The cytotoxicity effect of bismuth oxide particles synthesized hydrothermally using different reaction temperatures in vitro.

INTRODUCTION: Bismuth oxide (Bi2O3) particles gained attention in preclinical research especially in medical imaging. Bismuth oxide with its long circulation time is an alternative to the current iodine contrast media which directly possesses high X-ray attenuation coefficient. Exploration of bismuth compound is hampered owing to challenges in synthesizing control for in vivo stability. MATERIALS AND METHODS: This study aimed are to characterize Bi2O3 particles synthesized at 60, 90 and 120 °C via hydrothermal method and investigated cytotoxicity of cell viability assay, cell morphology analysis, intracellular reactive oxygen species (ROS) assay and expression of ER stress genes by real-time PCR. RESULTS: Results indicated that the size of rod-shaped Bi2O3 particles increased with rising synthesizing temperatures. The cytotoxicity of Bi2O3 particles in Chang liver cells was size-dependent. Bigger-sized Bi2O3 particles resulted in lesser toxicity effects. mRNA expressions of GRP78 and C/EBP homologous protein (CHOP) were down-regulated in all treated Chang liver cells due to the increasing size of Bi2O3 particles. Bi2O3 particles synthesized at 120 °C was found to be less toxic than iodine. CONCLUSION: Data suggested that the response of Chang liver cells to Bi2O3 particle cytotoxicity has a significant relationship with its reaction temperatures. This outcome is important in hazard assessment of Bi2O3 particles as a new contrast media and provides better understanding in synthesizing control to enhance its biocompatibility.

COVID-19 pandemic experience of diagnostic radiographers: A Singapore survey.

INTRODUCTION: Diagnostic Radiographers (DR) are the frontline responders during the COVID-19 outbreak, providing essential diagnostic imaging services for screening and monitoring of suspected and confirmed patients. Understanding the experience and perceptions of DR towards the COVID-19 outbreak enables radiography leaders to guide changes in the approach to managing response to future health outbreaks. This study aims to document the experiences of DR in Singapore during the COVID-19 pandemic. METHODS: All DR practising in Singapore institutions were invited to participate in an online survey, disseminated by the Singapore Society of Radiographers (SSR). The survey assessed the attitudes and perceptions of the respondents on the COVID-19 pandemic. The Holmes and Rahe Stress Scale was used to identify the respondents' life events closely related to the pandemic. Data collection took place from 5 July 2020 to 5 September 2020. RESULTS: A total of 123 DR responded to the survey, where 89.4% of the respondents had been involved in the imaging of suspected or confirmed COVID-19 patients. Those performing General Radiography had the highest number of cases - 300 cases a month. The fear of transmitting COVID-19 to their family presented as the primary stressor (77.2%), followed by the lack of manpower (73.2%). The global themes that emerged from the study were (1) adapting to change and (2) quality of support. CONCLUSION: Radiology departments in Singapore were able to cope with the high demands of the pandemic in terms of the provision of information, supplies, and physical equipment. However, they were less prepared to handle human factors such as mental health and staff morale. The safety and well-being of staff should not be compromised to reduce staff anxiety while performing their duties. Strategies to improve their ability to adapt to changes and provision of quality support are necessary measures in future pandemic situations.

Assessment of TB underreporting by level of reporting system in Lagos, Nigeria.

BACKGROUND: Nigeria has an estimated TB prevalence of 219 per 100,000 population. In 2019, Nigeria diagnosed and notified 27% of the WHO-estimated cases of all forms of TB and contributed 11% of the missing TB cases globally. OBJECTIVE: To assess TB underreporting by type and level of health facility (HF), and associated factors in Lagos State, Nigeria. METHODOLOGY: Quantitative secondary data analysis of TB cases was conducted in 2015. χ2 test was used to assess the association between treatment initiation, TB underreporting, local government area (LGA) and HF characteristics. RESULTS: Overall, 2,064 persons with bacteriologically confirmed TB (15.5%) were not matched to patients in sampled TB registers. Treatment status was unknown for 86 cases (IQR 55-97) per LGA. LGAs with higher case-loads had higher proportions of cases with unknown TB status. Discrepant reporting of treated TB was also common (60% HFs). Primary-level TB treatment facilities and unengaged private facilities were less likely to notify. CONCLUSION: There was TB under-reporting across all types and levels of HFs and LGAs. There is a need to revise or strengthen the process of supervision and data quality assurance system at all levels.

