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Background: For ambulatory cases with spastic diplegic cerebral palsy, single event multilevel surgery (SEMLS) has replaced previous methods of treatment for improving gait. This research aimed for investigation if single event multilevel surgery improved gait and function among cases with spastic cerebral palsy. Patients and methods: This was a prospective interventional study carried out on 24 children with spastic lower limbs attending to pediatric orthopedic unit in Zagazig University Hospital and managed with lower limb single event multilevel surgery. Clinical as well as radiological assessments were applied pre-and 6 months post-operative. Results: Single event multi-level surgeries performed in the children with CP generated positive outcomes in the GMFM which changed significantly from (45.67±3.70) in the preoperative assessment to (52.63±3.34) in follow up after 2 years postoperative with p value<0.001. A paired samples t-test revealed that spasticity significantly decreased from pre- (M=15.46, SD=2.187) to post- (M=10.71, SD=2.293) intervention, t(23)=17.53, p<.05, d=1.327, for Spasticity (after intervention) a statistically significant difference was found between groups (2, 21) = 17.502, p < 0.001. Also, a marked improvement occurred in the range of motion (ROM) as determined by ROM score which changed from (44.67±8.67) preoperatively to (33.00±9.09) after 6 months with P value <0.001. Conclusion: The results of SEMLS regarding deformity correction and quality of life improvement are considered satisfactory with minimal complications. [ABSTRACT FROM AUTHOR]

The neuron-to-neuron propagation of misfolded α-synuclein (αSyn) aggregates is thought to be key to the pathogenesis of synucleinopathies. Recent studies have shown that extracellular αSyn aggregates taken up by the endosomal-lysosomal system can rupture the lysosomal vesicular membrane; however, it remains unclear whether lysosomal rupture leads to the transmission of αSyn aggregation. Here, we applied cell-based αSyn propagation models to show that ruptured lysosomes are the pathway through which exogenous αSyn aggregates transmit aggregation, and furthermore, this process was prevented by lysophagy, i.e., selective autophagy of damaged lysosomes. αSyn aggregates accumulated predominantly in lysosomes, causing their rupture, and seeded the aggregation of endogenous αSyn, initially around damaged lysosomes. Exogenous αSyn aggregates induced the accumulation of LC3 on lysosomes. This LC3 accumulation was not observed in cells in which a key regulator of autophagy, RB1CC1/FIP200, was knocked out and was confirmed as lysophagy by transmission electron microscopy. Importantly, RB1CC1/FIP200-deficient cells treated with αSyn aggregates had increased numbers of ruptured lysosomes and enhanced propagation of αSyn aggregation. Furthermore, various types of lysosomal damage induced using lysosomotropic reagents, depletion of lysosomal enzymes, or more toxic species of αSyn fibrils also exacerbated the propagation of αSyn aggregation, and impaired lysophagy and lysosomal membrane damage synergistically enhanced propagation. These results indicate that lysophagy prevents exogenous αSyn aggregates from escaping the endosomal-lysosomal system and transmitting aggregation to endogenous cytosolic αSyn via ruptured lysosomal vesicles. Our findings suggest that the progression and severity of synucleinopathies are associated with damage to lysosomal membranes and impaired lysophagy. [ABSTRACT FROM AUTHOR]

