A novel computer-based technique for the assessment of tremor in Parkinson's disease

Parkinson's disease (PD) is a common neurodegenerative disease and the diagnosis of its idiopathic form remains challenging. The diagnosis of idiopathic form is based on clinical features which can have poor sensitivity with about 25% of patients diagnosed as having the disease actually having other conditions. In this study we assess the suitability and clinical value of a low cost computer-based system as an aid to diagnosis of PD, in particular the presence of tremor. All participants (12 patients and 10 controls) performed a shape-tracing task using a graphic tablet attached to a laptop. To assess the presence of tremors in the collected data, a statistical spectral analysis of the moment-to-moment fluctuations in the position signal of the output from the digitising tablet was performed. This allowed the comparison of power spectrums obtained from the control and patient responses respectively. A peak in log power between the 5 Hz & 6 Hz can clearly be identified in the patient's spectrum and is indicative of Parkinson's related tremor and no similar peak could be seen in the control's spectrum, suggesting this type of sequential task and automated data analysis may be useful in the diagnosis of tremor.

On the Use of Low-Cost Computer Peripherals for the Assessment of Motor Dysfunction in Parkinson's Disease Quantification of Bradykinesia Using Target Tracking Tasks

The potential of computer games peripherals to measure the motor dysfunction in Parkinson's diseases is assessed. Of particular interest is the quantification of bradykinesia. Previous studies used modified or custom haptic interfaces, here an unmodified force feedback joystick and steering wheel are used with a laptop. During testing an on screen cursor moves in response to movements of the peripheral, the user has to track a continuously moving target (pursuit tracking), or move to a predetermined target (step tracking). All tasks use movement in the horizontal axis, allowing use of joystick or steering wheel. Two pursuit tracking tasks are evaluated, pseudo random movement, and a swept frequency task. Two step tracking tasks are evaluated, movement between two or between two of five fixed targets. Thirteen patients and five controls took part on a weekly basis. Patients were assessed for bradykinesia at each session using standard clinical measures. A range of quantitative measures was developed to allow comparison between and within patients and controls using analysis of variance (ANOVA). Both peripherals are capable of discriminating between controls and patients, and between patients with different levels of bradykinesia. Recommendations for test procedures and peripherals are given.

Effects of edifenphos and glyphosate on the immune response and protein biosynthesis of bolti fish (Tilapia nilotica)

The effects of 1/1000 field recommended concentration of the organophosphorus compounds; edifenphos and glyphosate on the immune response and protein contents were investigated after different time intervals. The cell mediated immune response assessed by proliferative response of splenocytes to mitogens; phytohemagglutinin (PHA) and concanavalin A (Con A) for T cell and lipopolysaccharide (LPS) for B cell decreased significantly in tems of the level of stimulation index in the treated fish and reached maximal depression after 4 weeks. Humoral immunity assessed as splenic antibody plaque forming cells (PFC) measured after 5 days in vitro immunization to sheep erythrocytes (SRBC's) were suppressed in a concentration dependent pattern by the two compounds. The estimated ED50 for the PFC/10(6) cells of edifenphos and glyphosate were 1.48 x 10(-2) uM and 1.65 x 10(-2) uM respectively. The data also showed that serum antibody titres in the treated fish were decreased in a time dependent manner. The total protein content of serum treated with the two pesticides was decreased after different time periods compared with control. The blood serum of treated and untreated Tilapia nilotica were analyzed electrophoretically for protein components and the percentage of proteins in each fraction was determined.

Effect of dimethoate on the immune system of female mice

The functional status of the immune system of female mice exposed to a single oral dose of dimethoate (16 mg/kg) was evaluated by assessing cell mediated and humoral immune responses, in addition to the effect of dimethoate on spleen and body weights after different time intervals. The data showed that dimethoate caused a time-depended decrease in spleen weights in the absence of a change in body weights. The immunologic effect of dimethoate to female mice produced a dose-dependent decrease in the number of the rosette forming cells (total and active erythrocyte rosette). The ability of splenocytes to proliferation in response to mitogens; phytohemagglutinin (PHA) for T cell and lipopolysaccharide (LPS) for B cell were significantly decreased at the different times. As compared to control, a significant decrease in serum total immunoglobulins (Ig) and IgM was found, while IgG was non-significant deceased. Results of this study also revealed that dimethoate caused a significant decrease in the number of plaque forming cell (PFC/10(6) splenocytes) in a time dependent manner.

