Partial purification and characterization of extracellular protease from a halophilic and thermotolerant strain Streptomyces pseudogrisiolus NRC-15.

An alkaline protease was purified from a halophilic and thermotolerant potent alkaline protease-producing strain Streptomyces pseudogrisiolus NRC-15 using ammonium sulphate precipitation and Sephadex G-100 column chromatography. The enzyme was purified to 77.24-folds with a yield of 91.8% and the specific activity was 112 U/mg of protein. The protease showed a single band on SDS-PAGE with its molecular mass at 20 kDa and exhibited a maximum relative activity of 100% using casein as a substrate and. The enzyme had an optimum pH of 9.5 and displayed optimum activity at 50°C. The enzyme activity was completely inhibited by the serine protease inhibitor PMSF, suggesting the presence of serine residue in the active site. The enzyme activity was increased by the metal ions Ca2+, Co2+, K+ and Mg2+. The enzyme significantly enhanced the removal of stains when used with wheel detergent, indicating the potential of the enzyme for using as a laundry detergent additive to improve the performance of heavy-duty laundry detergent.

Early results of percutaneous plate fixation of unstable fractures of the dorsolumbar spine

Standard techniques for lumbar pedicle screw fixation involve open exposures and extensive muscle dissection that is associated with extensive blood loss, lengthy hospital stays, and significant cost. Mini-invasive techniques are widely accepted as being the less aggressive procedure in any kind of surgery. Further attempts of development of percutaneous techniques in spinal surgery were reported, but little among them with a real success. The aim of the present study is to evaluate the early results of treatment of unstable fractures of the dorsolumbar spine using the WSH [world spine holding] percutaneous spine fixation system. From March 2005 to March 2006, fourteen patients aged 18 - 58 years with unstable fractures of the dorsolumbar spine without neurological impairment were treated in Mansoura Emergency Hospital with the WSH percutaneous spine fixation system. The range of follow-up of the patients was 6-18 months. The mean operative time was around one hour and blood loss was negligible. The mean hospital stay was two days. According to the modified Macnab criteria, excellent results are 78.6%, good results are 14.3% and fair results are 7.1%. Complications included only one patient with subcutaneous hematoma and the need for screw reposition in one case. No septic problem was encountered. We conclude that preliminary results of the percutaneous fixation of the dorsolumbar fracture were promising allowing the surgeon to perform biomechanically sound internal spinal fixation with minimal tissue trauma to minimize approach related morbidity while achieving the same result as more traditional, invasive approaches

more sensible approach for treatment of pilonidal sinus

Evaluation of surgical management of pilonidal sinus using wide excision with primary closure with rotation-cutaneous flap. This study included 30 patients with chronic pilonidal sinus. A vertical elliptical excision of the sinus down to the presacral fascia was done. A cutaneous skin flap of similar size and shape was raised horizontally over the gluteus muscle fascia. The flap was then rotated about its pivot point to the presacral defect and sutured with vertical mattress stitch of 3-0 polypropylene. Wound infection occurred in 2 [6.7%] patients, minor wound dehiscence occurred in 1 [3.3%] patient. No case developed haematoma, seroma or superficial flap necrosis. The mean healing period was 16.6 +/- 2.9 days [range 12-21 days]. The mean period off work was 21.2 +/- 3.4 days [range 18-27 days]. No case developed re-infection, failed healing or recurrence during the follow up period. This technique is simple, reliable, placing the scars away from the midline and flattening the natal cleft - factors that help to prevent recurrence

Evaluation of preoperative localization of parathyroid adenoma using [99m]tc-sestamibi scintigraphy as a single diagnostic modality for patients with primary hyperparathyroidism

This- study was designed to evaluate the diagnostic yield of Technetium-99m hexakis methoxyisobutylisonitrile [Tc-99m-MIBI] scintigraphy in patients with primary hyperparathyroidism [PHPT] for identification of the site of parathyroid adenoma compared versus operative and histopathological findings. The study included 23 cases with PHPT; 5 nales and 8 females with mean age of 56.5 +/- 10.3; range: 39-69 years. Preoperative scanning using [99m]Tc-sestamibi was done. All patients underwent surgical exploration after methylene blue transfusion. Imaging data were compared with intraoperative finding. All identified and excised glands were sent for histopathological examination. Preoperative sestamibi scan defined a case with mediastinal parathyroid gland and another active cervical gland in 2 patients with persistent and recurrent hypercalcaemia, respectively. Preoperative sestamibi scan defined 6 cases with single parathyroid adenoma in each case, while surgical exploration defined 7 parathyroid adenomata; 5 cases had solitary adenoma and one case had adenoma in 2 parathyroid glands both stained blue after methylene blue infusion. Thus, sestamibi scan defined solitary parathyroid adenomas with an accuracy rate of 83.3%. However, sestamibi scan defined 3 cases with adenoma in 2 parathyroid glands and 2 cases had adenoma in 3 glands. Surgical exploration defined adenoma that confirmed histopathologically in 9 glands of the 12 identified by sestamibi scan; 4 cases had 2 adenomas and one case had one solitary adenoma, the other 3 glands showed only hyperplasia without adenoma formation. Thus, sestamibi scan defined multiple parathyroid adenomos with an accuracy rate of 75%. It could be concluded that preoperative localization of parathyroid gland depending on preoperative sestamibi scan could identify ectopic active glands with accuracy 100% and active cervical glands with an overall accuracy rate of 79.2% and concomitant intraoperative methylene blue localization allowed detection of active glands missed by preoperative sestamibi scan