A direct contact co‐culture of skin explants to SZ95 sebocytes (3D‐SeboSkin) has been shown to preserve the integrity of epidermal keratinocytes and dermis. In this study, the properties of epidermal melanocytes were evaluated in the same 3D SeboSkin ex vivo model. Skin explants (n = 6) were maintained in the 3D‐SeboSkin model, in direct contact to fibroblasts and alone in serum‐free medium (SFM). Histopathological, immunohistochemical, apoptosis and oil red staining evaluations were performed at Days 0 and 6 of incubation. Results revealed preservation and prominent proliferation of basal keratinocytes of the skin explants in addition to preservation of dermal collagen and vasculature at Day 6 in the 3D‐SeboSkin culture model and to a lesser extent in co‐culture with fibroblasts but not in SFM alone. Melan‐A+/Ki67‐ epidermal melanocytes remained attached to the dermis even at sites of epidermal detachment in the three skin explant models tested. However, the number of epidermal melanocytes was significantly conserved in 3D‐SeboSkin cultures in comparison with skin explants in SFM (p < 0.05), whereas no difference was found in comparison with the co‐culture with fibroblasts. Few DAPI/TUNEL+ apoptotic melanocytes could mostly be observed in SFM‐incubated skin explants. Furthermore, only SZ95 sebocytes in contact to skin explants in 3D‐SeboSkin exhibited increased lipogenesis with accumulation of abundant lipid droplets. These results denote that the 3D‐SeboSkin model yielded significant preservation of epidermal melanocytes and hence it is optimal for ex vivo studies of abnormalities of skin pigmentation, melanocyte neoplasms and effects of different hormones, cytokines, carcinogens and various therapeutics in a pattern that recapitulates the in vivo environment. [ABSTRACT FROM AUTHOR]

Background: Studies have shown increased intestinal permeability in irritable bowel syndrome. Validating serum biomarkers for altered intestinal permeability in irritable bowel syndrome will facilitate research and pathophysiology-based therapy. Aim and Objectives: To compare serum zonulin level between diarrhoea-predominant irritable bowel syndrome and constipation-predominant irritable bowel syndrome. Subjects and Methods: This was a Case control study, was carried out in Gastroenterology department, Ain Shams University Hospital, and military hospitals on 60 subjects classified into three groups: (First group): included 20 patients complaining of IBS-Diarrheal type, (Second group): included 20 patients complaining of IBS-constipation type, Third group (Healthy group): included 20 healthy persons, during a period of 6 months. Result: There was high statistically significant difference between the two cases groups as regard frequency of stool. Conclusion: We could not detect altered zonulin levels between individuals reporting IBS-D and IBS-C. On the other hand, higher zonulin levels are founded compared to healthy controls. These data suggest that zonulin might have utility as a simple serological biomarker for altered IP in patients with IBS. However, more research is needed to corroborate our findings of the role of zonulin in IBS. Identifying IBS patients with zonulinmediated intestinal tight junction dysfunction may allow mechanistically focused IBS therapy (e.g., larazotide acetate). [ABSTRACT FROM AUTHOR]

purpose: Epilepsy is a major public health problem worldwide. The aim of this study was to explore the level of awareness, knowledge regarding epilepsy and attitudes prevalent toward epilepsy among king Khalid university students. Methods: The descriptive and cross-sectional study was conducted with the voluntary participation of 227 participants from students at King Khalid University. The mean age of participating was (20.10 ± 1.3). Theoretical and practical colleges used questionnaires to assess students' knowledge about epilepsy and their attitudes towards it. Results: A total of 227 respondents completed the survey; the results showed almost all had heard about epilepsy. Only 83.7% have never had any information on how to treat a patient with epilepsy. 80.6% think non-medical treatment is beneficial for epilepsy %13.2% do not know how to do first aid to deal with epileptic seizures. Almost 32.6% did not know the cause of epilepsy, 59% believed that it was a hereditary disorder 44.1% believed epilepsy is a form of mental illness, 57.3% believed that epilepsy patients die because of epileptic seizures. 59% believed that it was a hereditary disorder 44.1% believed epilepsy is a form of mental illness, 11% of participants thought that epilepsy is caused by evil spirits, 57.3% believed that epilepsy patients die because of epileptic seizures. There were also many students who held negative attitudes towards patients with epilepsy in regard to major life milestones such as marriage and having children. 16.7% indicated that it presents an impediment in participation in sports, approximately 6.2% objected to marrying someone with epilepsy, Moreover 11.5% thought they should not have children and, the study showed 46,3% would not allow their child to play with a child with epilepsy. Moreover 14.5 afraid to live with someone with epi lepsy. the study showed 6,6 % objected accept working with a patient with epilepsy. Conclusions: The level of awareness, knowledge, and attitudes of students at King Khalid toward epilepsy were acceptable regarding this study. However, the negative attitudes and misconceptions still exist. Further studies are needed to determine methods of overcoming these negative attitudes and misconceptions toward epilepsy. [ABSTRACT FROM AUTHOR]