CONTEXTE: Le Nigeria a une prévalence de la TB estimée à 219 pour 100 000 habitants. En 2019, le Nigéria a diagnostiqué et notifié 27% des cas estimés par l'OMS de toutes les formes de TB et a contribué à 11% des cas de TB manquants dans le monde. OBJECTIF: Évaluer la sous-déclaration de la TB par type et niveau d'établissement de santé (HF), et les facteurs associés dans l'État de Lagos, au Nigeria. MÉTHODES: Une analyse quantitative des données secondaires des cas de TB a été réalisée en 2015. Le test χ2 a été utilisé pour évaluer l'association entre l'initiation du traitement, la sous-déclaration de la TB, la zone de gouvernement local (LGA) et les caractéristiques des HF. RÉSULTATS: Dans l'ensemble, 2 064 personnes ayant une TB confirmée par épreuve bactériologique (15,5%) n'ont pas été appariées à des patients dans les registres de TB échantillonnés. Le statut de traitement était inconnu pour 86 cas (IQR 55­97) par LGA. Les LGA ayant un plus grand nombre de cas avaient une plus grande proportion de cas dont le statut de traitement était inconnu. La déclaration discrète de la TB traitée était également fréquente (60% des HF). Les établissements de traitement de la TB de premier niveau et les établissements privés non engagés étaient moins susceptibles de faire des déclarations. CONCLUSION: Il y avait une sous-déclaration de la TB dans tous les types et niveaux d'HF et de LGA. Il est nécessaire de réviser ou de renforcer le processus de supervision et le système d'assurance qualité des données à tous les niveaux.

Di-µ-chlorido-bis-(chlorido-{8-[2-(di-methyl-amino)-ethyl-amino]-quinoline}-cadmium) ethanol monosolvate.

The title solvated bimetallic complex, [Cd2Cl4(C13H17N3)2]·C2H5OH, comprises two Cd2+ metal ions linked by a pair of µ2 Cl- ions. The coordination sphere around each Cd2+ ion is completed by three N atoms of a tridentate 8-[2-(di-methyl-amino)-ethyl-amino]quinoline ligand and another chloride ion to form a distorted fac-CdN3Cl3 octa-hedron. The ethanol mol-ecule is both an acceptor of an N-H⋯O and a donor of an O-H⋯Cl hydrogen bonds to its adjacent complex unit. In the crystal, weak aromatic π-π stacking is observed.

Periprosthetic Fractures after Total Knee Arthroplasty: the Influence of Pre-Operative Mechanical Factors versus Intraoperative Factors.

Introduction: Periprosthetic fractures are a devastating complication following total knee arthroplasty. Little is known about the effect of mechanical factors on the incidence of periprosthetic fractures. The aim of this study was to examine the correlation between pre-operative mechanical factors, like side of surgery, coronal alignment and pre-operative range of motion and intra-operative factors, and the incidence of a periprosthetic fracture, following primary total knee arthroplasty (TKA). Materials and Methods: Forty-two patients with periprosthetic fractures (PPF) after primary TKA were identified from our hospital arthroplasty registry. These patients were matched two-to-one for gender and age at primary knee arthroplasty to 84 patients without PPF. The incidence of periprosthetic fracture with regards to laterality, coronal alignment and pre-operative range of motion was analysed. Intra-operative factors like implant type, patellar resurfacing and notching were also analysed using logistic regression. Results: Coronal alignment, pre-operative range of motion and patella resurfacing were not significant predictors of periprosthetic fractures. Anterior femoral notching was found to be significantly higher in the fracture group with an odds ratio of 17. Left sided surgery was also significantly higher in the periprosthetic fracture group. Conclusion: Periprosthetic fractures are 17 times more likely to occur in a knee with anterior femoral notching. Preoperative factors like coronal alignment and poor preoperative range of motion do not seem to increase the risk of periprosthetic fractures after TKA.

