The incidentally discovered asymptomatic adrenal tuberculous mass mimicking malignancy

Tuberculous adrenal mass without any tuberculous changes in other sites is a rare entity. In this study we describe such a case. A male patient of 47 years with 6 months history of anorexia and weakness was presented. Ultrasonography and computed tomography revealed a mass in the right adrenal gland. It was mistaken as a malignant neoplasm and the diagnosis was confirmed by surgical exploration.

Treatment of toenail onychomycosis with 2% butenafine and 5% Melaleuca alternifolia (tea tree) oil in cream

The prevalence of onychomycosis, a superficial fungal infection that destroys the entire nail unit, is rising, with no satisfactory cure. The objective of this randomized, double-blind, placebo-controlled study was to examine the clinical efficacy and tolerability of 2% butenafine hydrochloride and 5% Melaleuca alternifolia oil incorporated in a cream to manage toenail onychomycosis in a cohort. Sixty outpatients (39 M, 21 F) aged 18-80 years (mean 29.6) with 6-36 months duration of disease were randomized to two groups (40 and 20), active and placebo. After 16 weeks, 80% of patients using medicated cream were cured, as opposed to none in the placebo group. Four patients in the active treatment group experienced subjective mild inflammation without discontinuing treatment. During follow-up, no relapse occurred in cured patients and no improvement was seen in medication-resistant and placebo participants.

Design, synthesis, and structure-activity relationships of acetylene-based histamine H3 receptor antagonists

New, potent, and selective histamine H3 receptor antagonists have been synthesized by employing the use of (1) an appropriately positioned nonpolar acetylene spacer group, (2) either a two-carbon straight chain linker or a conformationally restricting trans-cyclopropane ring between the C-4 position of an imidazole headgroup and the acetylene spacer, and (3) a Topliss operational scheme for side-chain substitution for optimizing the hydrophobic domain. Compounds 9-18 are examples synthesized with the two-carbon straight chain linker, whereas 26-31 are analogues prepared by incorporation of the trans-(+/-)-cyclopropane at the C-4 position of an imidazole headgroup. Synthesis of both the (1R,2R)- and (1S, 2S)-cyclopropyl enantiomers of the most potent racemic compound 31 (Ki = 0.33 +/- 0.13 nM) demonstrated a stereopreference in H3 receptor binding affinity for the (1R,2R) enantiomer 32 (Ki = 0.18 +/- 0.04 nM) versus the (1S,2S) enantiomer 33 (Ki = 5.3 +/- 0.5 nM). (1R,2R)-4-(2-(5,5-Dimethylhex-1-ynyl)cyclopropyl)imidazole (32) is one of the most potent histamine H3 receptor antagonists reported to date.

Development of a sensitive and quantitative analytical method for 1H-4-substituted imidazole histamine H3-receptor antagonists utilizing high-performance liquid chromatography and dabsyl derivatization

A sensitive and versatile analytical method utilizing high-performance liquid chromatography (HPLC) and precolumn derivatization of 1H-4-substituted imidazole compounds is described. A HPLC method using 4-dimethylaminoazobenzene-4'-sulfonyl chloride (dabsyl chloride) and ultraviolet (UV) detection was developed for the analysis of histamine (HA) H3-selective compounds in human plasma, rat plasma, or homogenized rat cortical tissue. The average intra- and inter-assay variability, over a range of 10 to 0.01 microg/ml, was determined to be acceptable. The lower limit of detection for the dabsylated ligands was estimated to be <1.0 ng/ml while the lower limit of quantitation (LLOQ) was determined to be 10 ng/ml of conjugate. This assay has demonstrated it's suitability for the sensitive quantitation of several structurally diverse 1H-4-substituted imidazole HA H3-receptor antagonists in biological matrices for pharmacokinetic and biodistribution studies.

Halohydrin analogues of cryptophycin 1: synthesis and biological activity

The chloro-, bromo-, and iodo-derivatives 2-4 of the antimitotic drug cryptophycin 1 were synthesized by opening the epoxide ring. The biological activities of the compounds were tested in an in vitro microtubule assembly and a cell proliferation assay. The chloro-derivative 2 showed lower activity in the tubulin assay compared to 3 and 4, but they all showed similar inhibition in the proliferation assay.

Effect of interleukin-2 on experimental acute toxoplasmosis

The traditional treatment of toxoplasmosis involves the use of pyrimethamine and sulphadiazine. This combination has a teratogenic effect and its use is limited especially in immunosuppressed cases. Spiramycin used safely during pregnancy is also not effective because it is toxoplasmistatic only. The potential efficiency of alternative immunotherapy was assessed. The present study was undertaken to evaluate the effect of exogenously supplied IL-2 on T. gondii infected mice. IL-2 was administered after infection (on days +2, +4, +6, +8), before and after infection (on days -3, -1, +2, +4, +6) and before infection (on days -8, -6, -4, -2). The date of infection was considered zero. Assessment of its effect was through: a) Parasitological study which included: parasite count, differentiation between living and dead tachyzoites and death rate of infection mice. b) Immunological study: detection of circulating antigen on the 3rd, 5th, 7th and 9th day p.i. The results showed that IL-2 was most effective when administered before and after infection in the form of significant reduction in parasitic count, least number of living tachyzoites, significant reduction in the death rate of infected mice and delayed appearance of circulating antigen with reduction in its level.

Angiotensin-converting enzyme inhibition alters clusterin mRNA expression in the kidney following renal mass reduction

The effect of the angiotensin-converting enzyme inhibitor captopril on clusterin mRNA was examined in partially nephrectomized male rats. Urine protein excretion was measured 3, 7, and 28 days after removal of five sixths of the renal mass. Nephrectomy caused a progressive increase in clusterin mRNA levels in the remnant kidney. Maximal clusterin mRNA levels occurred 7 days after nephrectomy and declined 28 days after nephrectomy. Captopril, 250 mg/ml in drinking water, prevented the injury-induced increase in clusterin mRNA at 7 and 28 days. Captopril had no effect on clusterin in sham-operated rats. As expected, the urine protein excretion increased progressively after nephrectomy, and this was attenuated by administration of captopril in the drinking water. Therefore, clusterin is a marker of renal injury which, along with proteinuria, is modulated by angiotensin-converting enzyme inhibition.