Background: Invasive liver biopsy is the current method for the assessment of liver fibrosis. In search of noninvasive alternatives, galectin-3-binding protein (G3BP) was introduced as a candidate-marker of hepatitis C-related fibrosis based on serum proteomics. Aim of the Work: to evaluate serum Galectin-3 as a marker of liver fibrosis and correlate it to the stage of fibrosis assessed by FibroScan, FIB-4 index and APRI score Patients and Methods: This was prospective study, was carried out on 30 patients with liver fibrosis/cirrhosis due to chronic HCV in the Hepatic Virology Unit and the gastroenterology department of Ain Shams university hospitals and 30 health controls with normal, non fibrotic and non cirrhotic, liver, from January 2022 to June 2022 Results: There were high significant difference between both groups as regard Serum level of Galectin-3 and APRI score. Conclusion: Serum level of galectin-3 was highly expressed in chronic HCV Egyptain patients and positively correlated to FIB-4 index, APRI score and fibroscan.so the serum level of galectin-3 beside other modalities, lab investigations and clinical examination may guide us about the progression to fibrosis and cirrhosis in those patients. In these patients, if galectin-3 levels were found to be high, serum alpha-feto protein level and ultrasonographic examination could be repeated at more frequent intervals. This may also guide us in terms of the treatment plan. Measurement of galectin-3 in sera of large number of patients and follow up may pave the way to pick up early fibrosis and showed its prognostic effect. [ABSTRACT FROM AUTHOR]

Age-dependent modification of the facial subcutaneous white adipose tissue (sWAT) connected with reduction of its volume, modification of collagen content and adhesion between dermal and adipose layers can significantly influence mechanical stability of the skin and cause the development of aging symptoms such as wrinkles. Typical aging appearance in facial skin is at least partly connected with special phenotypical features of facial preadipocytes and mature adipocytes. In this paper, we have discussed the possible roles of local inflammation, compartmental structure of facial sWAT and trans-differentiation processes such as beiging of white adipocytes and adipocyte-myofibroblast transition in facial skin aging. [ABSTRACT FROM AUTHOR]

Background: Psoriatic lesions may resolve with hypo- or hyperpigmentation. The involvement of melanocytes in this dichotomous clinical outcome is not fully investigated.Objectives: Qualitative and quantitative assessment of melanocytes in untreated lesional and non-lesional psoriatic skin (n = 15) and healthy controls (n = 10).Methods: Skin biopsies were labelled immunohistochemically (APAAP technique) with the antimelanocyte monoclonal antibodies (MoAbs) HMB45, Melan A, tyrosinase and microphthalmia-associated transcription factor (MITF). The labelled melanocytes were evaluated by an independent investigator with a digital image analyser.Results: Lesional melanocytes, in contrast to those in non-lesional and healthy skin, exhibited features of activation in the form of dilatation, prominent and long dendrites and intense labelling. The number of melanocytes was significantly increased in psoriatic lesions in comparison with non-lesional psoriatic and healthy skin as shown by counts of cells labelled with the MoAbs HMB45 (3-fold; p < 0.001), Melan A (1.6-fold; p < 0.01) and tyrosinase (1.5-fold; p < 0.01). In contrast, labelling with MITF revealed no significant difference (1.2-fold increase; p > 0.05). Likewise, no significant difference between non-lesional psoriatic and healthy skin control was found (p > 0.05). Furthermore, no positively labelled dermal cells were detected, apart from few only detected with Melan A.Conclusions: Epidermal melanocyte activity and numbers are increased in the epidermal compartment of psoriatic lesions providing an explanation for postinflammatory hyperpigmentation. [ABSTRACT FROM AUTHOR]

