Meat grinder hand injury in children: A report of 5 cases.

BACKGROUND: Meat grinder injury is considered one of the leading causes that may result in mutilating hand injury. It is commonly occurred in children due to negligence, limited awareness and inexperience about the machine processing and its possible complications. CASE PRESENTATION: We reported five cases of grinder-induced hand injuries, presented with their hands yet firmly wedged inside the grinder. Each hand was freed from inside of the grinder by reversed turning of the machine except for one case which needed extrication with the using of a cutting torch. After releasing of the injured hand, we performed amputation at the wrist level in two cases, at metacarpophalangeal levels in one case and we could perform revascularization in two cases. CONCLUSION: Meat grinder hand injuries in children is challenging, gentle and careful releasing of the hand without causing further damages along with meticulous repair of hand structure to restore hand function. The most important thing is to prevent household meat-grinder-related injuries through keeping it away from the reach of the children's hand.

Apa1 (rs7975232) SNP in the vitamin D receptor is linked to hepatocellular carcinoma in hepatitis C virus cirrhosis.

Background: As hepatocellular carcinoma (HCC) arising from chronic hepatitis C virus (HCV) infection in liver cirrhosis is a major problem in public health, early and rapid prediction of HCC is urgent. We hypothesized that a single nucleotide polymorphism in the Apa1 SNP in the vitamin D receptor may help diagnosis.Methods: We recruited 3 groups: 80 HCC patients with HCV cirrhosis, 80 HCV cirrhotic patients free of HCC and 80 healthy controls. Apa1 rs7975232 SNP was detected by PCR- RFLP technique. Routine laboratory markers were determined by standard methods.Results: The Apa1 CC genotype was more frequent (75%) in HCC than in the cirrhosis (35%) and control (20%) groups (P<0.0001). CC patients were more likely to have a more severe Child-Pugh score (P=0.027) and MELD score (P<0.05). In multivariate analysis, the CC genotype out-performed AFP is determining HCC.Conclusion: Apa1 CC genotype is linked to HCC in HCV C cirrhotic patients, and so has the potential to be an independent biomarker predictor for HCC occurrence in HCV cirrhosis.

The role of explorative tympanotomy in patients with sudden sensorineural hearing loss with and without perilymphatic fistula.

PURPOSE: The purpose of this study was to describe the role of explorative tympanotomy in patients with Profound Sudden Sensorineural Hearing Loss (SSNHL) without clinical evidence of perilymphatic or labyrinthine fistula and to compare intraoperative findings with the postoperative hearing outcome. STUDY DESIGN: Retrospective study of all patients diagnosed with SSNHL who underwent explorative tympanotomy between 2002 and 2005. SETTINGS: Tertiary care university-affiliated hospital. SUBJECTS AND METHODS: Eighty-two patients were diagnosed with unilateral profound SSNHL and underwent tympanotomy with sealing of the round and oval windows. Values of pure tone audiograms and percentage hearing loss of patients with and without intraoperative diagnosed perilymphatic fistula (PLF) were compared and analyzed. RESULTS: PLF was diagnosed in 28% cases intraoperatively. In most cases, hearing improved significantly after surgery. Interestingly, patients with PLF had a 2.4 times greater decrease of percentage hearing loss compared to patients without PLF. CONCLUSIONS: Explorative tympanotomy seems to be useful in patients with profound SSNHL. Patients with PLF benefit more from the surgical procedure and have better outcome than patients without PLF.

A comparison between amylase levels from peritonsillar, dental and neck abscesses.