Hydatidosis: experience with hepatic and pulmonary hydatid disease

From 1989-1992, 35 cases comprising of 20 hepatic and 15 pulmonary hydatid cysts were seen. Four patients with pulmonary hydatid disease had previous or concomitant hepatic hydatidosis compared to no concomitant pulmonary hydatid disease in the hepatic group. Hepatic hydatid disease had a greater tendency to be right sides, infected and calcified. Anaphylactic reactions occurred in 3 of 20 patients with hepatic hydatid disease against none in 15 patients with pulmonary disease. Management consisted of evacuation, drainage and obliteration of the residual cavity by capittonage in the lung and omentoplasty in the liver. Two patients, one hepatic and one with pulmonary hydatid disease developed infection of the residual cavity. Bronchocystic fistula occurred in 4 pulmonary and cystobiliary fistula in 2 hepatic hydatid disease patients. One patient with severe pleuropulmonary hydatidosis required a thoracoplasty. No recurrences have been noted in either group over a mean follow-up of 11 months (range 3 weeks- 3 years).

Angiotensin-converting enzyme inhibition attenuates proteinuria and renal TGF-beta 1 mRNA expression in rats with chronic renal disease

Evidence suggests that transforming growth factor beta 1 (TGF-beta 1), a multifunctional cytokine, induces renal extracellular matrix production and glomerular hypertrophy. The aim of the present study was to investigate the effect of captopril on the expression of TGF-beta 1 mRNA in a rat model of chronic renal failure: five-sixths nephrectomy. Chronic renal disease was induced by removal of the right kidney and ligation of three blood vessels supplying the left kidney. Sham-operated animals were used as controls. RNA was extracted from the viable remnant kidney of rats 1 day and 1 and 2 weeks following five-sixths nephrectomy and from the kidneys of rats who underwent sham surgery. TGF-beta 1 mRNA was induced within 24 h of partial nephrectomy, similar to that reported for early-onset genes. Subsequently, TGF-beta 1 mRNA expression continued to increase over the next 2-4 weeks. The upregulation of TGF-beta 1 correlated with the degree of proteinuria. Both the increase in TGF-beta 1 mRNA and proteinuria were abrogated by captopril treatment. In addition, no change in expression of ALK-5 or type II TGF-beta receptors following five-sixths nephrectomy was observed. These data suggest that captopril may protect against development of glomerulosclerosis and proteinuria by reducing TGF-beta 1 expression and hence matrix production.

High antagonist potency of GT-2227 and GT-2331, new histamine H3 receptor antagonists, in two functional models

GT-2227 (4-(6-cyclohexylhex-cis-3-enyl)imidazole) and GT-2331 ((1R,2R)-4-(2-(5,5-dimethylhex-1-ynyl)cyclopropyl)imidazole) were developed as new potent histamine H3 receptor antagonists. The functional activity of these ligands on the histamine H3 receptor-mediated inhibition of neurogenic contraction of the guinea-pig jejunum and histamine H3 receptor-mediated inhibition of norepinephrine release from guinea-pig heart synaptosomes were investigated. GT-2227 and GT-2331 both antagonized the inhibitory effects of (R)-alpha-methylhistamine on the contraction induced by electrical field stimulation in the guinea-pig jejunum with pA2 values of 7.9+/-0.1 and 8.5+/-0.03, respectively. In addition, GT-2227 and GT-2331 antagonized the inhibition of norepinephrine release in cardiac synaptosomes by GT-2203 ((1R,2R)-trans-2-(1H-imidazol-4-yl)cyclopropylamine), a histamine H3 receptor agonist. The current results demonstrate the antagonist activity for both GT-2227 and GT-2331 in two functional assays for histamine H3 receptors.

New acetylene based histamine H3 receptor antagonists derived from the marine natural product verongamine

New histamine H3 receptor antagonists were developed using an acetylene moiety as a replacement for the amide-oxime functionality of verongamine 5. Optimization of receptor binding was performed by following aliphatic Topliss tree guidelines. These new H3 ligands demonstrate excellent blood-brain barrier penetration.

Is the Barthel Scale appropriate in non-industrialized countries? A view of rural Pakistan

PURPOSE

To determine if the Barthel Index, a conventional scale for assessing disability, is appropriate for stroke patients in rural Pakistan, rather than an observational study by visiting stroke patients in their homes.

METHOD

Stroke patients attending hospital out patient clinics in Islamabad, together with others identified in local villages, were assessed to test the validity of the Barthel Activities of Daily Living Scale.

RESULT

For each item on the disability scale, differences in local customs, lifestyle and architecture meant that the Barthel Scale was not appropriate in rural Pakistan.

CONCLUSIONS

There is unlikely to be a disability scale which can be applicable universally. Care must be taken when standard scales are used for international comparisons of stroke disability.

An exercise training combined with dietary program for patients with hypertension

A controlled clinical trial was conducted to determine whether combined exercise training and diet alone reduce blood pressure (BP), body weight and body mass index (BMI) in three weeks. Twenty eight patients with diastolic BP < or = 110 mmHg were assigned to a hypertensive group and another 28 subjects with diastolic BP < or = 90 mmHg were subjected to the same intervention as control group (normotensive group). Exercise training and diet reduced diastolic BP by 24.7 mmHg and systolic BP by 32.8 mmHg in hypertensive group. There was a mean decreased of 5.3 mmHg in the diastolic BP in the normotensive group (P < 0.001). The systolic BP decreased only minimally. The weight loss ranged from 1 kg to 3 kg in hypertensive and 1 kg to 2 kg in the normotensive group. The mean weight loss was 1.6 kg (0.7) in hypertensive and 1.5 kg (0.5) in the normotensive group. In both the groups the weight reduction was highly significant (P < 0.001) and moderately positive correlation was also noted with the fall of BPs. The mean fall of BMI was 0.61 kg/m2 (0.21) and 0.51 (0.2) kg/m2 in the hypertensive and normotensive groups respectively. The findings indicated that a combined exercise training and dietary program could lower BP in patients with mild to moderate hypertension, but its long-term consequences on morbidity and mortality remain to be determined.

