Primary lumbar hernia in an elderly woman: case report

Lumber hernia is a rare posterior abdominal wall defect with fewer than 300 cases reported in literature. It accounts for less than 1.5% of total hernia incidence. Herniation is mainly through the inferior lumber triangle (Petit’s hernia) or through the superior lumber triangle (Grynfeltt’s triangle); with both these anatomical boundaries accounting for 95% of lumber hernias. Lumber hernias are classified as either congenital (20%) or acquired (80%), and the typical presentation is a patient with a protruding bulge in the back with a slow growth. Our patient was a 70-year-old woman who presented at the surgical outpatient department with a swelling on the right flank for two years. She revealed no known cause of the swelling that was progressively increasing in size, with a dull pain. Physical examination and ultrasonography revealed a defect in the posterolateral abdominal wall. Surgical dissection revealed a large hernial sac, which contained retro peritoneal fat, protruding through a 3-4 centimetres defect in the transversalis fascia lining the floor of the superior lumbar triangle. The hernia sac was reduced and the defect closed. There was no recurrence four months post-operative. Lumber hernias are rare, but a good history and physical examination is important to rule out most of the differential diagnoses. Early surgical management is recommended but the surgical approach should be individualised

Technical report on the environmental monitoring of the cage area at the Source of the Nile (SON) Fish Farm for Quarter 4: October – December 2017

