Detection of blaoxa genes and identification of biofilm-producing capacity of Acinetobacter baumannii in a tertiary teaching hospital, Klaten, Indonesia.

INTRODUCTION: Acinetobacter baumannii (A. baumannii) is commonly found as an agent of nosocomial infections and demonstrates a high antibiotic resistance due to its carbapenemase production. The objectives of this study were to explore the antibiotic resistance pattern, the presence of OXAs genes and the biofilm-producing capacity of A. baumannii isolated from clinical specimens. METHODS: Antibiotics susceptibility testing, detection of OXAs genes and the biofilm-producing capacity were performed using the Kirby Bauer method, polymerase chain reaction (PCR) and adherence quantitative assays, respectively. RESULTS: A total of 80 A. baumannii isolates were mainly obtained from sputum and most of them were resistant to antibiotics. All A. baumannii carried blaOXA-51 gene, yet no blaOXA-24 and blaOXA-58 genes were detected. Fourteen (82.4%) of the 17 meropenem resistant isolates carried blaOXA-23 gene, but it was not found in meropenem sensitive isolates. In addition, sixty (75.0%) of 80 isolates were biofilm producers with 2 (2.5%), 16 (20.0%), and 42 (52.5%) isolates were identified as strong, moderate and weak biofilm producers, respectively. CONCLUSION: Most of A. baumannii isolates had a high level of antibiotic resistance and had a capacity to produce biofilm.

Predictive value of assessment of different modalities in the diagnosis of infantile cholestasis.

This study investigated the relative accuracy and roles of abdominal ultrasonography, hepatobiliary scintigraphy and liver biopsy in the diagnosis of infantile cholestasis. A total of 50 infants (27 females) aged 1 - 12 months were classified into those with intrahepatic causes of cholestasis (n = 22) and those with extrahepatic causes (n = 28). Cholestasis is caused by a wide range of conditions and diagnosis requires meticulous history taking, thorough clinical examination and many laboratory tests. The most common cause of intrahepatic cholestasis was found to be idiopathic neonatal hepatitis (54.5%), followed by infectious hepatitis (9.1%), metabolic liver diseases (9.1%), intrahepatic biliary atresia (9.1%) and Alagille syndrome (4.5%). The most common cause of extrahepatic cholestasis was extrahepatic biliary atresia (96.4%). The incidence of choledochal cyst was low (3.6%). The cornerstone of the diagnosis of infantile cholestasis was found to be liver biopsy, which was associated with a high degree of accuracy.

Evolution of Physiologic Races and Virulence of Puccinia striiformis on Wheat in Syria and Lebanon.

Virulence-avirulence phenotypes of Puccinia striiformis isolates collected in Lebanon and Syria were determined on seedlings of the wheat-yellow rust differential genotypes. We found 25 and 11 physiologic races over 6 years (1994 to 1999) in Syria and Lebanon, respectively. The composition of physiologic races found in Syria and Lebanon differed greatly between 1994 and 1999. Races identified in 1999, such as 230E150 and 230E134, have wider spectra of virulence on resistant genotypes than races collected in 1994. In Lebanon, three races were found in 1994 compared with six races in 1999. Yellow rust differential genotypes were used in a trap nursery to monitor yellow rust populations under natural conditions. Races identified from cultivars in the trap nursery in Syria and Lebanon, and from land race cultivars in Iraq, were recovered among the races identified from farm fields. Yellow rust samples were collected from Yemen, and none of the races identified from Yemen samples were identical to those in Syria and Lebanon. Virulence frequencies in the yellow rust population on the differential genotypes tested in the trap nurseries were above 70% for some resistance genes. Yellow rust populations in Syria and Lebanon have diverse virulence phenotypes. P. striiformis populations appear to be changing over, and this would be an important consideration for wheat breeding programs in the region.

Computerized image analysis of p53 and proliferating cell nuclear antigen expression in benign, hyperplastic, and malignant endometrium.