The age-related increase in renal clusterin mRNA is accelerated in obese Zucker rats

Clusterin is a multifunctional glycoprotein associated with development and tissue injury. Because renal function decreases with advancing age in the obese Zucker rat, clusterin mRNA expression was examined in the kidney of young adult Zucker rats and compared with age-related changes in renal clusterin mRNA expression in Fischer 344 (F344) rats. Renal clusterin mRNA levels in the obese Zucker rat were 2.5-fold higher by 3 mo of age and fourfold higher at 5 mo of age compared with the lean strain. In comparison, renal clusterin mRNA in 12-mo-old F344 rats was twofold higher than in 3-mo-old animals and was tenfold higher at 24 mo of age. Clusterin mRNA was positively correlated with urinary protein excretion and negatively correlated with creatinine clearance in Zucker rats. Clusterin was increased in select nephrons of the obese Zucker rat kidney and in 24-mo-old F344 rat kidney as assessed by in situ hybridization. Increased expression of clusterin mRNA occurred mostly in the tubular epithelium of dilated, convoluted proximal tubules. These data indicate that renal clusterin mRNA levels increase as a function of age and that age-related increases in renal clusterin and the associated tubular abnormalities are accelerated in obese Zucker rats.

Histopathological variations among cases of Wilms' tumor in Bangladesh and its relationship with prognosis

Recent advancement in the cytopathologic features produced a number of variants of Wilms' tumor which are the primary determinant of survival of Wilms' tumor patients. This study was carried out with 47 patients of Wilms' tumor in different stages in three selected hospitals from 1991 to 1993. Among them 61.7% (29) were in Favorable histopathology and 38.3% (18) were in Unfavorable histopathology group. After managing the patients with multimodal therapy according to the protocol of National Wilms' tumor Study-III the favorable group had shown better prognosis. The difference between two groups was statistically significant (chi-square = 3.2, P < 0.05). Histopathological variations could be easily determined which might improve the overall prognosis of Wilms' tumor.

Analysis of psychiatric morbidity of outpatient children in Mitford Hospital, Dhaka

The objective of this study was to describe the pattern of psychiatric morbidity among 97 child patients who, for the first time attended the psychiatric outpatient department of Sir Salimullah Medical College & Mitford Hospital, Dhaka, in the year 1994. Dissociative disorder (Hysteria) comprised the largest group (21.65%), followed by epilepsy (19.59%). Majority of the cases were within 7-10 years age group with mean age 9.74 (+/- 2.39) years. Male outnumbered female patients and 53.61% cases came from rural background. The findings of the study indicate the need for establishment of child psychiatric treatment centres in different parts of the country including rural areas.

Phosphate excretion and phosphate transporter messenger RNA in uremic rats treated with phosphonoformic acid

The prevention of phosphate retention in chronic renal disease may reduce both renal osteodystrophy and disease progression. We evaluated the expression of the sodium-dependent phosphate transporter, NaPi-2, and the response to phosphonoformic acid (PFA) in rats with 5/6 nephrectomy-induced renal failure. Partial nephrectomy resulted in a significant proteinuria and reduced renal function. In addition, there was an approximately 50% reduction in the expression of NaPi-2 mRNA. Treatment of rats for 48 hr with PFA (0.6% in glucose drinking fluid) had no effect on NaPi-2 mRNA; however, PFA resulted in a significant increase in fractional phosphate excretion in both normal (7 +/- 0.5% vs. 3 +/- 0.2%) and uremic (60 +/- 4% vs. 36 +/- 4%) rats. Plasma phosphate concentration was higher in uremic rats (2.5 +/- 0.1 mM) compared with normal rats (1.9 +/- 0.04 mM) but not in uremic rats treated with PFA (2.1 +/- 0.04 mM). These data suggest that PFA can increase renal phosphate excretion independent of changes in phosphate transporter expression and prevent phosphate retention.

Serum IgE levels in patients with allergic problems and healthy subjects

Total serum IgE levels were estimated in 219 patients with various allergic disorders (119 with bronchial asthma, 68 with allergic rhinitis and 32 with urticaria) and 240 healthy age matched subjects. Serum IgE levels were significantly (P < 0.001) higher in healthy males (mean 181 IU/ml) than females (mean 99 IU/ml). Higher levels were found in the age group 15 to 24 years and lowest in over 55 years. Males had higher IgE levels than females at any given age. Mean IgE levels were significantly (p < 0.001) higher in all three groups of patients than in healthy subjects. Among all age groups, the difference in mean IgE levels between allergic subjects and controls was significant. Positive skin test reactivity (to pollen and dust allergens) was found in 60% patients with asthma, 51% with allergic rhinitis, 46% with urticaria and in 4.5% healthy subjects. Patients with positive skin test had higher mean IgE levels as compared to those with negative skin test, but the difference was insignificant.

Epidemiological study of endemic cretinism in a hyperendemic area

A cross sectional survey was carried out to detect prevalence of cretinism in two rural areas of Bangladesh (one hyperendemic and the other non-endemic area). The size of the study population was four thousand five hundred and nine, the age ranged from 2 to 45 years. The prevalence of cretinism was 0.6% in the hyperendemic area, while there were no case of cretinism in the non-endemic zone. Of the 27 cretins, 18 (67%) were of the neurological type and 9 (33%) of mixed type. Males were more likely to be affected than females (p < 0.05). Cretinism was more prevalent in the 2-9 years age group. The hyperendemic area was deficient of iodine in food and the cretins were underweight. These observations call for a need for coordinated public health actions to control this serious problem.