Molecular Evidence of Genome Editing in a Mouse Model of Immunodeficiency.

Genome editing is the introduction of directed modifications in the genome, a process boosted to therapeutic levels by designer nucleases. Building on the experience of ex vivo gene therapy for severe combined immunodeficiencies, it is likely that genome editing of haematopoietic stem/progenitor cells (HSPC) for correction of inherited blood diseases will be an early clinical application. We show molecular evidence of gene correction in a mouse model of primary immunodeficiency. In vitro experiments in DNA-dependent protein kinase catalytic subunit severe combined immunodeficiency (Prkdc scid) fibroblasts using designed zinc finger nucleases (ZFN) and a repair template demonstrated molecular and functional correction of the defect. Following transplantation of ex vivo gene-edited Prkdc scid HSPC, some of the recipient animals carried the expected genomic signature of ZFN-driven gene correction. In some primary and secondary transplant recipients we detected double-positive CD4/CD8 T-cells in thymus and single-positive T-cells in blood, but no other evidence of immune reconstitution. However, the leakiness of this model is a confounding factor for the interpretation of the possible T-cell reconstitution. Our results provide support for the feasibility of rescuing inherited blood disease by ex vivo genome editing followed by transplantation, and highlight some of the challenges.

Extradural hemangioma mimicking a dumbbell nerve sheath tumor in the thoracolumbar spine: Case report.

BACKGROUND: Extradural hemangiomas are rare, have varied and challenging clinical presentations, and require special considerations from the management point of view. CASE DESCRIPTION: A 70-year-old female presented with back pain that was ultimately attributed to a thoracolumbar extra-dural "dumbbell" hemangioma. Following surgical resection, the patient did well. CONCLUSION: Extradural hemangiomas may present as spinal extradural soft tissue masses that must be differentiated from dumbbell neurofibroma.

The influence of body mass index on functional outcome and quality of life after total knee arthroplasty.

AIMS: This study investigated the influence of body mass index (BMI) on the post-operative fall in the level of haemoglobin (Hb), length of hospital stay (LOS), 30-day re-admission rate, functional outcome and quality of life, two years after total knee arthroplasty (TKA). PATIENTS AND METHODS: A total of 7733 patients who underwent unilateral primary TKA between 2001 and 2010 were included. The mean age was 67 years (30 to 90). There were 1421 males and 6312 females. The patients were categorised into three groups: BMI < 25.0 kg/m(2) (normal); BMI between 25.0 and 39.9 kg/m(2) (obese); and BMI ≥ 40.0 kg/m(2) (morbidly obese). RESULTS: Compared with the normal and obese groups, the mean LOS was longer by one day (95% confidence interval (CI) 0 to 2) in the morbidly obese group (p = 0.003 and p = 0.001 respectively). The 30-day re-admisison rate was also higher in the morbidly obese group compared to the obese group (OR 2.323, 95% CI 1.101 to 4.900, p = 0.024); and showed a higher trend compared to the normal group (OR 1.850, 95% CI 0.893 to 3.831, p = 0.100). However, the morbidly obese group had a smaller drop in post-operative Hb level by a mean of 0.5 g/dl (0.3 to 0.6) and 0.3 g/dl (0.1 to 0.5), when compared with the normal and obese groups respectively (both p < 0.001). Furthermore, the mean improvement in Oxford Knee Score (OKS) and Knee Society Knee Score (KSKS) at two years follow-up was three points (two to four) and five points (two to seven) more in the morbidly obese group than in the normal group (both p < 0.001). The mean improvement in Knee Society Function Score, and Physical and Mental Component Scores of Short Form-36 were comparable between the three BMI groups (p = 0.736, p = 0.739 and p = 0.731 respectively). The ten-year rate of survival was 98.8% (98.0 to 99.3), 98.9% (98.5 to 99.2) and 98.0% (95.8 to 100), for the normal, obese and morbidly obese groups, respectively (p = 0.703). CONCLUSION: Although morbidly obese patients have a longer LOS and higher 30-day re-admission rate after TKA, they have a smaller drop in post-operative Hb level and larger improvement in OKS and KSKS at two years follow-up. The ten-year rate of survival of TKA was also comparable with those with a normal BMI. TAKE HOME MESSAGE: Morbidly obese patients should not be excluded from the benefits of TKA. Cite this article: Bone Joint J 2016;98-B:780-5.

