Splenic Epidermoid Cyst during Pregnancy; Case Report and Review of the Literature

Cystic disease of the spleen is not frequently encountered in surgical practice. It is broadly classified as parasitic and non-parasitic, the latter being a rare entity. In this case report, an epidermoid cyst of spleen led to acute abdomen in young age pregnant woman is presented. A 26-year-old woman with 15 weeks gestational age second pregnancy referred to emergency ward with left upper quadrant pain and tenderness that ultra sonography revealed large cyst (100х110mm) with internal echo in spleen in favor of hydatic cyst or abscess. The patient was managed medically for one week but developed her abdominal pain, epigastric fullness, anorexia and fever. New sonography was done for her and large cyst was detected in spleen (120х110mm). She had severe pain accompanied with anorexia and vomiting. Fetus was normal in sonography. Exploratory laprotomy with splenectomy was performed. Splenomegaly (200х130х90mm) with a cyst without any adhesion and inflammation was detected. Histopathology examination showed epidermoid cyst of spleen. (140х10х90mm). Though splenic epidermoid cyst is an uncommon entity, it should be considered in the differential diagnosis of an abdominal mass in a young individual. An attempt should be made to preserve the spleen provided there is adequate parenchyma otherwise splenectomy is the rule.

Using Combination of µ,β and γ Bands in Classification of EEG Signals

INTRODUCTION

In most BCI articles which aim to separate movement imaginations, µ and β frequency bands have been used. In this paper, the effect of presence and absence of γ band on performance improvement is discussed since movement imaginations affect γ frequency band as well.

METHODS

In this study we used data set 2a from BCI Competition IV. In this data set, 9 healthy subjects have performed left hand, right hand, foot and tongue movement imaginations. Time and frequency intervals are computed for each subject and then are classified using Common Spatial Pattern (CSP) as a feature extractor. Finally, data is classified by LDA, RBF MLP, SVM and KNN methods. In all experiments, accuracy rate of classification is computed using 4 fold validation method.

RESULTS

It is seen that most of the time, combination of µ,β and γ bands would have better performance than just using combination of µ and β bands or γ band alone. In general, the improvement rate of the average classification accuracy is computed 2.91%.

DISCUSSION

In this study, it is shown that using combination of µ, β and γ frequency bands provides more information than only using combination of µ and β in movement imagination separations.

Effect of various ratios of carbohydrate-protein supplementation on resistance exercise-induced muscle damage

AIM

Previous studies have indicated that exercise-induced muscle damage might be attenuated by coingestion of protein and carbohydrate supplement. The purpose of this study was to compare the effect of three various ratios of carbohydrate-protein (CHO+PRO) supplements on resistance exercise-induced muscle damage indices.

METHODS

Twenty-eight untrained male students voluntarily participated in this study and were randomly assigned to one of the four groups: 1) CHO+PRO 2:1 ratio, N.=7; 2) CHO+PRO 3:1 ratio, N.=8; 3) CHO+PRO 4:1 ratio, N.=7; 4) placebo group, N.=6. They performed a single bout of resistance exercise (whole body: 3 set×8-10 reps with 70-75% 1RM), with eccentric concentration. Every group consumed prepared CHO/PRO beverages (9% concentration, 10 mL/kg/bw-1 at different ratios) or the same amount of placebo beverage before and in 15 min intervals during exercise. Blood samples were taken before the exercise bout and also at 1 and 24 h post-exercise. In addition, muscle soreness scores were recorded before and 1, 24, and 48 h postexercise. Repeated measures ANOVA (between-within design) and Bonferroni post hoc test were used to analyze dependent measures (α=0.05).

RESULTS

Serum creatine kinase (CK) and myoglobin (Mb) increased in all groups compared with pre-exercise but the significant difference among groups was observed in 24 h postexercise, in a way that both CK and Mb levels were higher in placebo group. Muscle soreness increased for all groups from pre to postexercise, but there was not any significant difference among groups at any time point.

CONCLUSION

Findings of this study showed that CHO+PRO decreased serum CK and Mb at 24 h post exercise, but did not affect muscle soreness at any time points after exercise. Moreover, there were no significant differences between various ratios of CHO-PRO supplementation.

Unerupted primary molar teeth positioned inferior to the permanent premolar: a case report

Primary tooth impaction is a rare finding during the development of primary dentition. Several factors contribute to the impaction of a deciduous tooth. This report describes the diagnosis and treatment of a 10-year-old boy who presented an impacted second primary mandibular molar. This tooth, located inferior to the second premolar together with an odontoma, was positioned superior to the premolar teeth. Treatment consisted of surgical removal of the impacted deciduous tooth and odontoma and placement of a passive lower lingual holding arch. Periodic examination was indicated for follow-up. Early intervention was recommended to manage orofacial disfigurement and to avoid consequent problems.