OBJECTIVES: Pus of peritonsillar abscess (PTA) contains very high amylase levels in some patients. The objective of this study was to further test this finding and to check whether high amylase levels in peritonsillar abscess originate from contamination by saliva during aspiration. STUDY DESIGN: Prospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: The study includes 64 patients with PTA, 8 patients with a neck abscess and 12 patients with a dental abscess. MAIN OUTCOME MEASURE: Amylase levels of pus and serum were compared between the groups. Clinical data regarding hospitalisation length, recurrence rate and previous antibiotic treatment were also collected. RESULTS: Mean amylase levels in the pus of the PTA group were 3045 U/L (median 59 U/L), 13 U/L in the neck abscess group (P = 0.001) and 22 U/L in the dental abscess group (P = 0.001). Mean serum amylase was higher in the PTA group; PTA - 50 U/L, neck abscess - 37 U/L (P = 0.002) and dental abscess - 26 U/L (P < 0.002). All of the patients with amylase levels above 65 U/L had a first episode of PTA. In contrast, 40% of patients with amylase lower than 65 U/L had recurrent PTA (P = 0.003). CONCLUSION: A clear association is seen between minor salivary glands and peritonsillar abscess. The high amylase level in peritonsillar pus is not from contamination with saliva.

Cost-effectiveness of primary abdominal wall hernia repair in a 364-bed provincial hospital of Spain.

PURPOSE: Primary abdominal hernia is a prevalent condition that weighs heavily on human and financial health-care resources (e.g., 1.12% of the total budget of our hospital in 2008). Tension-free hernioplasty is the standard repair procedure, but the anesthetic technique varies, including local anesthesia with sedation (Lsed), regional (Reg), and general (Gen) anesthesia. As the cost-outcome relation of different anesthetic options has never been examined in our health district, we proposed to identify the most cost-effective anesthetic technique out of three options for primary abdominal hernia repair in terms of clinical outcome and health-care economics in this retrospective review. METHODS: The study sample of 400 patients with primary abdominal hernia in 2008 underwent tension-free hernioplasty using one of three anesthetic techniques: 74 Lsed, 283 Reg, and 43 Gen. The comparability of outcomes was ensured by dividing the sample into homogeneous groups according to the American Society of Anesthesiologists Physical Status classification (ASA 1 and 2) and adjusting for technical complexity, risk factors, and anatomic location. RESULTS: The clinical outcome of hernioplasty with Lsed was significantly better in terms of shorter hospital stay, lower early- and intermediate-term complication rate, and shorter time to recovery after discharge. The short-term recurrence rate did not differ between groups. The mean cost per hernioplasty procedure was 3,270.37 (Lsed), 4,740.37 (Reg), and 7,318.44 (Gen). CONCLUSION: The cost-effectiveness and incremental cost per patient showed the advantage of hernioplasty with Lsed versus Reg (794.59) and Lsed versus Gen (704.01), respectively.

Exploitation of multilayer coatings for infrared surface plasmon resonance fiber sensors.

We demonstrate surface plasmon resonance (SPR) fiber devices based upon ultraviolet inscription of a grating-type structure into both single-layered and multilayered thin films deposited on the flat side of a lapped D-shaped fiber. The single-layered devices were fabricated from germanium, while the multilayered ones comprised layers of germanium, silica, and silver. Some of the devices operated in air with high coupling efficiency in excess of 40 dB and an estimated index sensitivity of Delta lambda/Delta n=90 nm from 1 to 1.15 index range, while others provided an index sensitivity of Delta lambda/Delta n=6790 nm for refractive indices from 1.33 to 1.37.

Geochemical and geostatistical investigations of chromium pollution in groundwater.

Geochemical and geostatistical study of the chromium concentration in groundwater occurring at variable depths of 12 to 33.5 m (40 to 110 ft) in the Karachi urban area of Pakistan have been made. Samples were collected at variable distances, with a maximum of 1 km interval, on the bases of population, industries, types, and density. The chromium concentration has also been worked out to deduce the threshold value of the area under study and the estimation of probability impact modeling, in terms of concentration variation, by using the disjunctive kriging technique. The outcome of the present work appears to be a good tool to decipher pollution variation in the groundwater of highly urbanized areas, with respect to the population and industries. The patterns of distribution of chromium concentration in groundwater and pollution hotspots in particular localities appear to be more related to the types of industries than to the effect of population types.