Butitaxel analogues: synthesis and structure-activity relationships

N-Acyl analogues 8, 9, and 12-26 of butitaxel (3) were prepared in one or two steps from amines 5 and 6 through Schotten-Baumann acylation. Seventeen novel analogues, consisting of aliphatic carbamates, alicyclic amides, and heteroaromatic amides, were synthesized. They were evaluated for their in vitro ability to stimulate the formation of microtubules, their cytotoxicity toward B16 melanoma cells, and their solubility in water. The most potent analogue found in this study was N-debenzoyl-N-(2-thenoyl)butitaxel (20), possessing ca. 2-fold better tubulin assembly properties and cytotoxic activity against B16 melanoma cells than paclitaxel. Compound 20 was ca. 25 times more water soluble than paclitaxel.

Histochemical and immunohistochemical localisation of nitrergic neuronal and non-neuronal cells in the bursa of Fabricius of the chicken

The bursa of Fabricius of 24 chickens, 2-4 weeks old, was investigated to determine the distribution of nicotinamide adenine dinucleotide hydrogen phosphate-diaphorase (NADPH-d) staining and nitric oxide synthase (NOS) antigen, by use of NADPH-d histochemistry and NOS immunohistochemistry, respectively. NADPH-d reaction product was localised in neuronal cell bodies and nerve fibres. The stained cell bodies were predominantly in the different bursal compartments; some occurred in the wall and between the lymphoid follicles, and some in the immediate vicinity of blood vessels. Stained nerve fibres travelled mostly with blood vessels, but many were also observed in the connective tissue of the bursa, independent of blood vessels, and some in contact with the lymphoid follicle and interfollicular epithelium. In addition to neuronal profiles, the interfollicular epithelium of the plicae, and the vascular endothelium were densely stained, and lymphocytes were moderately labelled. NOS immunoreactivity was found in neuron-like cells and fibres which were confirmed to be neuronal in adjacent sections stained with antibodies raised against neuron-specific enolase. It was also detected in interfollicular epithelium and lymphocytes but not in vascular endothelium. The distribution patterns of NADPH-d and NOS suggest that nitric oxide (NO) may play a role in the regulation of the secretory activity of interfollicular epithelium and the blood flow through the bursa.

Open drainage of massive tuberculous empyema with progressive reexpansion of the lung: an old concept revisited

BACKGROUND

This study examined the results of open drainage of massive tuberculous empyema.

METHODS

During a 7-year period 47 patients with primary mixed chronic tuberculous empyema with near or total lung collapse were treated. The initial procedure was chest tube suction drainage, which permitted evaluation of the pleural cavity and the lung parenchyma despite minimal if any reexpansion of the lung. All patients were treated with antibiotics and multidrug regimens of antituberculosis agents. A pleurocutaneous window was established by removing sections of two ribs one intercostal space above the base of the pleural cavity. Irrigation was performed daily with dilute povidone iodine solution.

RESULTS

Twenty-eight patients achieved complete reexpansion of the lung after 4 to 30 months of drainage and are cured. Eleven are in various stages of reexpansion and probably will be cured. Eight patients did not achieve reexpansion. Criteria were established retrospectively on an ongoing basis that indicate when pulmonary reexpansion is possible.

CONCLUSIONS

These totally collapsed "entrapped" lungs expanded to fill the entire pleural space despite the presence of bronchopleural fistulas and an "open" pleura. Reexpansion was progressive, gradual, and dependent on improved compliance, clearing of bronchial inflammation and obstruction, and pleural cleansing. Criteria are established that identify those patients in whom complete reexpansion may take place and the disease may be cured.

Induction of apolipoprotein E mRNA in the hippocampus of the gerbil after transient global ischemia

B/A4 is the major component of brain amyloid plaque, one of the hallmarks of Alzheimer's disease (AD). B/A4 is a product of proteolytic processing of its precursor, the Alzheimer amyloid precursor protein (APP). Recently, apolipoprotein E (APO-E) has also been shown to be associated with Alzheimer's disease pathology because it is localized to plaques and tangles, and the gene encoding one of the isoforms of APO-E (E4) is associated with late-onset familial and sporadic AD. In addition, APO-E exhibits high affinity for binding to the B-peptide (B/A4). In this study, we have investigated changes in the steady state levels of APP, APO-E, and the astrocyte-specific marker, glial fibrillary acidic protein (GFAP) mRNA in the gerbil hippocampal CA1 region after a 10-min period of bilateral carotid occlusion-induced forebrain ischemia. Following this insult, we observed a loss of 90% of the CA1 neurons by 72 h post-ischemia. The mRNA levels on day 1 through day 7 post-ischemia were quantitated using an image analyzer. There was an increase in the transcription of APO-E and GFAP mRNAs, with the levels of APO-E mRNA being the highest (3-fold increase on day 7 post-ischemia) (P < 0.005). However, we did not see an increase in APP mRNA. In a parallel study [Hall, E.D. et al., Exp. Neurol., 135(1995) 17-27], we have also seen an increase in levels of APO-E and GFAP protein measured by immunocytochemistry. However, in contrast to the lack of an increase in APP mRNA, immunocytochemical measurement of APP did show an increase, perhaps due to delayed translation of previously formed mRNA. We suggest that neuronal injury or insult results in the induction of certain genes (and, therefore, protein synthesis) in the surrounding reactive astrocytes, and these proteins may contribute to post-injury amyloidogenesis.

