplasm that mainly affects adulst and the elderly and is usually located in the extremities. Here we report a child with giant cell tumor of soft tissue, which is a very rare condition in childhood Clinical presentation: A 5 year old girl presented with a 5 month history of left lower extremity pain. She had developed paraplegia before admission. On examination, mild left lumbosacral swelling and tenderness was found. Abdominal and pelvic CT-Scan revealed an expansile lytic lesion of the left side of sacrum with significant soft tissue component extending toward the left iliac bone. Lumbar MRI revealed a space occupying lesion originating from posterior L5 elements, projecting toward the L1.Intervention: The patient underwent surgery. A firm epidural hemorrhagic tumor of L5, S1, and S2 with no spinal cord involvement was found. Partial tumor resection [measuring 3*1*0.5 cm in maximal diameter] and laminectomy was done. Primary giant cell tumors of soft tissue are distinctive, rare neoplasms that exhibit a wide clinicopathologic spectrum similar to osseous GCTs and need to be differentiated from other giant cell rich soft tissue tumors. Recognition of this tumor is important due to its behavior as a low grade malignancy, but this cannot be predicted and metastasis does occur rarely

[Diagnosis of rotavirus and adenovirus type 40/41 in children with acute diarrhea by immunochromatography in Mofid Children Hospital]

Acute diarrhea is one of the leading causes of worldwide mortality and morbidity; four millions annual deaths. The aim of this study is to investigate the prevalence of rotavirus and adenovirus among children with acute diarrhea and to evaluate their clinical and laboratory findings. 199 children aged 1 to 168 months with acute diarrhea were studied in "Mofid" Children Hospital for a one year period. Clinical and laboratory findings including stool culture and WBC and RBC counts in their stool samples were analyzed. From 199 children with diarrhea, 14 cases [7%] were positive for viruses; 11 [5.5%] rotaviruses and 3[1.5%] adenoviruses. In Rotavirus and adenovirus, male to female ratio were 1.2/1 and 2/1, and the mean age were 40.8 and 20.4 months, respectively. Clinical findings comprised frequency, dehydration, fever, vomiting and watery diarrhea. Stool culture was negative and no RBC and WBC were detected. High prevalence of rotavirus and adenovirus in former studies and low prevalence of rotavirus in this study seems to be caused by the diagnostic method we used. Since a fast laboratory process is necessary for immunochromatography, other methods as EIA and PCR are recommended

[Diagnostic value of urinary N-Acetyl Glucose Aminidase in pyelonephritic patients]

Urinary tract infection [UTI] is one of the most common bacterial infections among children and its prevalence is between 5-7% in females and 1-1.6% in males.Urosepsis, febrile seizure, renal insufficiency and hypertension are common complications of acute pyelonephritis in children. The aim of this study was to evaluate the diagnostic value of urinary NAG in pyelonephritic patients. This is a Quasi Experimental study conducted between April 2005 and May 2006 on 72 children admitted in Mofid Hospital due to pyelonephritis. The first sample [fresh random urine] was obtained and its levels NAG and Creatinin were measured. The second one was obtained on 48th hour of after-treatment period. We examined pyelonephritic children [75% female] with mean age of 43 +/- 39 months. Post-treatment urinary NAG lavel was significantly higher than pre-treatment. Urinary NAG revealed to have a sensitivity of 78% and specificity of 72% in diagnosis of pyelonephritis. There was no significant correlation between urinary NAG level and CBC, ESR, CRP, Urinary WBC, Ultrasonography, DMSA scan and VCUG. We concluded that Urinary NAG is a sensitive and specific test in diagnosis of pyelonephritis

C-reactive protien and lactate dehydrogenase in serum and cerebrospinal fluid in rapid and early diagnosis of childhood meningitis

Bacterial meningitis is still a life threatening epidemiological problem especially in many developing countries; considering its dire consequences, its prompt and accurate diagnosis has become a priority for clinicians. Because of the various limitations of conventionally used laboratory techniques, we evaluated and compared the diagnostic utility of C-reactive protein and lactate dehydrogenase in serum and cerebrospinal fluid in the diagnosis of bacterial meningitis and its effectivity in distinguishing it from aseptic meningitis. A total of 125 pediatric cases, aged between 1 month and 12 years, including patients with bacterial meningitis [n=45], aseptic meningitis [n=42] and a control group [n=38], were retrospectively analyzed on the basis of data from the initial clinical examinations. Cultures, smears and other common serum and CSF indices were compared with serum and CSF CRP levels and LDH activity. Compared with each of the other variables, there were significant differences in the mean values of serum-CRP, CSF-glucose, CSF-LDH and CSF/serum LDH ratio between the bacterial and aseptic meningitis groups [p<0.001]. Of all the tests applied, the highest sensitivity [95%] and negative predictive value [95%] belonged to CSF-LDH activity and the most specific [100%] test with the highest positive predictive value [100%] was CSF-CRP titration as well as smear and culture. Combination of CSF-CRP serum-CRP, and CSF-LDH yielded the highest sensitivity [100%] and negative predictive value but the combined application of CSF-LDH and CSF-CRP proved to be the most specific and efficient. In the presence of a normal CRP titration and low glucose level in CSF, bacterial meningitis is excluded, whereas elevated level of CSF-LDH activity is a valid confirmatory predictor of BM. In addition, combination of these three tests with serum CRP is far more effective than the separate determination of any of these parameters

[Nocardiosis; a case report]

Nocardia could be transmitted to lungs through dust particles; then transmitted to other organs via vascular system. We describe a 11-year old boy presenting with headache and vomiting. CT studies revealed hemorrhage in his right hemisphere as well as cerebral edema. He was hospitalized with primary diagnosis of hydrocephaly and pseudotumor cerebri. Further studies showed nocardia astroides in acid fast and blood agar culture