Rate of colorectal neoplasia in patients with Hodgkin lymphoma

AIM

Survivors of Hodgkin lymphoma (HL) are at increased risk of breast, lung, thyroid, stomach, pancreatic and colon cancer. There is limited information on the utility of endoscopic screening for colon cancer. We aimed to describe the adenoma detection rate (ADR) in patients with HL to determine the appropriate timing of colonoscopy screening.

METHOD

We retrospectively studied patients with HL who underwent colonoscopy between 2000 and 2017.

RESULTS

A total of 251 patients underwent colonoscopy. Eighty (32%) patients had 151 colonic polyps. Thirty per cent of the polyps exhibited high-grade dysplasia, and invasive colon adenocarcinoma was found in 10 patients. Patients with the nodular sclerosing subtype of HL had a significantly lower ADR than others (P = 0.002). The ADR was 5% in patients younger than 35 years (n = 64), 23% in patients between 35 and 40 years of age (n = 22), 39% in patients between 40 and 50 years of age (n = 51) and 46% in patients older than 50 years (n = 114).

Ventral hernia recurrence in women of childbearing age: a systematic review and meta-analysis

BACKGROUND

There is no consensus agreement on the optimal management strategy for ventral hernia in women of childbearing age. The theoretical increased risk of ventral hernia recurrence can impact management strategies. We conducted a systematic review of the literature to report the ventral hernia recurrence rate in women of childbearing age who underwent hernia repair prior to their pregnancy and propose a management algorithm.

METHODS

We systematically searched multiple databases including MEDLNE, PubMed, and the Cochrane Library sources from inception to August, 2017. Two reviewers independently identified 314 primary studies, assessed methodological quality, and extracted data. Quality of included studies was assessed by employing the Newcastle Ottawa quality assessment tool for cohort studies. A separate tool was utilized for assessing the methodological quality of case series. A meta-analysis of proportions was conducted of studies reporting incidence of recurrence using STATA, employing a random effects model, to calculate a pooled weighted incidence rate (with 95% confidence interval). Descriptive statistics were employed to report the findings of studies which did not report any ventral hernia recurrence.

RESULTS

Five retrospective studies were included in our review, enrolling a total of 14,638 female participants. Upon stratifying patients according to pregnancy status after primary hernia repair, 13,494 were found to be in the non-pregnant cohort whereas 1,144 were included in the pregnant cohort. Overall, 9% (95% CI 8-9%) of the non-pregnant patients experienced a recurrence whereas 12% (95% CI 10-15%) of patients that became pregnant subsequent to a ventral hernia repair experienced a recurrence. No major adverse events were recorded throughout the course of pregnancy.

CONCLUSIONS

Ventral hernias in women of childbearing age have a pooled recurrence rate of 12%. Pregnancy may be considered a risk factor for ventral hernia recurrence. Female patients of childbearing age with asymptomatic or minimally symptomatic ventral hernias that do not pose a significant strain on the patients' quality of life could be provided with the option of watchful waiting, with appropriate education of risks while discussing management.

The pedicled occipital artery scalp flap for salvage surgery of the neck

A small group of patients with complex head and neck cancer present with problems of wound healing following radiotherapy and reconstructive surgery. Provision of skin cover to the neck in these cases is often required and presents a challenge to the reconstructive surgeon. We present the use of a pedicled scalp flap based on the occipital artery for such defects. This flap is an axial patterned scalp flap incorporating hair-bearing skin. It may be up to 15 cm wide and can reach beyond the midline of the chin. The anatomy of the flap is described and its use illustrated in three cases. This flap is a useful addition to the options for reconstruction of neck defects in patients with head and neck cancer.

Physico-chemical properties of Aspergillus flavus var. columnaris alpha-amylase

The best temperature for the preservation of A. flavus var. columnaris alpha-amylase was -5 degrees C followed by 5 degrees C. CaCl2 at 0.005 M had no effect on the activity in both temperatures. Repeated freezing (-5 degrees C) and thawing followed by freezing (-5 degrees C) had no effect on stability of alpha-amylase. On the other hand, 25 degrees C was the lowest preservation temperature without any effect on the stability on alpha-amylase. 0.005 M CaCl2 decreased the activity of alpha-amylase and reached a 100% inhibition at 35th day. The fungal alpha-amylase had an optimum temperature of 55 degrees C at pH 4.6, but had 60 degrees C in buffer containing 0.005 M CaCl2 and 50 degrees C in buffer containing 0.005 M Na2-EDTA. The addition of 0.01 M CaCl2 greatly increased the thermostability of alpha-amylase at 40, 45, 50, 55 and 60 degrees C for 30 min. Optimum pH for alpha-amylase only was 5, but in the presence of 0.01 M CaCl2 or Na2-EDTA 5.6. The enzyme only was stable for 4 h at 25 degrees C. Whereas addition of 0.01 M CaCl2 showed a loss of 4% compared to a 22% loss in the presence of 0.01 M Na2-EDTA after 4 h at 25 degrees C and 65% loss in the presence of 0.01 M CaCl2 together with 0.01 M Na2-EDTA in the beginning and a 100% loss after 4 h at 25 degrees C. The optimum temperature for the activity of alpha-amylase at pH 5 was 50 degrees C for the enzyme only but 55 degrees C in the presence of 0.01 M CaCl2. However, at pH 6 and 7 optimum temperature was 55 degrees C for the activity of the enzyme only or with 0.01 M CaCl2. The presence of 0.01 M CaCl2 at pH 5, 6 and 7 resulted in increase of enzyme activity at the temperatures above 50, 40 and 25 degrees C, respectively. However, 0.01 M CaCl2 at pH 5 and 6 resulted in decreasing enzyme activity at temperatures below 55 and 45 degrees C, respectively.