Bovine viral diarrhoea, bovine herpesvirus and parainfluenza-3 virus infection in three cattle herds in Egypt in 2000

This study reported field outbreaks of bovine viral diarrhoea virus (BVDV) infection, either alone or mixed with bovine herpesvirus-1 (BHV-1) and/or parainfluenza-3 virus (PI-3V) in Egypt during 2000. In Lower Egypt, young calves in three cattle herds in El-Minufiya Province, El-Fayoum Province and in governmental quarantine in El-Behira Province, showed symptoms of enteritis, either alone or accompanied by respiratory manifestations. The affected herds were visited and the diseased animals were clinically examined. Many epidemiological aspects, such as morbidities, mortalities and case fatalities, as well as the abortive rate, were calculated. Ethylenediamine tetra-acetic acid-blood samples, sterile nasal swabs and serum samples were obtained for virological and serological diagnosis. The laboratory investigations revealed that the main cause of calf mortalities in the three herds was infection with BVDV, either alone, as on the El-Minufiya farm, or mixed with PI-3V, as on the El-Fayoum farm, or mixed with both BHV-1 and PI-3V, as in the herd in governmental quarantine in El-Behira Province. A total of nine dead calves from the three herds were submitted for thorough post-mortem examination. Tissue samples from recently dead calves were obtained for immunohistochemical and histopathological studies. The most prominent histopathological findings were massive degeneration, necrosis and erosions of the lining epithelium of the alimentary tract. Most of the lymphoreticular organs were depleted of lymphocytes. In pneumonic cases, bronchopneumonia and atypical interstitial pneumonia were evident. The present study suggested that the immunosuppressive effect of BVDV had predisposed the animals to secondary infection with BHV-1 and PI-3V. This study concluded that concurrent infection with BVDV, BHV-1 and PI-3V should be considered as one of the infectious causes of pneumoenteritis and, subsequently, the high morbidities and mortalities among young calves in Egypt. Preventive and control measures against these infectious agents should therefore be adopted. All animals imported into Egypt should be free from BVDV infection. Control programmes for the detection and removal of BVDV-persistent cattle should be applied in cattle herds all over the country.

Clinico-Pathological Features and Immunohistochemical Comparison of p16, p53, and Ki-67 Expression in Muscle-Invasive and Non-Muscle-Invasive Conventional Urothelial Bladder Carcinoma

INTRODUCTION

The identification of bladder detrusor muscle invasion in urothelial cancer is essential for prognosis and management. We studied the clinical, histological, and immunohistochemical expression of p16, p53, and Ki-67 in urothelial detrusor muscle-invasive bladder cancer (MIBC) and urothelial non-detrusor muscle-invasive bladder cancer (NMIBC) in Egyptian patients.

METHODS

Sixty-two bladder urothelial cancer cases obtained through TURBT were included and divided into two groups: (MIBC, stage T2) and NMIBC (T1). Tissue blocks were recut and re-examined microscopically; then, the immunostaining of p16, p53, and Ki-67 was performed to compare both groups and evaluate the 13% cut-off for Ki-67, 20% for p53, and p16 intensity in various conditions aided by telepathology technology.

RESULTS AND CONCLUSION

Hematuria was the main clinical first presentation, with no significant difference between either group. The mean age was 61.6 years, with male predominance (52 males and 10 females). The absence of papillary histological pattern was associated with a higher stage, including detrusor muscle invasion (p = 0.000). The overall average percent of p53 immunostaining was 12.9%, revealing no significant difference between MIBC and NMIBC when a cut-off of 20% was implicated. The Ki-67 expression was correlated with higher grade and muscle invasion; however, no association was found with the other two markers' expression. The negative immunostaining of p16 was associated with low grade and NMIBC in the case of the preservation of the papillary pattern. We recommend further studies on the cut-off of widely used markers and more immunohistochemical and genetic studies on the p16(INK4A), taking into consideration the histological pattern of conventional carcinomas.

Recent advances in three-dimensional ultrasound virtual cystoscopy in modeling and local staging for urothelial carcinoma with histopathological correlation: a cohort prospective study

Background

Bladder urothelial carcinoma is an alarming urologic malignancy. Complex factors like modelling and local staging can affect treatment strategy. However, local staging, particularly the muscle invasion status, significantly influences decisions regarding treatment strategies. Therefore, this study aims to evaluate the novel advances of three-dimensional (3D) ultrasound (US) imaging to assess local staging in comparison with conventional cystoscopy.

Methods

Forty-three patients with painless haematuria and conventional cystoscopy findings of bladder mass underwent 3D US virtual cystoscopy. All specimens from conventional cystoscopy were processed histologically.

Results

Out of 43 participants, 18 (41.9%) patients proved to have invasive urothelial carcinoma by histopathology. The 3D US had a sensitivity of 97.5% and a specificity of 100%; however conventional cystoscopy was accurate in only 53.5% of the studied cases. Furthermore, in the case of malignant ulcers, mural extension into both the submucosal and the muscle layers was more readily appreciated in multiplanar images.

Conclusion

3D US updates are promising for use in bladder tumour modelling and local staging; however, they can be of value in evaluating mural and extramural tumour extent and have proven accuracy.

Post carotid endarterectomy seizure

Post carotid endarterectomy seizure is a known clinical presentation in patients who suffer from hyperperfusion syndrome. This case focuses on the importance of identification of high risk patients for developing this syndrome and delaying their discharge from the hospital after successful carotid endarterectomy.

Post carotid endarterectomy seizure

Post carotid endarterectomy seizure is a known clinical presentation in patients who suffer from hyperperfusion syndrome. This case focuses on the importance of identification of high risk patients for developing this syndrome and delaying their discharge from the hospital after successful carotid endarterectomy.