Optimal dose of pre-incision/post-incision gabapentin for pain relief following lumbar laminectomy: a randomized study

BACKGROUND

Gabapentin has been introduced as an effective agent for post-operative pain control. This study aimed to test the effects of pre- and post-incision administration of different doses of gabapentin on post-operative morphine requirement and pain following lumbar laminectomy.

METHODS

In this randomized clinical trial, 175 patients were allocated into seven groups of 25 patients each to receive placebo or gabapentin 600, 900 or 1200 mg pre- or post-incision. Total patient-controlled intravenous morphine consumption during the first 24 post-operative hours, and the time to the first demand for morphine were recorded. Pain score at rest (visual analogue scale) was recorded every 30 min in the first 4 h and then every 2 h until 24 h post-operatively. Side-effects were observed.

RESULTS

In the first 12 h, morphine consumption was less, pain scores were lower and the time to the first demand for analgesia was longer in groups receiving gabapentin 900 or 1200 mg either pre- or post-incision, compared with placebo and gabapentin 600 mg (P<0.001). There was no difference between gabapentin 900 and 1200 mg. Pain score, morphine consumption and time to the first demand for analgesia in equal pre- or post-incision doses of gabapentin were not significantly different. No differences in the side-effects were observed between groups.

CONCLUSION

Gabapentin 900 or 1200 mg, administered either pre- or post-incision, was found to be effective in pain management following lumbar laminectomy. Similar doses of gabapentin provide the same post-operative analgesia whether administered pre- or post-incision.

A novel technique for the removal of fractured instruments in the apical third of curved root canals

AIM

To report on a conservative approach for removal of a fractured file in the severely curved apical portion of the distobuccal canal of a mandibular molar.

SUMMARY

With the assistance of stainless steel hand files and a chloroform-dipped gutta-percha cone, a fractured rotary NiTi instrument was successfully removed. The use of this technique may assist in removal of loose instrument fragments that are not easily accessible to other removal techniques.

KEY LEARNING POINTS

Instrument fractures do not always lead to an unfavourable prognosis and their removal from the apical third of curved canals should not be routinely attempted. The case highlights that it is possible to conservatively remove loosely bound objects from the hard-to-reach areas of the root canal system.

Occupational stress and work-related unintentional injuries among Iranian car manufacturing workers

This study in 2004 and 2005 aimed to present the pattern of job stress among car manufacturing workers in one factory in the Islamic Republic of Iran, and to assess its relationship with occupational injuries. Data were collected from 608 male workers (508 at-risk general workers and 100 with injuries in the last year). Job stress was assessed by the Belkic occupational stress index. The prevalence of job stress was 21.3%. The main occupational stressors were time pressure (78.5%), mode of payment and evaluation (56.4%), and interaction with people and machines (41.3%). The risk of injury among those with job stress was significantly higher than those without job stress (OR = 2.0; 95% CI: 1.20-3.30). Job stress was responsible for 11.9% of all occupational injuries in this group.

The effect of anionic and cationic surfactants on indicators and measurement of dissociation constants with two different methods

The effects of cationic cetyltrimethylammonium bromide (CTAB), hexadecylpyridinum chloride (HDPC) and anionic sodium dodecylsulphate (SDS) surfactants on dissociation constants and transition intervals of methyl red, methyl orange and cresol red were studied spectrophotometrically. The results show that all studied indicators strongly interacted with cationic micelles (CTAB and HDPC). In the case of methyl red, relatively strong interaction with anionic surfactant (SDS) was obtained. However, no effect of SDS on dissociation constants of cresol red and methyl orange was observed. The dissociation constants of indicators were calculated with both the proposed and known chemometric (DATAN) method with a reasonable agreement on the data achieved.

Genotypic comparison of bacteria recovered from human bite marks and teeth using arbitrarily primed PCR

AIMS

This study assessed, for forensic purposes, the feasibility of genotypically matching oral streptococci recovered from recent human bite marks with those from the teeth of the biter.

METHODS AND RESULTS

Streptococci were isolated from the incisors of eight volunteers. Arbitrarily primed PCR (AP-PCR) distinguished 106 streptococcal genotypes among the participants, each harbouring at least eight distinct strains. In a crime simulation, a sample from an experimental bite mark was analysed by an experimenter unaware of its origin. The bacteria were unambiguously matched to the biter by comparing the amplicon profiles with those from the eight participants. In contrast, bacteria from an additional bite mark (not generated by one of the original participants) could not be matched to any of the eight participants. Between 20 and 78% of catalogued bacterial genotypes were recovered 12 months later from each participant. Throughout the study period, none of the bacterial genotypes were shared between participants.