Minimally invasive fixation for treatment of fracture dislocation of the proximal humeral epiphysis in children

Fracture dislocation of the proximal humeral epiphysis in children is rare and constitutes only 3% of all epiphyseal injuries. In dealing with such fractures, there is still much controversy in treatment modalities. In this study we try to evaluate the results of treatment of proximal humeral epiphyseal fracture dislocation with open reduction and internal fixation. From 2001 to 2004, fourteen children between the age of 4 to 15 years with unstable or irreducible types of fracture dislocation of the proximal humeral epiphysis were treated with minimal exposure, open reduction and internal fixation using Rush rods or K. wires. There were 11 boys and 3 girls. The mean follow-up was 22.7 months [12 - 36]. The union rate was 100% and the average duration of union was 5.9 weeks. According to Neer's scoring system, 13 children [92.9%] had excellent results, and one child [7.1%] had satisfactory results. Occasional pain was a complaint occurs in 2 children [14.3%] and superficial wound infection was detected only in one child [7.1%]. We think that open reduction through minimal exposure and fixation with Rush rods or K. wires is an effective way to manage these unstable or irreducible fractures of the proximal humeral epiphysis as it allows more rapid rehabilitation of the shoulder motion and function

Otitis media with effusion screening in school children seasonal and socioeconomic implications

Children from four primary schools with age range 5-12 years have been screened for otitis media with effusion [OME]. Two schools were located at rural areas and the other two belonged to urban districts. Children of each school were screened at January [winter season] and at September [2000] [late summer season]. The sample in this study showed that the incidence of OME was higher during winter season than summer. Socioeconomic study showed higher incidence of OME in urban areas than rural areas. Gender effect showed male predominance for OME. The age group from 5-8 years had higher incidence for both rural and urban areas during the two seasons, i.e. summer and winter. Children 9-10 years showed another peak of incidence of OME at urban areas only during winter

Quantitative coronary angiography in silent versus manifest ischemia

This study aims at predicting the relation between the percentage stenosis through quantitation of the atheroma by using quantitative coronary angiography [QCA] in patients with silent ischemia in comparison to those with manifest one, and studying whether the severity of the lesion could affect the symptoms or not. i.e. patients with more tight lesions have painful ischemia and those with less severe lesions have painless ischemia. QCA is a new technique for accurate estimation of severity of coronary stenosis. The severity of coronary artery disease [CAD] in silent myocardial ischemia is reported by some investigators to be less and by others to be more than manifest ischemia. The relation between CAD severity and symptomatology is also a matter of controversy. Thirty patients were included in this study, half of them had silent and the other half has painful ischemia. Resting ECG, exercise stress test, 24Hs Holter ECG monitoring and coronary angiography were done to all patients. The following QCA parameters were measured [[%diameter stenosis [%DS],%area stenosis [%AS], length of the lesion in mm and plaque area in mm2]. The QCA parameters were compared in the two groups and correlated to patients' symptoms. No significant correlation was found between the severity of the CAD measured by QCA and patients' symptoms. There was a significant relation between the severity of ischemia during stress test and the QCA parameters in both manifest and silent ischemia. [R=0.56, P=0.002, n=30]. Also, the total ischemic burden during 24Hs Holter monitoring gives a significant relation to QCA parameters [R=0.53, P=0.002, n=30] with no significant relation to the symptoms. Severity of the CAD measured by quantitative coronary angiography affects the duration of ischemia during exercise stress test and 24Hs Holter ECG monitoring but not the severity of the symptoms

Immunoglobulins and cardiac enzymes interrelationship in acute myocardial infarction

This study included 25 patients [16 males and 9 females] with acute myocardial infarction with age range from 40 to 65 years. We assessed the serum level of C K and LDH. IgA and IgG within the first 24 hours of the onset of infraction we found a good significant correlation between CK and IgG [mean 323 +/- 79.96 Vs 208 +/- 77.6 u/ml with r = 0.83, P<0.05]. Also there is a significant correlation between CK and IgA [mean 167 +/- 29.4 u/ml r = 0.72, P<0.05]. While the LDH [mean 191 +/- 65.76 u/ml] show a high significant correlation with IgA [r =0.90 and P<0.05] also it correlated significarnty with IgG [r =0.76, P<0.05]. Also we found less significant correlation between the amplitude of ST segment changes and IgA. [r =0.66 and IgG, r =0.56]. However there was no any correlation between the depth or duration of the Q wave and any of the cardiac enzymes or immunoglobulins .So we can conclude that C K. IgA and IgG are significant elevated than normal in almost all patients. IgG is elevated early even earlier than CK and show a close relation to CK while is closely related to LDH