Artifactual strain-specific signs of incipient brain amyloidosis in APP transgenic mice

In an attempt to generate transgenic mice modeling Alzheimer-type amyloidogenesis, the COOH-terminal 103 residue human APP segment was expressed in brain regions known to be vulnerable in AD. Transfected cells overexpressing this transgene were previously shown to develop intracytoplasmic inclusions that were immunoreactive with antibodies to the APP COOH-terminus. Transgenic C57B6/SJL mice produced transgene-coded mRNA in their brains at levels up to sixfold above endogenous APP, most abundantly within cortical and hippocampal pyramidal neurons. Immunocytochemistry with anti-A beta antibodies revealed occasional structures that resembled diffuse amyloid, but which could not be detected on serial sections. Immunolabeling with antibodies to APP regions NH2-terminal to the transgene-coded domain revealed elevated immunoreactivity within perikarya and neurites in regions expressing the highest transgene and endogenous APP mRNA levels, similar to observations previously reported within vulnerable neurons in AD brain. However, subsequent breeding revealed that this phenotype segregated with the B6/SJL background rather than the transgene, thus emphasizing the importance of genetic background to observations of putative AD-type pathology in transgenic animals.

Localization of nitrergic neuronal and non-neuronal cells in the ultimobranchial glands of the chicken

The ultimobranchial glands of 20 chickens, aged 2-3 months, were investigated for their nicotinamide adenine dinucleotide hydrogen phosphate-diaphorase (NADPH-d) reactivity and the distribution of nitric oxide synthase (NOS), using NADPH-d histochemistry and NOS immunocytochemistry respectively. Formazan, the blue reaction product of NADPH-d, was localised in the neuronal cell bodies and nerve fibres. Most of the cell bodies were found in the parenchyma. Some of them occurred in the wall of the ultimobranchial cysts, and a few in the immediate vicinity of the blood vessels. Labelled nerve fibres mostly travelled with blood vessels, while few of them appeared in the cystic lining. In addition to neuronal profiles, some C cells, cystic lining, and vascular endothelium were also labelled. NOS staining was found in neuron-like cells and fibres that were confirmed as neurons in adjacent sections stained with antibodies against neuron-specific enolase. It was also detected in cystic lining and in some C cells, but not in vascular endothelium. The distribution patterns of NADPH-d and NOS suggest that NO may play a role in the regulation of the secretory activity of and the blood flow through the ultimobranchial glands.

Dobutamine-atropine stress echocardiography in asymptomatic healthy individuals. The relativity of stress-induced hyperkinesia

BACKGROUND

Interpretation of dobutamine-atropine stress echocardiography (DASE) is based on the assumption that the normal response to dobutamine-atropine infusion is characterized by increased systolic thickening and motion of the left ventricular (LV) walls, whereas a reduction or no change is considered indicative of coronary artery disease. The aim of this study was to quantitatively assess changes in LV dimension and wall motion patterns during DASE in a healthy population.

METHODS AND RESULTS

Forty-two asymptomatic voluntary subjects (22 men) with a mean age of 59 years (range, 31 to 79 years) and a likelihood of < 5% for coronary artery disease underwent DASE with digital recording of two-dimensional and M-mode echocardiography at baseline and low-dose and peak infusion rates. Mean end-diastolic and end-systolic LV diameters and areas decreased and wall thicknesses increased progressively throughout the test. Wall motion and thickening increased from baseline to low-dose infusion in nearly all subjects. However, from low-dose to peak infusion, the mean absolute wall motion and relative wall thickening decreased by 13.1% (95% CI, 2.7 to 23.5) and 21.4% (95% CI, 6.4 to 36.4) regardless of age, sex, or use of atropine. Changes in fractional shortening and absolute wall thickening varied considerably, with a decrease observed in 15 and 13 individuals (36% and 31%), respectively.

CONCLUSIONS

In healthy subjects, measures of wall motion and wall thickening increased from baseline to low-dose infusion but decreased from low-dose to peak infusion. These findings call for revision of the assumptions on which the common analysis of DASE is based.

Calcineurin associated with the inositol 1,4,5-trisphosphate receptor-FKBP12 complex modulates Ca2+ flux

The immunosuppressant drug FK506 binds to the immunophilin protein FKBP12 and inhibits its prolyl isomerase activity. Immunosuppressive actions, however, are mediated via an FK506-FKBP12 inhibition of the Ca(2+)-activated phosphatase calcineurin. Physiologic cellular roles for FKBP12 have remained unclear. FKBP12 is physically associated with the RyR and IP3R Ca2+ channels in the absence of FK506, with added FK506 disrupting these complexes. Dissociation of FKBP12 results in alteration of channel Ca2+ conductance in both cases. We now report that calcineurin is physiologically associated with the IP3R-FKBP12 and RyR-FKBP12 receptor complexes and that this interaction can be disrupted by FK506 or rapamycin. Calcineurin anchored to the IP3R via FKBP12 regulates the phosphorylation status of the receptor, resulting in a dynamic Ca(2+)-sensitive regulation of IP3-mediated Ca2+ flux.

Reproducibility of digital exercise echocardiography

We determined the intra, inter-observer and temporal variability of upright bicycle exercise echocardiography in 50 consecutive patients with suspected coronary heart disease. Using significant artery stenoses as reference, the sensitivity of digital exercise echocardiography was 89% and the specificity 92%. Regarding the presence or absence of exercise-induced ischaemia, intra-observer agreement was 86% (73-94% with 95% confidence limits, kappa value (K) 0.70 (0.50-0.91)). Inter-observer agreement between two independent observers was 92 (81-98)% (K = 0.81 (0.63-0.99)). Temporal variability was examined by repeating exercise echocardiography after one week in 30 stable patients; it demonstrated 90 (78-97)% agreement (K = 0.71 (0.40-1.00)). The inter-observer agreement appeared to be lower in patients or myocardial segments with wall motion abnormalities at rest (86% and 82%, respectively) than in patients or segments with normal myocardial function at rest (96% and 94%, respectively); ns, P < 0.05, respectively). Analysis of specific regions showed a significantly higher level of agreement (P < 0.05) regarding exercise-induced ischaemia in segments supposed to be supplied by the circumflex branch of the left coronary artery (96%) than in the perfusion bed of the left anterior descending branch (87%) and right coronary artery (88%). Comparing estimated values of echocardiographic ejection fraction, analysis of intra-observer variability showed a correlation coefficient of 0.91 and 95% confidence limits of a single estimate of ejection fraction of +/- 10.3%. Corresponding analyses of inter-observer and temporal variability showed correlation coefficients of 0.93 and 0.84, respectively, and 95% confidence limits of single estimates of ejection fraction of +/- 9.6% and +/- 13.0%, respectively. Thus, the diagnostic result and the reproducibility of digital exercise echocardiography are satisfactory and comparable with those obtained by myocardial scintigraphy. However, approximately 10% of the examination results may be reversed when the test is repeated or reevaluated by the same or by another observer. The result seems to be less reproducible in patients with abnormal wall motion at rest than in patients with normal myocardial function before exercise.