CONTEXT: The endometrium is an intrinsically dynamic tissue with great capability for regeneration and proliferation; consequently, there is some overlap between features seen in benign, premalignant, and malignant lesions. This leads to marked intrabiopsy, interbiopsy, and interobserver variability. OBJECTIVE: We studied the specificity and sensitivity of computerized image analysis of molecular markers to evaluate its potential use as a diagnostic tool. DESIGN: Specimens from 100 patients were examined and the following histologic diagnoses were assigned: proliferative endometrium (n = 10), secretory endometrium (n = 10), endometrial hyperplasia (n = 40; 30 with no atypia, 10 with atypia), and carcinoma (n = 40; 20 endometrioid, 10 serous, and 10 clear cell). All cases were evaluated immunohistochemically for p53 and proliferating cell nuclear antigen (PCNA) expression. Computerized image analysis was performed with a CAS 200 digital analyzer. RESULTS: Expression of p53 was found only in carcinomas (65%) and endometrial hyperplasia with atypia (30%). Expression of p53 was higher in the poor prognostic categories (serous carcinoma and clear cell carcinoma) than in endometrioid carcinoma. In endometrioid carcinoma, p53 expression correlated with grade. Proliferating cell nuclear antigen showed a similar pattern of results to p53 in the various carcinoma subtypes and endometrioid carcinoma grades. Endometrial hyperplasia PCNA values were the lowest among all the groups. Both carcinomas and proliferative endometrium showed higher glandular and stromal PCNA values, significantly different from endometrial hyperplasia with atypia. In proliferative endometrium, stromal PCNA was the highest among all of the groups. The p53 and PCNA results correlated with each other for carcinoma. CONCLUSIONS: Computerized image analysis correlates well with the established morphologic groups of endometrial pathology and yields results consistent with previous studies. Owing to its higher degree of sensitivity, computerized image analysis is of potential use in cases of diagnostic dilemmas and can help objectively allocate the case in the correct category (e.g., proliferative endometrium vs. endometrial hyperplasia, endometrial hyperplasia with atypia vs. endometrioid carcinoma). It is particularly useful in the evaluation of stromal changes.

A new predictive modality of cranial bone thickness.

The objective of this study was to evaluate A-mode ultrasound in the assessment of cranial bone thickness utilizing an in vivo animal model. A prospective study was performed that identified four standardized calvarial points in 10 Landrace porcine skulls. The individual points were scanned with an A-mode ultrasonic transducer to obtain bone thickness measurements. The same points were measured subsequently using digital calipers for objective comparison. The accuracy of each of the measurement modalities was evaluated for inter- and intrarater reliability. The association between ultrasonic and caliper measurements was evaluated using Student's t-test, Pearson's correlation coefficient, and linear regression models to assess the effect of confounding variables. The mean difference between the ultrasonic and the caliper values was 0.31 +/- 0.22 mm (standard deviation). The statistical analyses employed strongly supported the predictive value of ultrasound as a function of the true calvarial thickness (p < 0.05, r > 0.88, R2 = 0.89). The results suggest that ultrasound is an accurate reflection of cranial bone thickness in an in vivo animal skull model. The development of a portable, noninvasive ultrasonic device can have substantial clinical implications for craniomaxillofacial surgery.

Cytophotometric estimation of hepatocytes DNA in chronic liver diseases including schistosomiasis for detection of early preneoplastic changes.

No doubt chronic liver diseases due to schistosomiasis and other causes as virus hepatitis are not uncommon among Egyptian patients. Besides, neoplastic changes in such patients are always seen. So, the aim of this work was to evaluate the estimation of hepatocytes DNA in chronic liver diseases as a diagnostic feature for early preneoplastic changes in different groups of patients. These groups included (a) chronic persistent hepatitis, (b) chronic active hepatitis, (c) liver cirrhosis due to schistosomiasis and other causes & (d) hepatocellular carcinoma. The results were evaluated histochemically and histopathologically. It was concluded that the cytophotometic evidence of hepatocytes DNA in chronic liver diseases is a promising mean in detecting early preneoplastic changes.

Estimates of the population of Egypt, 1780-1882: a study in historical demography.

PIP: The authors examine population levels and trends in Egypt between 1780 and 1882. Data are presented on the total population for 1780 and 1882, including ranges and sources of estimated, and on births, deaths, and natural increase between 1846 and 1877 (SUMMARY IN ARA)^ieng