Indication for pediatric tracheostomy has changed. Upper airway obstruction secondary to infectious disorders is no longer the commonest indication. The aim of this study was to establish data on indications, outcome and complications of pediatric tracheostomy. A retrospective analysis of pediatric tracheostomies carried out between March 2002 to March 2004 was done. Eighteen patients were identified. The commonest indication was prolonged ventilation (94.5%) followed by pulmonary toilet (5.5%). None was performed for upper airway obstruction. Postoperative complications were encountered in six patients (33.3%), the commonest being accidental decannulation notably in children less than six years of age. Twelve patients (66.6%) were successfully decannulated. The mortality rate was 16.6%. All death were non tracheostomy related. The commonest indication for tracheostomy was prolonged ventilation and tracheostomy in children is relatively safe despite complications.
Tracheostomy procedure ; Complications Specific to Antepartum or Postpartum ; Universities ; trends ; Obstruction

A 35-year-old female patient with previous left knee anterior cruciate ligament repair for a skiing injury presented six years later with a traumatic lateral patellar subluxation. Radiographs and magnetic resonance imaging of her left knee joint showed an ossific structure in the region of the lateral meniscus. This was diagnosed as a meniscal ossicle and confirmed during successful arthroscopic excision. The imaging features of meniscal ossicles are reported.
Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Bone and Bones ; pathology ; Diagnostic Imaging ; methods ; Female ; Humans ; Knee Joint ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Menisci, Tibial ; diagnostic imaging ; pathology ; Postoperative Complications ; Radiographic Image Interpretation, Computer-Assisted ; Tibial Meniscus Injuries

<b>OBJECTIVEb>To investigate the underlying mechanism of apoptosis-inducing effect of a specific COX-2 inhibitor SC236 in gastric cancer cells.

<b>METHODSb>Western blot analysis was used to measure apoptosis-related proteins, cytochrome c, and caspase-3. The catalytic activity of the caspases was measured using a colorimetric assay.

<b>RESULTSb>Treatment of AGS gastric cancer cells with SC236 caused a significant elevation of the pro-apoptotic protein Bak, release of cytochrome c to the cytosol, and activation of caspase-3. A specific caspase-3 inhibitor, z-DEVD-fmk, blocked SC236-induced apoptosis.

<b>CONCLUSIONb>SC236 inhibits cell growth and induces apoptosis in gastric cancer cells at least partly through the up-regulation of Bak, stimulation of cytochrome c release, and activation of caspase-3.

Adenocarcinoma ; metabolism ; pathology ; Apoptosis ; drug effects ; Caspase 3 ; Caspases ; metabolism ; Cell Line, Tumor ; Cyclooxygenase 2 Inhibitors ; pharmacology ; Cytochromes c ; metabolism ; Humans ; Oligopeptides ; pharmacology ; Poly(ADP-ribose) Polymerases ; metabolism ; Pyrazoles ; pharmacology ; Stomach Neoplasms ; metabolism ; pathology ; Sulfonamides ; pharmacology ; bcl-2 Homologous Antagonist-Killer Protein ; metabolism

<b>OBJECTIVEb>This study was aimed to characterize the Helicobacter pylori strains isolated from different geographic regions in China and different ethnic groups in Yunnan province in terms of cagA, iceA, vacA and HP0519 genes which were proposed to be related to the pathogenesis.

<b>METHODSb>150 Helicobacter pylori strains were collected from Yunnan province, Fujian province and Beijing. Chromosome DNA was extracted and polymerase chain reaction (PCR) was carried out to determine the 3' region of cagA, iceA, vacA and HP0519 status with specific primers. PCR results were analyzed statistically according to their isolated original and clinical outcomes.