Crystal structure of bis-{N-[2-(di-methyl-amino)-eth-yl]quinolin-8-amine-κ(3) N,N',N''}nickel(II) dichloride 3.5-hydrate.

In the title compound, [Ni(C13H17N3)2]Cl2·3.5H2O, the geom-etry of the NiN6 complex cation is slightly distorted octa-hedral, with a facial arrangement of the two tridentate N-[2-(di--methyl-amino)-eth-yl]quinolin-8-amine ligands around the metal ion. The asymmetric unit consists of two independent complex half-mol-ecules located on centres of inversion, together with two chloride counter-anions and 3.5 water mol-ecules of solvation, one of which is disordered across an inversion centre. In the crystal, O-H⋯O, O-H⋯Cl and N-H⋯Cl hydrogen-bonding inter-actions form a three-dimensional network structure.

Di-chlorido-{8-[2-(di-methyl-amino)-ethyl-amino]-quinoline-κ(3) N,N',N''}zinc.

In the title complex, [ZnCl2(C13H17N3)], the coordination sphere of the zinc cation is distorted square pyramidal. The three N atoms of the N,N',N''-tridentate 8-[2-(di-methyl-amino)-ethyl-amino]-quinoline ligand and one chloride ion constitute a considerably distorted square base. The apical site is occupied by another chloride ion. The distortion from the ideal square-pyramidal geometry is manifested by the N-Zn-N angle of 133.25 (11)°. Like most square-pyramidal metal complexes, the zinc cation is displaced towards the apical chloride ion. In the crystal, mol-ecules are linked by N-H⋯Cl inter-actions. This leads to the formation of chains of mol-ecules parallel to the b-axis direction.

First experience with using simple polymerase chain reaction-based methods as an alternative to phenotypic drug susceptibility testing for Myobacterium tuberculosis in Iraq.

CONTEXT: In Iraq, the time-consuming, phenotypic drug susceptibility testing (DST) on agar is the sole method available for detecting drug resistance in Myobacterium tuberculosis (TB). Furthermore, only single laboratory across Iraq is performing it on wide scale. AIMS: To explore utility of rapid, polymerase chain reaction (PCR)-based systems in detection of drug resistance in under the Iraqi settings. SETTINGS AND DESIGN: Cross-sectional study. A total of 79 nonduplicated isolates were included in this study. Multiplex allele-specific PCR was used to detect mutations at positions 531, 526, and 516 of the rpoB gene. Two simplex PCR systems were used to detect mutations in katG3 15 gene and inhAP-15. STATISTICAL ANALYSIS USED: Chi-square and crosstabs by SPSS v. 20. RESULTS: On DST, out of 69 isolates, 55 isolates were found multidrug-resistant (MDR)-TB; six isolates were susceptible to both rifampin (RIF) and isoniazid (INH); two isolates were resistant to RIF but not to INH; and six isolates were resistant to INH but not RIF. RIF and INH resistance mutations were detected in 50 (90.9%), and 43 (78.2%) MDR cases, respectively. Combine resistance mutations to RIF and INH were detected in 40 MDR cases (72.7%). The most frequently mutated codon was the codon 531 in rpoB gene, mutated in 42 isolates. inhAP-15 and katG315 codons were found mutated in 23 and 25 MDR cases (54.8% and 58.1%), respectively. Among 57 RIF-resistant isolates, 52 (91.2%) were harboring mutations resistance to RIF. CONCLUSIONS: These PCR-based methods are potential diagnostic and/or screening tools to detect drug-resistance TB in Iraqi settings.

cis-Dichlorido-tetra-kis-(dimethyl sulfoxide-κO)chromium(III) chloride dimethyl sulfoxide monosolvate.