The monitoring of water quality and biotic communities at Source of the Nile (SON) fish farm area, for quarter 4 (October – December) was undertaken in December 2017. The activity aimed at assessing possible changes in the water environment at SON cage area. The following parameters were assessed: water physico-chemicals and nutrients, algae, zooplankton, benthic macro invertebrates, and fish communities. Total depth was above 5.0 m (range: 5.63 – 9.74 m) at all sampled points and decreased towards the downstream of cages. Water transparency ranged from 1.26 – 1.48 in the cage area and 1.08 to 1.34 m away from the cages. Within the cage area, Dissolved Oxygen ranged from 5.7 – 6.4 mg/L at the surface, and 5.1 – 6.4 mg/L at the bottom, while in the non-cage areas, the range was 5.5 – 7.5 mg/L at the surface and 2.6 – 7.0 mg/L at the bottom. Temperature ranged from 27.0 – 28.0 o C at the surface and 25.5 – 27.5 o C at the bottom waters for all sites, and were within the optimal range (25 – 32 o C). pH in both surface and bottom waters was above 7.0 (range: 7.5 – 9.2) at all sites. Conductivity within cage area ranged from 100.5 – 102.6 μScm-1 in surface water and 101.8 – 112.1 μScm-1 in bottom water. In the non-cage areas conductivity ranged from 11.0 – 104.4 μScm-1 in surface water and 100.2 – 110.0 μScm-1 at the bottom. Ammonium nitrogen concentration during December was less than 0.02 mg/L at all sites (0.007 – 0.018 mg/L within the cage sites, and 0.012 – 0.019 mg/L in the non-cage sites). Nitrite nitrogen ranged from 0.002 – 0.169 mg/L in the cage area, and 0.003 – 0.057 mg/L in the non-cage areas. Similar to previous records of June and September 2017, nitrate nitrogen concentration generally increased towards the downstream site, being lowest at RPT (0.041 mg/L) and highest at DSC (0.204 mg/L). Soluble reactive phosphorus was less than 0.005 mg/L at all sites, and varied within narrow margin (range: 0.003 – 0.0048 mg/L in cage sites, and 0.0032 – 0.0047 mg/L in non-cage sites). The TP concentration ranged from 0.085 – 0.107 mg/L in the cages, and 0.090 – 0.118 mg/L in the non-cage sites and was higher than recorded in September (0.038 – 0.044 mg/L in the cages and 0.04 to 0.109 mg/L away from cages). Total nitrogen concentration was in the range of 0.138 – 0.553 mg/L within cage area and 0.421 – 0.513 mg/L in non-cage areas. The concentration of TSS ranged from 0.76 – 4.33 mg/L in the cage area and 0.57 – 2.76 mg/L in the non-cage areas. The phytoplankton community was composed of blue-green algae, green algae and diatoms, dominated by blue-green algae. The abundance of algae was higher in the non-cage areas (mean:7.20 ± 2.14 mm3L-1, Range: 5.15 – 10.20 mm3L-1) than recorded in the cage areas (mean: 6.0 ± 0.71 mm3L-1, Range: 5.30 – 6.98 mm3L-1), similar to observations of September 2017 (5.6 mm3L-1 in the non-cage sites). At all sampled points, blue-green algae contributed >70% of total abundance. Total zooplankton abundance ranged from 982,213 – 1,310,830 ind.m-2 in the non-cage sites, and 740,601 – 1,503,130 ind.m-2 in the cage areas. Similar to observations of September 2017, the upper cage site (WIC3 and WIC4) presented lower zooplankton abundance (mean: 788,954 ± 68,381 ind.m-2) when compared to the lower cage site with mean abundance of 1,128,232 ± 530,186 ind.m-2. Like in the previous sampling periods, copepods were the numerically dominant group (92.69 – 97.22 % of total zooplankton abundance) at all sampled points, with no major differences between cage and non-cage areas. The high abundance of copepods was attributed to the abundance of the juvenile stages (copepodites and Nauplius larvae) which contributed 83.72 – 92.78% of the total zooplankton abundance and this was mainly due to the Nauplius larvae (66.4 – 83.2 %). Cladocera relative abundance ranged from 0.32 – 3.98% while that of rotifers ranged from 1.55 – 3.74%. The macro-benthic community comprised molluscs, annelids and arthropods. Taxa richness ranged from 5 – 11 taxa in the cage area, and 7 – 9 taxa in the non-cage areas. The abundance of benthic invertebrates within the cage area ranged from 1,134 – 2,416 ind.m-2 and this was higher than previously recorded in September (294 – 1,415 ind.m-2). In the non-cage sites abundance was in the range of 420 – 3,992 ind.m-2. Oligochaete annelids which are reported to be very tolerant to pollution contributed 0 - 28 % of the abundance of benthos at cage sites and 3 - 20% at the non-cage sites. Diptera made the greatest contribution at almost all sites, with the percent abundance being higher in non-cage sites (40 – 86%) than what was recorded in the cage sites (37 – 82%). Chironomus spp. and Chaoborus sp. were the main contributors to the observed Diptera abundance at all sites. Six fish species, including haplochromines (Nkejje) as a single species group, were recorded in the vicinity of the cages during December 2017. Five fish species were recorded from upstream the cage site, four species from within cage area, and two species from downstream the cages. Overall mean catch rates were 1.8 fish/net/night and 148.6g/net/night compared to 1.7 fish/net/night and 175.4g/net/night recorded in September 2017. By weight, catch rates in December 2017 were highest upstream the cage site (312.1g/net/night) and also by numbers (3.1 fish/net/night). Four species of haplochromines were recorded in the vicinity of the cages during the survey of December 2017 compared to six species recorded in September 2017. The overall catch rate for the haplochromines, in December 2017 was 1.7fish/net/night and 27.5g/net/night compared to 3.4 fish/net/night and 62.3g/net/night recorded in the previous survey of September 2017. Among the fish species examined during December 2017 survey, most of the haplochromine cichlids (88.9%) were mature but only 50% breeding. Only one specimen of L. niloticus was mature and breeding. All S. afrofischeri and S. victoriae specimens examined were mature and in breeding condition while M. kannume was immature. The diet of fishes encountered comprised mostly of fish and insects, which are known natural foods of the fish species. Infection by fish parasites during the survey of December 2017 was not noticed in any fish recorded from the experimental gillnets. The overall observation on concentrations of nutrients, levels of physico-chemical variables, and biotic communities indicated minimal impact of cages on water quality. The farm should therefore continue adhering to the best environmentally sustainable aquaculture practices, especially continuing with fallowing or rotation of cages to allow resident organisms maintain their natural population densities, distribution and community structure in the area; reducing excess uneaten feed and other suspended materials which would impact on nutrient status and biota; as well as wise use of any chemicals in the area

Cloning and Functional Studies of a Splice Variant of CYP26B1 Expressed in Vascular Cells

