In Vivo Visualization of Hair Follicles by Ultrasound Biomicroscopy in Alopecia Areata and its Correlation with Histopathology

Ultrasound biomicroscopy (UBM) is a non-invasive imaging technique used in examination of several skin diseases but never in imaging hair and scalp diseases.  Main objective of this investigation was assessment of the efficacy of UBM for in vivo visualization of hair follicles in cases of alopecia areata (AA) and correlation of findings with histopathological findings. This study included 30 patients with AA. Two areas, one with AA and a control area, were marked, examined by UBM and then biopsied for histopathological examination. In patients with alopecia totalis (AT) or universalis (AU) only an AA area was examined. Non-echogenic conical shadows reaching the epidermal entrance echo (probably corresponding to the hair follicles) were seen and were wider and fewer in number in areas of AA than in normal control areas. No significant difference was found regarding number and width of hair follicles between UBM and histopathological examination. However, a significant increase in length of follicles in histopathology was detected, indicating that the UBM image was probably unable to reach the deepest part of the follicle. Main limitation of the study is small number of cases. No significant difference was found between UBM and histological measurements of hair follicle number and width in patients with AA, making UBM a useful tool for in vivo visualization of hair follicles. </p

High frequency of Plasmodium falciparum chloroquine resistance marker (pfcrt T76 mutation) in Yemen: An urgent need to re-examine malaria drug policy

<p>Abstract</p> <p>Background</p> <p>Malaria remains a significant health problem in Yemen with <it>Plasmodium falciparum </it>being the predominant species which is responsible for 90% of the malaria cases. Despite serious concerns regarding increasing drug resistance, chloroquine is still used for the prevention and treatment of malaria in Yemen. This study was carried out to determine the prevalence of choloroquine resistance (CQR) of <it>P. falciparum </it>isolated from Yemen based on the <it>pfcrt </it>T76 mutation.</p> <p>Methods</p> <p>A cross-sectional study was carried out among 511 participants from four governorates in Yemen. Blood samples were screened using microscopic and species-specific nested PCR based on the 18S rRNA gene to detect and identify <it>Plasmodium </it>species. Blood samples positive for <it>P. falciparum </it>were used for detecting the <it>pfcrt </it>T76 mutation using nested-PCR.</p> <p>Results</p> <p>The prevalence of <it>pfcrt </it>T76 mutation was 81.5% (66 of 81 isolates). Coastal areas/foothills had higher prevalence of <it>pfcrt </it>T76 mutation compared to highland areas (90.5% <it>vs </it>71.8%) (p = 0.031). The <it>pfcrt </it>T76 mutation had a significant association with parasitaemia (p = 0.045). Univariate analysis shows a significant association of <it>pfcrt </it>T76 mutation with people aged > 10 years (OR = 9, 95% CI = 2.3 - 36.2, p = 0.001), low household income (OR = 5, 95% CI = 1.3 - 19.5, p = 0.027), no insecticide spray (OR = 3.7, 95% CI = 1.16 - 11.86, p = 0.025) and not sleeping under insecticide treated nets (ITNs) (OR = 4.8, 95% CI = 1.38 - 16.78, p = 0.01). Logistic regression model confirmed age > 10 years and low household income as predictors of <it>pfcrt </it>T76 mutation in Yemen <it>P. falciparum </it>isolates.</p> <p>Conclusions</p> <p>The high prevalence of <it>pfcrt </it>T76 mutation in Yemen could be a predictive marker for the prevalence of <it>P. falciparum </it>CQR. This finding shows the necessity for an in-vivo therapeutic efficacy test for CQ.<it> P. falciparum </it>CQR should be addressed in the national strategy to control malaria.</p