Abstract  A comparative study was conducted to assess the contact and fumigant toxicities of eleven monoterpenes on two important stored products insects—, Sitophilus oryzae, the rice weevil, and Tribolium castaneum, the rust red flour beetle. The monoterpenes included: camphene, (+)-camphor, (−)-carvone, 1-8-cineole, cuminaldehyde, (l)-fenchone, geraniol, (−)-limonene, (−)-linalool, (−)-menthol, and myrcene. The inhibitory effect of these compounds on acetylcholinesterase (AChE) activity also was examined to explore their possible mode(s) of toxic action. Although most of the compounds were toxic to S. oryzae and T. castaneum, their toxicity varied with insect species and with the bioassay test. In contact toxicity assays, (−)-carvone, geraniol, and cuminaldehyde showed the highest toxicity against S. oryzae with LC50 values of 28.17, 28.76, and 42.08 μg/cm2, respectively. (−)-Carvone (LC50 = 19.80 μg/cm2) was the most effective compound against T. castaneum, followed by cuminaldehyde (LC50 = 32.59 μg/cm2). In contrast, camphene, (+)-camphor, 1-8-cineole, and myrcene had weak activity against both insects (i.e., LC50 values above 500 μg/cm2). In fumigant toxicity assays, 1-8-cineole was the most effective against S. oryzae and T. castaneum (LC50 = 14.19 and 17.16 mg/l, respectively). Structure-toxicity investigations revealed that (−)-carvone—, a ketone—, had the highest contact toxicity against the both insects. 1-8-Cineole—, an ether—, was the most potent fumigant against both insects. In vitro inhibition studies of AChE from adults of S. oryzae showed that cuminaldehyde most effectively inhibited enzyme activity at the two tested concentrations (0.01 and 0.05 M) followed by 1-8-cineole, (−)-limonene, and (l)-fenchone. 1-8-Cineole was the most potent inhibitor of AChE activity from T. castaneum larvae followed by (−)-carvone and (−)-limonene. The results of the present study indicate that (−)-carvone, 1,8-cineole, cuminaldehyde, (l)-fenchone, and (−)-limonene could be effective biocontrol agents against S. oryzae and T. castaneum. [ABSTRACT FROM AUTHOR]

Background: Increased cutaneous cells following warm water challenge in pruritus-related polycythemia vera (PV) have been reported, but their nature and magnitude are not known. Methods: Qualitative and quantitative assessments (digital image analysis) of the cutaneous mononuclear cells, eosinophils and mast cells were carried out in PV patients and healthy controls (n = 10 each) following exposures to water at room temperature and warm water. Results: Infiltration of the spongiotic epidermis and dermis by mononuclear cells and eosinophils together with edema and vasodilatation of upper dermis following warm water contact was clearly observed only in PV patients. In contrast to controls, significant increase in numbers of mononuclear cells and eosinophils in comparison with exposure to water at room temperature at the dermal-epidermal junction (p < 0.01), papillary dermis (p < 0.01) and perivascular area (p < 0.05) was found. Obvious mast cell degranulation was seen in PV sections after warm water contact, but no significant increase of their numbers was observed whether among PV patients or healthy controls (p > 0.05). However, the numbers of papillary dermal mast cells in specimens obtained from PV patients following room temperature water exposure were significantly more than those of healthy controls (p < 0.05). Conclusions: PV represents an invisible dermatosis in which the infiltrating mononuclear cells and eosinophils may have a role in warm water-induced pruritus. [ABSTRACT FROM AUTHOR]

Anetoderma is a rare disease of unknown etiology, today classified as a subtype of the circumscribed elastotic disorders. The clinical picture shows atrophic patches located mainly on the upper trunk which characteristically give the palpating finger the sensation of a hernial orifice. Our patient with primary idiopathic anetoderma presented a rarely reported concomitance of the inflammatory type of lesions described by Jadassohn and Pellizzari together with the non-inflammatory Schweninger-Buzzi type. Histologically and ultrastructurally, both kinds of lesions revealed similar pictures with a scanty perivascular lymphomononuclear cell infiltrate, with rarefied, partly fragmented elastic fibres and normal collagen fibrils. These findings indicate that these two types of lesions represent different stages of the same disease and not a simple association. Furthermore, they support the opinion that the classification of anetoderma into two separate Jadassohn-Peltizzari and Schweninger-Buzzi types may be unnecessary. After treatment with oral tetracycline 1 g/day for 3 weeks, no new lesions appeared: however, no improvement of the already present lesions occurred during a 6-month follow-up period. [ABSTRACT FROM AUTHOR]