Novel cytotoxic 3'-(tert-butyl) 3'-dephenyl analogs of paclitaxel and docetaxel

3'-(tert-Butyl) 3'-dephenyl analogs of paclitaxel were synthesized from 10-deacetylbaccatin III and oxazolidinecarboxylic acid 7 followed by acylation of intermediate amines 10 and 11. Oxazolidinecarboxylic acid 7 was prepared in five steps and in good overall yield from L-tert-leucine. Twelve analogs were synthesized and evaluated for their in vitro ability to stimulate the formation of microtubules and for their cytotoxicity against B16 melanoma cells. Amide, carbamate, urea, and thiourea congeners were prepared. The most potent derivatives found in this study are the docetaxel analog 13, the N-[(tert-amyloxy)carbonyl] analog 17, and the 3'-phenylurea and 3'-tert-butylurea derivatives 20 and 23. Six of these analogs were shown to be ca. 90 times more soluble in water than paclitaxel and ca. 4-5 times more water-soluble than docetaxel.

Common aerobic bacteria in post operative wound infection and their sensitivity pattern

Two hundred and four post-operative patients were examined and pus samples were collected with sterile cotton swabs from 64 patients with infected wounds. The samples were cultured aerobically and the isolates were identified as per standard methods. The prevalence rate of post-operative wound infection were 31.37% and the total number of bacterial isolates were 76 (37.25%). The isolates were identified up to their species level & they were E. coli, Staph. aureus, Kl. Pneumoniae, Ps. aeruginosa. Pr. vulgaris and S. pyogenes. Gram negative bacilli were the predominant organisms and among them E. coli was the most common. In antimicrobial susceptibility test Gentamycin and Cephalexin were found sensitive.

Register of Australian grain legume cultivars. Lens culinaris (lentil) cv. Northfield

Lens culinaris subsp. microsperma cv. Northfield was selected, from the ICARDA breeding line ILL5588 (originally collected from Jordan), for uniform height, maturity, seed type, colour and freedom from symptoms of Ascochyta lentis. Growth habit is erect becoming trailing during flowering. Plant height at maturity is slightly shorter than Aldinga but Northfield matures several days earlier. Northfield is less likely to lodge at maturity than many other cultivars making harvesting easier. Pods are bivalved, rhomboid and 2-seeded. Seeds are biconvex with a uniform red testa without marbling or speckling. Seed size is small (2.5-3.5 g per 100 seeds). It was evaluated in field trials in South Australia, New South Wales, Victoria and Western Australia over 4 years. Mean yields (1.18 t/ha) were 19% less than Aldinga (1.4 t/ha) but exceeded that of Kye (0.93 t/ha). Northfield has field resistance to A. lentis with lower levels of seed infection (1%) than Aldinga (24-48%). This results in seeds being free of blemishes, an advantage when seed is marketed whole and for seed purposes. Seed protein content of Northfield (22.2-25.2%) is similar to that of Aldinga. Northfield is less prone to seed cleaning damage than similar cultivars.

Evaluation of hospital diets in five hospitals at Dhaka city

The study was undertaken to assess the prevalent situation of diets provide to different types of patients in five hospitals at Dhaka. Calorie content of foods supplied to the patients was about 50% of the calorie that was mentioned on diet menus for different hospitals. The patients intake of food supplied by the hospital was very low. Except BIRDEM, majority of the patients in other hospitals were not satisfied with different types of foods supplied to them by the hospitals. Calorie, carbohydrate, protein, vegetable fat, iron and calcium intake by the patients differ significantly (p = 0.03-0.001) in different hospitals. The hospital diet is imbalanced to met therapeutic need.

Structure-activity studies of antitumor taxanes: synthesis of novel C-13 side chain homologated taxol and taxotere analogs

Taxol and taxotere analogs with one carbon homologated side chains were synthesized from 10-deacetylbaccatin III and a key oxazolidineacetic acid intermediate, which was synthesized in four steps from (S)-(+)-2-phenylglycine. 10-Deacetyl-1a'-homotaxol and 1a'-homotaxotere were at least 27 times less active than taxol in the microtubule assembly assay. The inability of these homologs to induce microtubule formation may be due to unfavorable solution conformations, preventing productive interactions with the taxol binding site on microtubules.

Epilepsy in Pakistan: a population-based epidemiologic study

A house-to-house, cross-sectional, population study of epilepsy on 24,130 individuals of all ages from southern Pakistan indicates an age-specific prevalence rate of 9.99 in 1,000 (14.8 in 1,000 in rural and 7.4 in 1,000 in urban areas) for recurrent, nonfebrile "active" epilepsy in Pakistan. Mean onset of epilepsy was 13.3 years, and 74.3% epileptic persons were aged < 19 years at onset of the disorder. The most common seizure type was tonicclonic in 77% [primary generalized tonic-clonic (GTC) in 59% and secondarily generalized in 18%], simple partial (SPS) in 5%, complex partial (CPS) in 6%, generalized absence in 1%, tonic in 3%, and myoclonic in 3% cases. Multiple seizures types in the same person were evident in 9.6% of only the generalized group. A putative cause could be suggested in 38.4% of cases: 32% had a positive family history of epilepsy, most common among siblings. Common perceived precipitants included fever in 29.2% and emotional disturbances in 16.6%. Only 3% of epileptic persons believed that their illness was due to super-natural causes. Treatment status was very poor, with only 2% rural and 27% urban epileptic persons receiving antiepileptic drugs (AEDs) at the time of the survey. We discuss the logistic and management problems of population-based epidemiologic studies in developing countries.