Association of HLA class II allele and haplotype frequencies with chronic myelogenous leukemia and age-at-onset of the disease.

Chronic myelogenous leukemia (CML) is characterized by the presence of Philadelphia chromosome resulting from bcr/abl translocation. To clarify the association between HLA class II allele and haplotype frequencies in CML, 50 patients referred to Hematology Oncology and Bone Marrow Transplantation (BMT) center, Shariaty Hospital, Tehran, Iran, were randomly selected and compared with a group of 80 unrelated healthy blood donor subjects. HLA class II alleles were determined by PCR-SSP method. The results showed that the frequencies of DQB1*03011 (P=0.01) and DQA1*0505 (P=0.05) were higher, while that of DQB1*03032 (P=0.04) was lower in patients than in the controls. Regarding age-at-onset, the frequency of HLA-DRB1*07 (P=0.03) and -DQA1*0201 (P=0.03) alleles were higher in patients younger than 35 years. The most frequent haplotypes in our CML patients were HLA-DRB1*11/-DQB1*03011/-DQA1*0505 (P=0.01) and HLA-DRB1*04/-DQB1*0302/-DQA1*03011 (P=0.02). In conclusion, it is suggested that positive and negative association in certain HLA alleles and haplotypes exist in Iranian patients with CML.

Physical properties of ultrafast deposited micro- and nanothickness amorphous hydrogenated carbon films for medical devices and prostheses.

Hydrogenated amorphous carbon films with diamond-like structures have been formed on different substrates at very low energies and temperatures by a plasma-enhanced chemical vapour deposition (PECVD) process employing acetylene as the precursor gas. The plasma source was of a cascaded arc type with argon as the carrier gas. The films grown at very high deposition rates were found to have a practical thickness limit of approximately 1.5 microm, above which delamination from the substrate occurred. Deposition on silicon (100), glass, and plastic substrates has been studied and the films characterized in terms of sp3 content, roughness, hardness, adhesion, and optical properties. Deposition rates of up to 20 nm/s have been achieved at substrate temperatures below 100 degrees C. A typical sp3 content of 60-75 per cent in the films was determined by X-ray-generated Auger electron spectroscopy (XAES). The hardness, reduced modulus, and adhesion of the films were measured using a MicroMaterials NanoTest indenter/scratch tester. Hardness was found to vary from 4 to 13 GPa depending on the admixed acetylene flow and substrate temperature. The adhesion of the film to the substrate was significantly influenced by the substrate temperature and whether an in situ d.c. cleaning was employed prior to the deposition process. The hydrogen content in the film was measured by a combination of the Fourier transformation infrared (FTIR) spectroscopy and Rutherford backscattering (RBS) techniques. From the results it is concluded that the films formed by the process described here are ideal for the coating of long-term implantable medical devices, such as prostheses, stents, invasive probes, catheters, biosensors, etc. The properties reported in this publication are comparable with good-quality films deposited by other PECVD methods. The advantages of these films are the low ion energy and temperature of deposition, ensuring that no damage is done to sensitive substrates, very high deposition rates, relatively low capital cost of the equipment required, and the ease of adjustment of plasma parameters, which facilitates film properties to be tailored according to the desired application.

Monitoring of pesticide residues in human milk, soil, water, and food samples collected from Kafr El-Zayat Governorate.