Effect of chemicals on fungal alpha-amylase activity

The effect of 8 growth regulators at concentrations of 1,000, 5,000 and 10,000 ppm on the activity of fungal (Aspergillus flavus var. columnaris) alpha-amylase was studied. Indol acetic acid (IAA) and naphthalene acetic acid (NAA) inhibited alpha-amylase activity by 2% and 7% at 1,000 ppm. The other 6 growth regulators, indol butyric acid (IBA), gibberellic acid, cumarin, cycocel (CCC), atonik-G and kylar, did not inhibit but stimulated alpha-amylase activity (0 to 9%) at 1,000 ppm. All growth regulators studied inhibited alpha-amylase activity at 5,000 and 10,000 ppm concentration except kylar. The effect of organic acids and formaldehyde at 0.01, 0.005, and 0.001 M was studied. Acetic acid stimulated alpha-amylase at all concentrations, but formic acid, oxalic acid, lactic acid and citric acid inhibited alpha-amylase activity by 91, 100, 100 and 79%, respectively, at a concentration of 0.01 M, while by 31, 100, 15 and 20%, respectively, at 0.005 M. Formaldehyde induced 7, 3 and 2% inhibition at 0.01, 0.005 and 0.001 M, respectively. At 0.01 M either sorbitol or fructose inhibited alpha-amylase by 8%, Maltose 7%, sucrose 6%, phenol, glucose and galactose each by 5%, ethanol, glycerol, arabinose and sodium benzoate each by 4%, isopropanol and mannitol 1%, but methanol and ammonium citrate dibasic did not inhibit alpha-amylase. The results indicate that CuCl2, SnCl2, AgNO3 and Fe2(SO4)3 were the strongest inhibitors, followed by Cd(C2H3O2), HgCl2, Na2-EDTA, Na2HPO4, and CaCl2 in decreasing order. NaCl, NaBr and Mn SO4 did not inhibit alpha-amylase at concentrations from 10 mM to 0.01 mM.

Soybeans vs. textured soy proteins as meat extenders. Cooking losses, palatability, and thiamin content of freshly cooked and frozen meat loaves

The effects of replacing 30 percent of the ground beef in meat loaves with boiled ground soybeans or textured soy protein (TSP) were studied. The substitutions were equally effective in increasing yields of freshly cooked, raw frozen and cooked, and cooked, frozen, and reheated meat loaves. Scores for several palatability characteristics, including general desirability, were higher for meat loaves containing soybeans than for loaves containing TSP. The mixtures and loaves contained similar amounts of protein and thiamin. Cooking losses and mean palatability scores indicated advantages for freezing raw loaf mixtures rather than cooked loaves.

Studies on nodulation of soyabeans in Egypt. II. Effect of seed-diffusates on Rhizobium japonicum

The growth inhibition zones of R. japonicum (E 45) by either surface-sterilized seeds or autoclaved seeds (as well as dicotyledones, cotyledone, or seed coat) of Harosoy soyabean cultivar indicate the presence of antibacterial substances. Several physical and chemical seed treatments were done in a trial to eliminate or decrease the observed inhibitive effects of the seed-diffusates in order to obtain successful nodulation. The antibacterial substances are thermostable (121 degrees C), water-soluble or partially insoluble, exist in the whole seed and could be inactivated by certain chemical seed treatments as well as by germination for 12 hrs. or more before inoculation.

Studies on nodulation of soyabean in Egypt. I. Selection of an efficient strain of Rhizobium japonicum

Both pot (sterilized sand cultures) and field experiments were run, using 23 different strains of Rhizobium japonicum and the commercial soyabean inoculum "Okadin". The failure of the control (non-inoculated plants) to form nodules may be due to the abscence of adequate densities of effective soyabean-rhizobia strains and their low persistence under Egyptian soil conditions. Therefore, inoculation with an efficient strain of R. japonicum seemed to be necessary. However, the strains used varied in their effectiveness, indicating that both the total number of nodules and total nitrogen content of the nodules should not be taken as an index.