Blood pressure and glycemic status in relation to body mass index in a rural population of Bangladesh

A cluster sampling of five villages in Dohar thana were selected for screening of hypertension and diabetes in relation to age structure and body habitus. All the subjects over 15 years of age were enlisted for investigation. The response rate was more than 70%. Height, weight, blood pressure (BP) and capillary blood glucose (fasting and 2-hPG) were measured. Diagnostic criteria of international standard were used for hypertension and diabetes. Out of 1005 participants 106 subjects (10.5%) had systolic blood pressure (sBP) more than 140 mmHg and 9% of them had diastolic blood pressure (dBP) more than 90 mmHg. The prevalence of non-insulin-dependent diabetes mellitus (NIDDM) was 2.1% and impaired glucose tolerance (IGT) was 13.3%. The mean body mass index (BMI) of men was 20.39 (SD = 2.91) and that of women was 20.11 (SD = 2.92), having no significant difference between them. Increased age (> or = 50 yr), high BMI (> or = 23.0) and hyperglycemia (2-hPG > 7.8 mmol/L) were the risk factors for both systolic (sBP > 140 mmHg) and diastolic (dBP > 90 mmHg) hypertension. Likewise, increased age, high BMI and hypertension showed significant association with glucose intolerance. Moreover, significant correlations were observed between age and BP (sBP, r = 0.328 p < 0.001; dBP, r = 0.187 p < 0.001) BMI and BP (sBP, r = 0.193 p < 0.001; dBP, r = 0.192 p < 0.001) and 2-hPG and BP (sBP, r = 0.188 p < 0.001; dBP, r = 0.134 p < 0.001).

[Dobutamine stress echocardiography. Use of dobutamine stress echocardiography in diagnosis and assessment of ischemic heart disease]

Dobutamine stress echocardiography (DSE) is a new diagnostic method for evaluation of patients with known or suspected coronary artery disease. We studied 30 consecutive patients referred for evaluation of chest pain. Coronary angiography was carried out in 28 patients. DSE was performed the following day. Readable echocardiographic recordings were obtained in all patients. Blinded wall motion analysis revealed a diagnostic sensitivity of 91% (95% confidence limits: 79-100%) for dobutamine stress echocardiography using coronary angiography as reference. No severe adverse events or arrhythmias occurred. It is concluded that DSE is well tolerated, feasible and has a high sensitivity for detecting coronary artery disease.

Attempting pregnancy after miscarriage and curettage--what is the minimum interval?

We describe a normal pregnancy that was conceived less than 3 weeks following curettage for a blighted ovum. A delay between curettage and subsequent pregnancy is often recommended. Evidence supporting such a delay is examined.

Plasma level of antioxidant nutrients (retinol and alphatocopherol) in cases with different grades of cervical carcinoma

A study was conducted on 23 patients on various grades of cervical cancer, selected purposely from Dhaka Medical College Hospital. Vitamin A and E level of this histologically proved cases showed mean serum level of vitamin A was 0.41 +/- 0.19 and that vitamin E was 4.21 +/- 2.15, and these low level was constant in all Histopathological grading of cervical cancer. Contraceptive user and smoker had very low level of vitamin A and E. Majority (51%) of the cases, were from lower middle class and 49% were from lower class, seventy seven percent were illiterate, 97% were married before 18 years, 57% had more than 6 children, 71% did not use contraceptive. The availability of vitamin A rich food were within reach of lower income group, than the food source of vitamin E which are usually of animal origin. It is concluded that in cervical cancer had low level of antioxidant vitamins A and E. Further study is indicated for understanding detail antioxidant nutrients role in aetiopathology of cervical cancer in Bangladesh.

The Alzheimer beta-amyloid protein precursor/protease nexin-II is cleaved by secretase in a trans-Golgi secretory compartment in human neuroglioma cells

Alzheimer beta-amyloid protein precursor (beta APP) is expressed endogenously and abundantly by human neuroglioma (H4) cells. Its secretory processing has been shown to involve discrete proteolysis within the beta A4 region, thus preventing beta-amyloid formation, by an enzyme which has been referred to as 'beta APP secretase'. This cleavage results in secretion of a soluble N-terminal 135 kDa protein and retention of an integral membrane C-terminal fragment within the cell. The membrane-associated C-terminal fragment is sorted to lysosomes where it undergoes limited degradation. We show here that most newly synthesized beta APP is degraded via a non-lysosomal pathway before maturation in H4 cells, and most mature beta APP is processed predominantly by the so-called secretase. The rapid kinetics of appearance/disappearance of a cleaved 135 kDa protein within a microsomal fraction and the slow accumulation of this form in the extracellular medium indicated that secretase cleaves beta APP in an intracellular compartment. Low-temperature block (20 degrees C) was used to demonstrate that beta APP is cleaved within a late Golgi compartment after sulphation which occurs in the trans-Golgi network (TGN). This is consistent with (1) the immunolocalization of most of the beta APP within a Golgi compartment that reacts with wheat germ agglutinin, (2) the fact that less than 1.5% of the total mature full-length beta APP is present at the plasma membrane and (3) subcellular fractionation studies which showed that the mature full-length and intracellular cleaved beta APPs co-sediment with a membrane fraction that is slightly more dense than the plasma membrane. This study provides evidence that most of the beta APP secretase in H4 cells is intracellular, and confirms that the resulting C-terminal fragment is delivered to lysosomes immediately after cleavage. These results are discussed with regard to the possibility that mature full-length beta APP escapes secretase cleavage and is delivered directly from the TGN to the lysosome without passing through the plasma membrane. Either pathway will result in the generation of amyloidogenic fragments.