CONCLUSIONS

Streptococci isolated from recent bite marks can be catalogued by AP-PCR and matched to the teeth responsible for the bite.

SIGNIFICANCE AND IMPACT OF THE STUDY

The study provides 'proof of concept' that genotypic analysis of streptococci from bite marks may provide valuable forensic evidence in situations where the perpetrator's DNA cannot be recovered.

["The fate" of a peri-cystic-jejunostomy in the treatment of the hydatid liver cysts]

The persistence of a hepato-jejunal fistula after 9 years from a peri-cystic-jejunostomy in the treatment of hydatid liver cysts is an amazing condition. We discover this kind of fistula during the operation for cholelithiasis. This association between fistula and a "after-hydatid" choledocholithiasis is an opportunity to discuss some pathogenic and evolutive mechanisms about both of two entities.

Effect of Monensin on Serum Lipoproteins, Triglycerides, Cholesterol and Total Lipids of Periparturient Dairy Cows

Serum concentrations of very low-density lipoproteins (VLDL), low-density lipoproteins (LDL), high-density lipoproteins (HDL), triglycerides, cholesterol, and total lipids of a group of monensin-treated cows (n = 7) were compared with those of a control group (n = 6) from about 10 days before calving to 45 days postpartum. Monensin was fed in the diet from about 20 days before predicted calving date to 45 days after parturition. Blood samples were obtained on days 20 and 10 before predicted calving, and on days 4, 15, 25 (phase I), and days 35 and 45 (phase II) post calving. Cholesterol (p = 0.046) and total lipids (p = 0.003) were lower in the treatment group 10 days before calving. Concentrations of serum triglycerides and VLDL (p = 0.017), and that of LDL (p = 0.032) were significantly higher in the treatment group in phase I postpartum. No significant difference was detected between groups during phase II. Comparison of the entire length of the trial showed higher concentrations of triglycerides and VLDL in the treatment group (p = 0.009). It is concluded that monensin is effective in increasing secretion of triglyceride-rich lipoproteins from the liver during the postpartum transition period of dairy cows. This may be effective in reducing the intensity of hepatic lipidosis and the incidence of periparturient diseases resulting from disturbances in energy metabolism.

[The main utility of trans-anastomosis external drainage in the hydatid liver cysts treatment by peri-cystic-jejunostomy]

We purpose to make a metanalysis of a external drainage and his role in the treatment of the hydatid liver cysts when it was made a anastomosis between peri-cystic cavity and a isolated loop of jejunum. The paper watch 74 cases which were operated in "I. Juvara" surgical clinic and in which it was used the external drainage of peri-cystic cavity. The drainage roles consist in follow up of peri-cystic cavity evolution, but, more than that, in early diagnosis and treatment of secondary infection of cavity, the main postoperative complication. The drainage excludes the possibility of unfavourable evolution of postoperative infection, in which case the result of operation may be compromised.

Isolation and genotypic comparison of oral streptococci from experimental bitemarks

The feasibility of recovering and genotypically comparing oral bacteria from bitemarks for forensic purposes was assessed experimentally. Volunteers firmly bit their own upper arms and bitemarks were sampled at intervals to recover viable Streptococcus isolates. The recoverability of bacteria decreased over time but an average of more than one thousand viable organisms was recovered 24 hrs after biting, provided the site remained relatively undisturbed. Physical exertion, manual rubbing and application of moisturizing lotion all decreased bacterial recoverability compared to controls. Streptococci could also be recovered from bites inflicted on various fabrics. Genomic profiles (DNA "fingerprints") of bacteria recovered from bitemarks could be identified exclusively with those from the teeth of the individual responsible. These findings suggest that a bacterial genotyping approach to bitemark analysis could have forensic application in situations where the perpetrator's DNA cannot be recovered from an oral contact site.

A field evaluation of driver eye and head movement strategies toward environmental targets and distractors

A new systems approach for evaluating field performance of drivers is presented in a practical experimental demonstration. The emphasis reflected in this paper is on driver head and eye movement behaviour toward environmental targets and distractors. A unique video technology set-up was designed to record eye and head movements. Simultaneous video-tapings of driver eye/head movements and the environmental scene were time synchronised. Two intersections (one busy and one quiet) were carefully selected and analysed for their static and dynamic visual targets and distractors. A subject made 40 repetitive left-turns alternately at busy and quiet intersections in a naturally moving traffic environment. Both head movement patterns and eye movement frequencies differed significantly between the two intersections. Results suggest that the eye and head movements are highly dependent upon the type of turn configuration, type and frequency of targets, type and frequency of distractors, and traffic control configurations.