<b>RESULTSb>For cagA 3' region, 93% (139/150) of the Chinese Helicobacter pylori strains belonged to East Asian type according to the specific primer of TF/JR. Among the 150 strains, 75% (113/150) belonged to iceA1, and 19% (29/150) to iceA2. The dissemination of iceA was not associated with any of the geographic regions, different ethnic groups or different clinical outcomes. 96% (144/150) of the vacA s region belonged to s1. In the vacA middle region, m2, m1b, m1b-m2 were 57% (85/150), 27% (41/150) and 11% (16/150) respectively. However, m1a was only observed in two strains from Fujian. Neither vacA s1 nor m2 showed significant difference between Yunnan, Fujian and Beijing. However, the distribution of mlb-m2 in Yunnan was higher than that in Fujian and Beijing. In Yunnan province, the distribution of vacA s1 was not associated with different ethnic groups but m2 from Bai group was less than other two ethnic groups. The ratio of m1b in Bai group was higher than that in other groups. Both vacA' s region and m region alleles had no significant relationship with the clinical outcomes. With the 15 bp and 24 bp DNA insertion and deletion primers test, 93% (140/150) of the strains were positive. The distributions of the 15 bp and 24 bp DNA insertion or deletion were different according to the different ethnic groups.

<b>CONCLUSIONb>By JF/TR primer, 93% of the Chinese strains cagA's 3' region belonged to East Asian type. Most of the Chinese strains vacA's allele was s1. The distribution of vacA s1 had no relationship with the clinical outcome of the isolates. From different geographic regions and ethnic groups, the distribution of vacA m region allele was different. 93% of the Chinese strains HP0519 genes had 24 bp or 15 bp insertion or deletion character. The biological meaning of the polymorphism of HP0519 needs advanced investigation.

China ; Genes, Bacterial ; genetics ; Helicobacter Infections ; ethnology ; genetics ; Helicobacter pylori ; classification ; genetics ; isolation & purification ; Humans ; Polymerase Chain Reaction

INTRODUCTION: Dengue continues to be a major health concern in the Philippines. This study aimed to establish trends and correlations between the incidence of dengue and rainfall, humidity and temperature, respectively, in the different regions. METHODS: Using 2018 records obtained from DOH and PAGASA, correlations were made between monthly measurements of climatic factors and the incidence of dengue using Pearson’s r, while maps and interpolations were generated using quantum geographical information system software. RESULTS: There was a significant positive but weak correlation between the incidence of dengue and rainfall (r = 0.379, 95% CI 0.255, 0.491; p < 0.001) and humidity (r = 0.215, 95% CI 0.080, 0.342; p = 0.002). There was a significant negative but weak correlation between the incidence of dengue and temperature (r = -0.145, 95% CI -0.277, -0.008; p = 0.039). A strong positive correlation was noted between the incidence of dengue, and rainfall and humidity, respectively, in several regions. Multiple regression indicates that rainfall, humidity and temperature are poor predictors of the incidence of dengue (R2 = 0.1436, 0.0461 and 0.0209, respectively). CONCLUSION This study showed overall a significant but weak correlation between an increased incidence of dengue and heavy rainfalls and high relative humidity, and a weak negative correlation for temperature. A high positive correlation of an increased incidence of dengue and heavy rainfalls and high relative humidity was observed in several regions.
Dengue ; humidity ; temperature

Spontaneous spinal epidural haematoma is a rarely encountered cause of back pain. It often leads to cauda equina syndrome, necessitating emergency spinal surgery. We report the case of a 19-year-old Chinese man who presented with pain in the lower back, which started after he had carried some heavy boxes. He denied a history of fall or trauma. Magnetic resonance (MR) imaging showed a hyperintense biconvex-shaped lesion in the posterior epidural space on both T1- and T2-weighted sequences, diagnostic of a spinal epidural haematoma. The patient, who was admitted and managed conservatively, had gradual resolution of his pain. No neurological deficit was detected on discharge or on follow-up. Repeat MR imaging showed total resolution of the lumbar spinal epidural haematoma. The clinical characteristics, MR imaging features, diagnosis and management of spontaneous spinal epidural haematoma are discussed.
Adult ; Edema ; diagnosis ; pathology ; Female ; Hematoma, Epidural, Spinal ; diagnosis ; pathology ; Humans ; Low Back Pain ; diagnosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Polyradiculopathy ; diagnosis ; Young Adult