The regulatory effects of sebocytes on melanocytes (HMel) are unknown. In this study, SZ95 sebocytes co-cultured with HMel, whether in direct cell contact or with SZ95 sebocytes in inserts, resulted in epidermal HMel flattening with increase in surface area and multiple small dendrites formation. Only in high Ca2+ level and direct cell contact co-culture, the HMel dendrites were remarkably long and preferentially targeted and attached to SZ95 sebocytes. Likewise, only high Ca2+ SZ95 sebocyte conditioned medium stimulated HMel proliferation in a time-dependent manner at days 9 (142.9%, P < 0.01) and 12 (179.2%, P < 0.0001) of incubation when compared with day 0. In contrast, melanin contents significantly decreased on incubation with high Ca2+ SZ95 sebocytes in comparison with low Ca2+ SZ95 sebocytes at days 6 ( P < 0.01) and 9 ( P < 0.05) of incubation. These results denote that sebocytes also modulate HMel functions and may contribute to skin colour in sebaceous glands-rich body regions. [ABSTRACT FROM AUTHOR]

Discusses the cases of patients with invasive zygomycosis having a fatal outcome. Signs and symptoms; Results of skin biopsy, computed tomography and magnetic resonance imaging; Treatment options; Differential diagnosis.

Schistosomiasis (bilharziasis) is an endemic parasitic disease of a major source of morbidity and mortality for developing countries. It is caused by different species of blood flukes (trematode worms) of the genus Schistosoma, the most important of which are S. haematobium which infests the genitourinary tract and S. mansoni and S. japonicum which infest the gastrointestinal tract. The incidence of schistosome‐induced male infertility is not known and probably underestimated being overshadowed by the more severe and often fatal urinary and gastrointestinal complications. Several causes may contribute to schistosomiasis‐induced male infertility, such as hormonal imbalance, testicular tissue damage and genital ductal system obstruction, in addition to decreased libido and erectile dysfunction due to associated hormonal imbalance and prostatic infestation. Demonstration of the schistosome ova in seminal plasma or testicular tissue confirms the diagnosis. Treatment of schistosomiasis‐induced male infertility depends on clinical evaluation and includes, besides anthelmintic treatment, hormonal replacement and assisted reproduction (IVF/ICSI) in cases of severe oligozoospermia and or obstructive and nonobstructive azoospermia. [ABSTRACT FROM AUTHOR]

Congenital bilateral absence of vas deferens (CBAVD) results in obstructive azoospermia in which testicular function, such as spermatogenesis, is preserved. Bilateral testicular biopsy is not only diagnostic but also therapeutic as retrieved spermatozoa are usually cryopreserved for assisted reproduction. In this case report, CBAVD was confirmed in a 24‐year‐old azoospermic man on the basis of persistent azoospermia associated with low semen volume, absent fructose and normal hormonal levels, ultrasonographically (absent seminal vesicles) and histologically (intact spermatogenesis). Interestingly and incidentally, only the right testicular biopsy showed ova of two parasitic species of Schistosoma, namely Schistosoma haematobium which infests the genitourinary tract and Schistosoma mansoni which infests the gastrointestinal tract. Both species are rare causes of azoospermia, and the case should be further managed as CBAVD in which the left testicle is considered the preferred site of sperm retrieval for assisted reproduction. [ABSTRACT FROM AUTHOR]

Opinion Statement: Extramammary Paget's disease (EMPD) is a rare, slow growing non-melanoma skin cancer.Diagnosis is often significantly delayed, since clinical presentation may resemble common benign dermatoses. Treatment is characterized by high recurrence rates. This is in part due to ill-defined margins and by frequent development of satellites. Improvement of outcome needs a better preoperative planning with fluorescence diagnostics or scouting biopsies. Mohs micrographic surgery has some advantages for patients, such as reduced relapse rates and prolonged relapse-free survival. Improved identification of Paget cells in cryosections by immunostainings or alternatively the use of delayed Mohs with formalin-fixed material reduces the rate of false-negative results. Surgery remains the cornerstone of treatment. [ABSTRACT FROM AUTHOR]