The structure of the title compound, [CrCl2(C2H6OS)4]Cl·C2H6OS, consists of a Cr(III) ion coordinated by four O atoms of dimethyl sulfoxide (DMSO) ligands and two chloride ions in cis positions, forming a distorted CrCl2O4 octa-hedron. An isolated Cl(-) counter-anion and a positionally disordered DMSO mol-ecule [occupancy ratio 0.654 (4):0.346 (4)] are also present. In the structure, the complex cations inter-act with the Cl(-) counter-anions and the DMSO solvent mol-ecules via weak C-H⋯Cl and C-H⋯O inter-actions, forming a three-dimensional network.

Di-µ-chlorido-dichlorido-bis{8-[2-(di-methyl-amino)-ethyl-amino]-quinoline}dicadmium monohydrate.

The title complex, [Cd2Cl4(C13H17N3)2]·H2O, is centrosymmetic and contains two Cd(2+) ions bridged by two Cl(-) ions, leading to a strictly planar Cd2Cl2 core. Each Cd(2+) ion is further coordinated by an additional Cl(-) ion and three N atoms of a tridentate 8-[2-(di-methyl-amino)-ethyl-amino]-quinoline ligand in the form of a considerably distorted octa-hedron for the overall coordination sphere. A lattice water mol-ecule is located on a twofold rotation axis and links pairs of complexes through N-H⋯O and O-H⋯Cl hydrogen bonds.

Haemangiopericytoma of the oropharynx.

Haemangiopericytoma (HPC) is a rare vascular tumor arising from the pericytes of Zimmermann and is characterized by its unpredictable and variable biological behavior. These tumors are common in the trunk and the extremities and less than 16% of the cases occur in the head & neck region. Its occurrence in the oral cavity and pharynx is uncommon. We report an extremely rare case of haemangiopericytoma of the oropharynx arising from the tonsillo-lingual sulcus as a pedunculated mass, which was successfully excised perorally after a preliminary tracheostomy. No recurrence has been noted on a follow-up of more than six years.

Metastatic nasal chondrosarcoma.

Chondrosarcomas are uncommon tumors which originates in the head and neck and accounts for approximately 10 to 15% of all cases. Most chondrosarcomas exhibit an indolent growth pattern. Nasoseptal tumors may mimic common sinonasal conditions, making early diagnosis difficult. We report a case of nasoseptal metastatic chondrosarcoma which was atypical, characterized by an aggressive growth pattern and widely disseminated.

[Carcinoma and acute pancreatitis--case reports]. / Rak a ostre zapalenie trzustki--opis przypadków.

The coexistence of pancreatic carcinoma with severe form of acute pancreatitis (AP) is not only an extremely rare phenomenon described in literature but also a real problem in the aspect of differential diagnostics of neoplastic and inflammatory morphological changes in this organ. The study objective was the analysis of clinical material obtained from patients with inflammatory and neoplastic lesions, treated surgically in I Department of General and Endocrinological Surgery, Medical University of Bialystok in the years 1980-2005. Of these patients, 7 had pancreatic carcinoma at various stages of advancement diagnosed in the late postoperative period after severe form of AP. Patients' history, physical examination as well as biochemical tests and imaging diagnostic procedures (ultrasonography, CT) of the abdominal cavity explicitly showed severe form of acute pancreatitis. In every case, CA19-9 antigen values were substantially elevated (mean 780 +/-325 IU/ml, norm 0-37 IU/ml). Histopathological analyses of samples collected during laparotomy revealed the presence of necrotic-purulent tissues. In the late postoperative period, i.e. 3-24 months, all these patients were reoperated on for pancreatic carcinoma or its metastases. Only in one case, radical Whipple surgery was performed. All the remaining patients underwent palliative procedures or samples for histopathological examinations were only collected. In all the seven cases, metastatic carcinoma was diagnosed, including pancreatic carcinoma in 6 patients. These observations seem to indicate that severe AP may be insidiously accompanied by pancreatic carcinoma and that this coexistence should always be taken into consideration.