Background: All-trans retinoic acid (atRA) plays an essential role in the regulation of gene expression, cell growth and differentiation and is also important for normal cardiovascular development but may in turn be involved in cardiovascular diseases, i.e. atherosclerosis and restenosis. The cellular atRA levels are under strict control involving several cytochromes P450 isoforms (CYPs). CYP26 may be the most important regulator of atRA catabolism in vascular cells. The present study describes the molecular cloning, characterization and function of atRA-induced expression of a spliced variant of the CYP26B1 gene. Methodology/Principal Findings: The coding region of the spliced CYP26B1 lacking exon 2 was amplified from cDNA synthesized from atRA-treated human aortic smooth muscle cells and sequenced. Both the spliced variant and full length CYP26B1 was found to be expressed in cultured human endothelial and smooth muscle cells, and in normal and atherosclerotic vessel. atRA induced both variants of CYP26B1 in cultured vascular cells. Furthermore, the levels of spliced mRNA transcript were 4.5 times higher in the atherosclerotic lesion compared to normal arteries and the expression in the lesions was increased 20-fold upon atRA treatment. The spliced CYP26B1 still has the capability to degrade atRA, but at an initial rate one-third that of the corresponding full length enzyme. Transfection of COS-1 and THP-1 cells with the CYP26B1 spliced variant indicated either an increase or a decrease in the catabolism of atRA, probably depending on the expression of other atRA catabolizing enzymes in the cells. Conclusions/Significance: Vascular cells express the spliced variant of CYP26B1 lacking exon 2 and it is also increased in atherosclerotic lesions. The spliced variant displays a slower and reduced degradation of atRA as compared to the full-length enzyme. Further studies are needed, however, to clarify the substrate specificity and role of the CYP26B1 splice variant in health and disease

Complement lectin pathway activation is associated with COVID-19 disease severity, independent of MBL2 genotype subgroups

IntroductionWhile complement is a contributor to disease severity in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, all three complement pathways might be activated by the virus. Lectin pathway activation occurs through different pattern recognition molecules, including mannan binding lectin (MBL), a protein shown to interact with SARS-CoV-2 proteins. However, the exact role of lectin pathway activation and its key pattern recognition molecule MBL in COVID-19 is still not fully understood.MethodsWe therefore investigated activation of the lectin pathway in two independent cohorts of SARS-CoV-2 infected patients, while also analysing MBL protein levels and potential effects of the six major single nucleotide polymorphisms (SNPs) found in the MBL2 gene on COVID-19 severity and outcome.ResultsWe show that the lectin pathway is activated in acute COVID-19, indicated by the correlation between complement activation product levels of the MASP-1/C1-INH complex (p=0.0011) and C4d (p<0.0001) and COVID-19 severity. Despite this, genetic variations in MBL2 are not associated with susceptibility to SARS-CoV-2 infection or disease outcomes such as mortality and the development of Long COVID.ConclusionIn conclusion, activation of the MBL-LP only plays a minor role in COVID-19 pathogenesis, since no clinically meaningful, consistent associations with disease outcomes were noted

A CYP26B1 Polymorphism Enhances Retinoic Acid Catabolism and May Aggravate Atherosclerosis

All-trans retinoic acid, controlled by cytochrome P450, family 26 (CYP26) enzymes, potentially has beneficial effects in atherosclerosis treatment. This study investigates CYP26 subfamily B, polypeptide 1 (CYP26B1) in atherosclerosis and the effects of a genetic polymorphism in CYP26B1 on retinoid catabolism. We found that CYP26B1 mRNA was induced by retinoic acid in human atherosclerotic arteries, and CYP26B1 and the macrophage marker CD68 were colocalized in human atherosclerotic lesions. In mice, Cyp26B1 mRNA was higher in atherosclerotic arteries than in normal arteries. Databases were queried for nonsynonymous CYP26B1 single nucleotide polymorphisms (SNPs) and rs2241057 selected for further studies. Constructs of the CYP26B1 variants were created and used for production of purified proteins and transfection of macrophagelike cells. The minor variant catabolized retinoic acid with significantly higher efficiency, indicating that rs2241057 is functional and suggesting reduced retinoid availability in tissues with the minor variant. rs2241057 was investigated in a Stockholm Coronary Atherosclerosis Risk Factor (SCARF) subgroup. The minor allele was associated with slightly larger lesions, as determined by angiography. In summary, this study identifies the first CYP26B1 polymorphism that alters CYP26B1 capacity to metabolize retinoic acid. CYP26B1 was expressed in macrophage-rich areas of human atherosclerotic lesions, induced by retinoic acid and increased in murine atherosclerosis. Taken together, the results indicate that CYP26B1 capacity is genetically regulated and suggest that local CYP26B1 activity may influence atherosclerosis