Plasma LH and FSH levels in azoospermia and in normal male and female human subjects

Immunoassay of human plasma LH and FSH level was carried out in the Institute of Nuclear Medicine, Bangladesh. Apparently normal male and female volunteers and subjects having primary sterility were studied. Plasma LH and FSH levels of normal males ranged from 1.9 to 20.48 (mean 7.3) and 1.17 to 6.75 (mean 3.30) m IU/ml respectively. Corresponding values for females were 0.99 to 38.92 (mean 17.94). Level of LH and FSH in azoospermic males were found higher than normal ones with the mean value of 17.0 and 5.67 m IU/ml respectively. The study gives an impression about the plasma LH and FSH levels in azoospermia and normal population in Bangladesh.

Comparative inhibitory action of 4 standard bacteriophages on the larvicidal activity of certain mosquito pathogenic bacteria against Culex pipiens larvae

Four bacteriophage (CP-51, CP-54, Yousten-4 and Yousten-14) were assayed against 7 entemopathogenic bacterial strains. The two CP ones, indicating variability of the host range of the tested phages which was suggested to be related to the environmental characteristics of the tested strains. On testing the susceptibility of 5 bacterial strains to the phage Yousten-4 at different cultural ages, a correlation was found between incubation time and level of bacterial susceptibility to the tested phage. This observation was explained to be due to the number of vegetative cells and/or sporulation.

A field survey of bacteriophage contamination of mosquito breeding places, inhibiting bacterial insecticide

Twelve geographically different mosquito breeding places were described and sampled for the detection of naturally existed bacteriophage viruses which could transduct and lysate 5 entomopathogenic bacteria. The surveyed places are classified into seepage, sewage, and irrigation breeding water. Bacterial free filtrates of the collected samples were assayed against the tested bacteria in vitro and against 3rd instar Culex pipiens larvae as well. Nine out of the twelve places could demonstrate the presence of phages. Bacillus thuringiensis H-14 was foud susceptible to phage(s) present in polluted and irrigated water of 5 location, while, B. thuringiensis Berliner was susceptible to only a specific phage of one breeding place (polluted, sewage water). With regard to Bacillus sphaericus strains 1593 and 114, bacteriophages of sewage and irrigated water could lysate them and these phages are characterized by being of a moderate host range, except one phage which showed high specificity with strain 114 and was detected in a polluted sewage water sample collected from Dakahliya Governorate. The detected phages proved to lysate both B. thuringiensis H-14 and B. sphaericus 1593 on their larvicidal action through a series of bioassay experiment, almost all results indicate the presence of a significant inhibitory activity.

Isolation, purification and ultrastructure of bacteriophages from natural mosquito breeding places in Egypt

Two bacteriophages were isolated from field collected samples representing two different mosquito breeding places. The phage AB-1 (isolated from Abheit village, Faiyoum Governorate "seepage water") and the phage GA-2 (isolated from El-Gabal El-Asfer Qualyobia Governorate "sewage drain water") were purified. Both bacteriophages were ultrastructurally described with respect to their morphology, dimensions, phases of bacterial attack and lysogeny. No major differences were observed between both isolated phages in relation to specificity, however; they were isolated from two different types of breeding places and two different geographic areas as well. This study may assume a wide host range of the isolated phages and reflect how bacterial insecticides used for mosquito larval control could be inhibited by such bacteriophage.

Prediction of the service life of dental porcelains by the measurements of post-indentation slow crack growth

Statistical fatigue life for body dental porcelains, cooled in a furnace and in air, was predicted from measurements of post-indentation slow growth of radial cracks in water and in air. Cracks were induced in the surfaces of porcelain discs by a Vickers indenter at an applied load of 9.8 N. Crack lengths were measured at various times over a period of 5 months to calculate the stress corrosion susceptibility coefficient, n. Lifetime under service stress was estimated from the measured value of n. The ratios of service stress to fracture strength were calculated as 0.47 and 0.69, respectively, for glassy and feldspathic porcelains which were cooled in a furnace and aged in water. The corresponding ratios for tempered (cooled in air) specimens were 0.58 and 0.67, respectively. These were estimated values when service life exceeds 10 years. The results suggest that the air cooling process can effectively increase the service life of glassy porcelains, but, for feldspathic porcelain it is less effective.

Effect of bacteriophage lysogeny on the efficacy of two bacterial larvicide formulations under field conditions

Two types of man-made ditches were selected for carrying out this experiment; one polluted with nitrogenous matters (sewage water) and second filled with accumulated irrigated clear non-chlorinated water. No phages were detected in samples collected from both types of ditches. However, phage(s) specific to only B. sphaericus was (were) detected after spraying the two types with both B. thuringiensis H-14 and B. sphaericus commercial formulations. The detection of phage(s) was observed after 3 days post-spraying in the polluted ditch and after one week in the non-polluted one. This observation was explained by a possible transduction of naturally existed phage(s) on other spore forming bacteria to the sprayed B. sphaericus only, as its commercial formulation is based on spores which germinate to produce vegetative cell, while B. thuringiensis H-14 contains only the O-endotoxin as active ingredient, and also due to the increase of the number of bacteria in the sprayed ditches due to the recycling of B. sphaericus in the aquatic breeding places.

Variability in grain protein concentration of peas and lentils grown in Australia

Protein and yield data were obtained from South Australian and Interstate pea and lentil variety trials conducted between 1986 and 1989, covering 94 pea and 58 lentil genotypes. Crude protein concentration varied significantly across sites and averaged 25.0% in peas and 24.4% in lentils. Protein concentration was not significantly correlated with yield at most individual sites. Minimum protein concentration in peas was 1.6% below the mean of three check cultivars in line RA155, while the maximum was 2.3% above that mean in lines P255-2 and P262-1. In lentils the range was 1.2% above the check mean in ILL5562 and 1.0% below in ILL6017. A further lentil genotype, 'Chilean', was 6.0% above controls, but was inadequately replicated in these trials. Genotypic variation in pea and lentil protein concentration was lower than in many other species, but the lack of correlation between protein and yield suggests that independent selection of both characters during breeding is possible and should be successful without the rate of gain in one trait being reduced by that in the other.