Free Anterolateral Thigh Flap for Reconstruction of Major Craniofacial Defects

ABSTRACT Free-tissue transfer has revolutionized skull-base surgery by expanding the ability to perform cranial base resection and by improving the quality of reconstruction. The anterolateral thigh flap has come recently into use in the field of head and neck reconstruction. Its role in craniofacial and midface reconstruction has not been specifically defined. This study involved a total of 18 patients who were treated over a 5-year period from 1998 to 2003. Seventeen patients had locally advanced head and neck cancer, requiring craniofacial resection, and one patient had a complicated gun shot wound of the forehead. Thirteen patients were treated at the National Cancer Institute, Cairo University, Egypt, and five patients at the University of Miami, Florida. The patients presented with defects of the anterior skull base (5), lateral skull base (3), scalp and calvarium (3), and the midface (7). The anterolateral thigh flap was used as a myocutaneous flap in 11 cases and as a perforator fasciocutaneous flap in seven cases. Musculocutaneous perforators supplied the majority of flaps (17/18). Total flap survival occurred in 17 cases; one patient developed complete flap necrosis. The most commonly used reciepient vessels were the facial vessels and the external jugular vein. Major complications included one case with meningitis; the patient died after failure of treatment. Another patient died 6 weeks postoperatively from pulmonary embolism. One patient developed CSF leak that stopped spontaneously. In addition, two patients developed minor wound dehiscence that healed spontaneously. The donor-site wound healed without problems except in two cases. One patient had an incomplete take of the skin graft; the other developed wound infection and superficial sloughing. Both wounds healed spontaneously. In addition to the feasibility of simultaneous flap harvesting with tumor resection, the flap's advantage in skull base reconstruction is its reliable blood supply, which can provide adequate dural cover and protection of the brain. Its size and moderate thickness are suitable for reconstruction of scalp and calvarial defects. The abundance of reliably vascularized fat in the flap may be an advantage in long-term maintenance of the volume of the flap in midface reconstruction. Similar to other soft tissue flaps, additional skeletal reconstruction may still be required to achieve an optimal functional and aesthetic result

Role of trehalose on antioxidant defense system and some osmolytes of quinoa plants under water deficit

Abstract Background For scavenging reactive oxygen species, plant possess effective system that protect them from destructive oxidative reaction. Parts of this system as osmoprotectants and antioxidative enzymes are key elements in the defense mechanisms. A field experiment was conducted to evaluate the potential of foliar treatment of trehalose (Tre) with different concentrations (0, 0.1 mM, or 0.5 mM) in improving antioxidant defense system of quinoa plant under normal irrigation and drought stress conditions. Results Drought stress caused significant increases in some osmoprotectants as glucose, trehalose, TSS, free amino acids, and proline. Meanwhile, trehalose foliar treatment with different concentrations significantly decreases in free amino acids and proline contents. More accumulation of the tested organic solutes of leaves (glucose, sucrose, trehalose, TSS) of the trehalose-treated plant in both normal irrigated and drought-stressed quinoa plants as compared with the corresponding controls. Treating quinoa plants with trehalose resulted in significant decrease in lipid peroxidation, hydrogen peroxide contents, and LOX activity in normal irrigated and drought-stressed plants. These decreases correlated with significant increases in total phenolic contents as compared with untreated control. Different concentrations of trehalose resulted in significant increases in antioxidant enzymes. Maximum increase antioxidant enzymes were observed by treating plants Tre at 0.5 mM either under normal irrigation or drought conditions. Conclusion It could be concluded that foliar spray of trehalose was effective in improving quinoa performance by reducing hydrogen peroxide free radical and by enhancing antioxidant compounds (phenolics), compatible osmolytes, membrane stability, and antioxidant enzymes

New Heuristics for Interfacing Human Motor System using Brain Waves

There are many new forms of interfacing human users to machines. We persevere here electric-mechanical form of interaction between human and machine. The emergence of brain–computer interface allows mind-to-movement systems. The story of the Pied Piper inspired us to devise some new heuristics for interfacing human motor system using brain waves, by combining head helmet and LumbarMotionMonitor. For the simulation we use java GridGain. Brain responses of classified subjects during training indicates that Probe can be the best stimulus to rely on in distinguishing between knowledgeable and not knowledgeable

The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature

Background: Autologous breast reconstruction using the extended latissimus dorsi flap has been infrequently reported. In the current study, the authors are reporting their own clinical experience with this method. A review of the literature is also discussed. Materials and Methods: Over a three year period, 14 patients underwent breast reconstruction using the extended latissimus dorsi (LD) flap. Patients with small to medium sized breasts were selected. The age of the patients ranged from 29 to 42 years with a follow-up period ranging from six to 18 months. The indications, flap-related complications and donor site morbidity and aesthetic results were evaluated. Results: The main indication to use the flap was dorsal donor site preference by patients. The remaining patients were either not suitable for a flap from the abdomen or wished to get pregnant and were offered the dorsal donor site. Neither total nor partial flap loss was recorded but donor site morbidity was mainly due to seroma, which was treated conservatively in all patients, except for one who required surgery. Another two patients suffered from wound breakdown and distal necrosis of the back flaps. Mild contour deformity was also noted on the back of all patients but caused no major concern. Indeed, the overall patient satisfaction was very high. Conclusion: The extended LD flap proved to be a good option for autologous breast reconstruction in selected patients. Patients should be warned of the potential for seroma and mild contour back deformity