[Surgical treatment of thyroid disease in adolescents]. / Leczenie chirurgiczne chorób tarczycy u mlodocianych.

Surgical treatment of goitre in children and teenagers under 18 is relatively rare and undertaken for strict therapeutic indications. It still arouses much controversy among surgeons, being loaded with a high percentage of complications, usually distant ones. The aim of the study was to analyse the surgical treatment of various goitre types under the age of 18 basing on 65 operations performed in the years 1994-1998. Operations for non-toxic and hyperactive nodular goitre, including Graves-Basedow disease, were predominant. Five cases of thyroid carcinoma were found. No serious complications were observed during and after the surgery. Our own material and the 5-year observation reveal that surgical treatment of thyroid diseases in children and adolescents carried out for definite indications by an experienced operating team is successful and causes only few complications.

[Diagnosis and surgical treatment of pancreatic carcinoma]. / Rak trzustki--diagnostyka i leczenie.

The aim of the study was presentation of our experiences in the diagnostics and treatment of pancreatic carcinoma in confrontation with current opinions. Between 1983 and April 1998 308 patients (198 males and 110 females with mean age 61 years) were treated at our department. In 211 cases tumor was primarily localized in the head and in 97 cases (31.5%) in the body or tail of pancreas. The diagnosis was determined on the basis of clinical symptoms and laboratory investigations. Diagnostic accuracy of performed investigations was as following. Ultrasonography-86%, CT-scan-95%, and ERCP-94%. Ultrasonography or CT guided biopsy and serodiagnostics improved detectability of resectionable carcinoma in the last past years. Among 308 patients, 292 underwent surgery. Since 1997 an intraoperative ultrasonography and cholangioscopy of common bile duct and Virsung were performed as a routine. The procedures depended on the localization and the grade of advance of the tumors. UICC classification of pancreatic tumors, pTNM (4th edition 1987) it was used. Only in 25 patients (8%) (tumors pT1a-bN0M0) it was possible to perform radical operation (resection of the pancreas). However in 172 patients (56%) only palliative procedures were done (pT2N1M0). In 95 patients (31%) only laparotomy and biopsy were performed (tumors pT2N1M1). The study shows that although diagnostic methods are improved, the tumors of the pancreas are diagnosed in stages making unable the radical procedures. Only about 10% of carcinomas are resectable. It is caused by with non-characteristic picture of the disease in its early stage.

Diagnosis and surgical treatment of pancreatic carcinoma.

The aim of study was presentation of our experiences in diagnosis and treatment in pancreatic carcinoma in confrontation with current opinions. Between 1984-1995 at our Department was treated 211 patients with carcinoma of exocrine part of the pancreas. It were 137 male and 74 female with mean age 58.9 years. In 151 cases (70.5%) primary seat of tumour was located in the head and in 60 cases (29.5.1%) in the body or tail of pancreas. The diagnosis was determined on the basis of clinical symptoms and laboratory investigation Diagnostic accuracy of X-ray investigations was as follow: Ultrasonography-86%, CT-scan-91%, ERCP-94%. Ultrasonography or CT guided biopsy and serodiagnosis improved detectability of resectionable carcinomas in the last past years. Among 211 patients, 199 underwent surgery. The procedures depended on the localisation and grade of advance of the tumours. UICC classification of pancreatic tumours, pTNM (4th edition 1987) was used. Only in 21 patients (9.9%) (tumours pT1a-b N0M0) was possible to perform radical operation (resection of the pancreas). However in 107 patients (50.7%) were done only paliative procedures (pT2N1M0). In 83 patients (39.3%) only laparotomy and biopsy were performed (tumours pT2N1M1). The study shows that although improvement of the diagnostic methods tumors of the pancreas are diagnosed in stages making unable the radical procedures and only about 10% of carcinomas are resectable. It is relevant with non-characteristic picture of the diseases in its early stages.