Pesticide residues in human milk and environmental samples from Kafr El-Zayat Governorate in Egypt were analyzed. This governorate is located near one of the biggest pesticide factories in Egypt. Organochlorine and organophosphorus pesticides were monitored, including those that have been prohibited from use in Egypt. Human milk samples (31 samples) from Kafr El-Zayat were compared with 11 samples collected from Cairo. Data were compared with results from studies performed in 1987 and 1990. The present study showed that aldrin and dieldrin, heptachlor and heptachlor epoxide, and endrin residues have been eliminated from human milk. Estimated daily intakes (EDIs) of DDT complex and gamma-HCH by breast-fed infants in Kafr El-Zayat were 85.96 and 3.1% of the respective acceptable daily intakes (ADIs). beta-HCH residues showed an increasing pattern, especially in human milk samples from Cairo. DDT complex and HCH isomers in orange, spinach, lettuce, potatoes, and clover samples ranged from undetectable to very low concentrations. Higher levels of DDT and HCH were detected, but aldrin, dieldrin, endrin, and the heptachlors were not detected in food of animal origin. Residues in fish samples were below maximum residue limits established by some developed countries. Those in animal milk samples approached the extraneous residue limits of the Codex Committee on Pesticide Residues. HCH residues in soil were negligible, but DDT residues in soil were somewhat higher. Among water samples, groundwater samples had the highest residues of HCHs and DDTs, followed by Nile River water and then tap water. However, the organochlorine pesticide residues were found at concentrations below the maximum allowable limits set by the World Health Organization for drinking water. Among 12 organophosphorus pesticides monitored as parent compounds, dimethoate, malathion, methamidophos, and chlorpyrifos residues were detected in low concentrations in soil samples from a pesticide factory. No organophosphorus pesticide residues were found in plant samples, except for very low residues of dimethoate in an orange sample. Water samples were devoid of organophosphorus residues as parent compounds.

Changes in genital vasculature after tubal Falope-ring sterilization.

PIP: 10 women for whom total abdominal hysterectomy and bilateral salpingo-oophorectomy was planned had unilateral Falope ring sterilization 1 month previously by laparoscopy to provide specimens for study of the vasculature of the ovary and fallopian tubes. The indication for hysterectomy was unremitting uterine bleeding uncontrolled by curettage. The subjects ranged in age from 30 to 46 (mean 40.3 years) and in parity from 4 to 11 (mean 6.1). The specimens were injected with 50% lead oxide in 10% formol in the uterine and ovarian arteries, and with barium in the uterine and ovarian veins. X-ray films were taken the same day. all specimens showed venous dilation. In all cases the ovarian branch of the uterine artery and its anastomoses with the ovarian artery were intact. The degree of compromise of the arterial circulation depended on the position of the Falope ring, less damage when the ring was on the medial or middle tube, and more damage when it was more distal. Circulation to the ligated tube distal to the ring was diminished. The implications of these results on the possibility of menstrual irregularities after tubal sterilization and on potential for reanastomosis were discussed.^ieng

Cholesterol esterase in preglomerular microvessels from normal and cholesterol-fed rabbits.

Feeding cholesterol to rabbits produces an atherosclerotic model sharing common metabolic features with the disease in humans, including the vascular lipid accumulation. In coronary vascular cells, this lipid accumulation has been associated with decreased prostacyclin (PGI2) biosynthesis and acid cholesterol esterase activity. Unlike the coronary vascular bed, renal microvasculature appears relatively resistant to atherosclerotic injury. This study examined whether renal microvessels from cholesterol-fed rabbits demonstrated similar metabolic changes in coronary vascular cells. Rabbits were fed either a 0% or 2% cholesterol diet for 1 mo. Similar to coronary vascular cells, in renal microvessels from cholesterol-fed rabbits PGI2 biosynthesis decreased and tissue concentrations of cholesterol and cholesteryl esters increased. However, unlike coronary vascular cells, renal microvascular cholesterol esterase activity increased. Light and electron microscopy revealed sporadic lipid deposits in renal microvessels from cholesterol-fed rabbits and no foam cells or occlusive lesions. In vitro addition of prostanoids to normal renal microvessels had no effect on cholesterol esterase activity. It is inviting to speculate that the increased acid cholesterol esterase activity in renal microvessels from cholesterol-fed rabbits protected them from developing extensive microvascular lesions. These biochemical events may explain the relative resistance of human renal microvessels to the development of occlusive atherosclerotic microvascular lesions.