Serum paraoxonase activity and protein thiols in chronic renal failure patients

Serum paraoxonase is known to prevent low-density lipoprotein oxidation and atherogenesis. Association of paraoxonase with the oxidative status and lipid profile in chronic renal failure (CRF) patients on conservative management and those on chronic maintenance hemodialysis was analyzed in the present study. Serum paraoxonase, protein thiols, lipid hydroperoxides, lipid profile, creatinine and albumin levels were estimated by spectrophotometric methods in CRF patients on conservative management, those on hemodialysis and in healthy controls. Total cholesterol, triglycerides, low-density lipoprotein cholesterol, lipid hydroperoxides and creatinine levels were higher and high-density lipoprotein cholesterol, protein thiols, albumin levels and paraoxonase activity were lower in patients than in healthy controls. Paraoxonase activity correlated positively with protein thiols and high-density lipoprotein cholesterol and negatively with low-density lipoprotein cholesterol and lipid hydroperoxides. In conclusion, paraoxonase activity is decreased in CRF patients particularly on chronic maintenance hemodialysis and correlates well with the oxidative stress markers.

Downstaging for cervical cancer: a community-based study in the rural areas of Udupi district, Karnataka, India

The objective of this study is to determine the feasibility of utilizing trained auxiliary nurse midwives (ANMs) in downstaging for cancer cervix in a rural area. The study population included all married women in the age group of 35-59 years in two villages of the field practice area. It was a cross-sectional study. Two ANMs were trained in history taking, visual inspection of the cervix, using of speculum and collecting Papanicolaou smears. After training, they made home visits and identified women with gynaecological symptoms suggestive of cervical cancer. These women were asked to report to Rural Maternity and Child Welfare whom homes where the ANMs did a visual inspection of the cervix and made a cervical smear. A total of 1402 women were registered of the ANMs could identify 368 women (26%) with symptoms. Only 192 (52.2%) of these women reported for examination. Chronic cervicitis accounted for the largest proportion of the cases (44.8%). In all, three cases were diagnosed as suspected cases of cancer cervix. On cytology, three cases (1.5%) turned out to be malignant. When clinical findings of the ANM were compared with results of cytological examination, a high degree of sensitivity (78.4%) and positive predictive value (97.1%) were observed in diagnosing abnormal cytological findings. However, the sensitivity for detecting specific conditions was generally low. Sensitivity for detecting erosion was 45%, for chronic cervicitis 30%, and malignancies were totally missed. In conclusion, this study clearly shows that ANMs, if trained, would be capable of identifying symptomatic women, differentiating a normal cervix from an abnormal one and taking an adequate smear for cytological examination.

Genotypic analysis of invasive Streptococcus pneumoniae from Mali, Africa, by semiautomated repetitive-element PCR and pulsed-field gel electrophoresis

As part of a large, ongoing study of invasive infections in pediatric patients in Bamako, Mali, 106 cases of invasive pneumococcal disease were identified from June 2002 to July 2003 (J. D. Campbell et al., Pediatr. Infect. Dis. J. 23:642-649, 2004). Of the 12 serotypes present, the majority of isolates were not contained in PCV7 (the 7-valent pneumococcal conjugate vaccine), including 1 isolate that was serotype 1, 12 isolates that were serotype 2, 58 isolates that were serotype 5, 7 isolates that were serotype 7F, and 1 isolate that was serotype 12F. To determine whether clonal dissemination of the predominant serotypes had taken place, genotyping was performed on 100 S. pneumoniae isolates by using two methods: pulsed-field gel electrophoresis (PFGE) of SmaI-digested genomic DNA, and the Bacterial Barcodes repetitive-element PCR (rep-PCR) method. Criteria for delineating rep-PCR genotypes were established such that isolates of different serotypes were generally not grouped together. The two methods were equally discriminatory within a given pneumococcal serotype. PFGE separated the isolates into 15 genotypes and 7 subtypes; rep-PCR separated isolates into 15 genotypes and 6 subtypes. Using either method, isolates within serotypes 2, 5, and 7 formed three large, separate clusters containing 1 genotype each. Both methods further distinguished related subtypes within serotypes 2 and 5. Interestingly, one of the PFGE subtypes of serotype 5 is indistinguishable from the Columbia(5)-19 clone circulating in Latin America since 1994. The data support that serotypes 2 and 5 were likely to be the result of dissemination of particular clones, some of which are responsible for invasive disease over a broad population range.

Intracardiac echocardiographic measurement of left ventricular volume

We tested the utility of intracardiac echocardiography (ICE) in measuring left ventricular (LV) volume. In 4 normal dogs, a 10-F percutaneous sheath was placed inside the LV along its major axis. An ICE catheter (9 F, 9 MHz) was then inserted through the sheath into the LV. The ICE catheter was pulled back in 1-mm intervals starting from the apex, and 2-D tomographic images were continuously acquired. Subsequently, the ICE catheter was replaced in the LV by a conductance catheter to measure single-beat volume signals. Stroke volume was determined by thermodilution for validation. All measurements were made in each dog while pacing the atrium at two different cycle lengths (range=300-500 ms). The endocardium was segmented in the ICE images throughout the cardiac cycle, and LV volume was computed by integrating multiple segments (range=55-70 mm). We found that ICE accurately reconstructed LV 3-D anatomy. Stroke volume by ICE was in excellent agreement with thermodilution (error = 3.8+/-3.0%, r = 0.99, n = 8). Morphology of LV volume signals correlated well with instantaneous volume signals derived by conductance (r=0.93, n=8). In conclusion, ICE accurately reconstructs LV anatomy and volume throughout the cardiac cycle in the normal heart. This approach could facilitate interventional diagnostic and therapeutic procedures.

Semi-automatic segmentation of the endocardial boundary in intracardiac echocardiographic images

Intracardiac echocardiograpby (ICE) has been employed in guiding clinical interventional procedures. ICE could also be useful for 3-D anatomical and functional imaging of the heart. In this regard, we developed and tested a method to semi-automatically determine the endocardial boundary in multiple tomographic ICE images. Compared to manual segmentation, we found that semi-automatic segmentation of the endocardial boundary in ICE images was feasible and enabled accurate and efficient reconstruction of 3-D geometry of the heart cavity.

Vibrational spectroscopy studies of formalin-fixed cervix tissues

Optical histopathology is fast emerging as a potential tool in cancer diagnosis. Fresh tissues in saline are ideal samples for optical histopathology. However, evaluation of suitability of ex vivo handled tissues is necessitated because of severe constraints in sample procurement, handling, and other associated problems with fresh tissues. Among these methods, formalin-fixed samples are shown to be suitable for optical histopathology. However, it is necessary to further evaluate this method from the point of view discriminating tissues with minute biochemical variations. A pilot Raman and Fourier transform infrared (FTIR) microspectroscopic studies of formalin-fixed tissues normal, malignant, and after-2-fractions of radiotherapy from the same malignant cervix subjects were carried out, with an aim to explore the feasibility of discriminating these tissues, especially the tissues after-2-fractions of radiotherapy from other two groups. Raman and FTIR spectra exhibit large differences for normal and malignant tissues and subtle differences are seen between malignant and after-2-fractions of radiotherapy tissues. Spectral data were analyzed by principal component analysis (PCA) and it provided good discrimination of normal and malignant tissues. PCA of data of three tissues, normal, malignant, and 2-fractions after radiotherapy, gave two clusters corresponding to normal and malignant + after-2-fractions of radiotherapy tissues. A second step of PCA was required to achieve discrimination between malignant and after-2-fractions of radiotherapy tissues. Hence, this study not only further supports the use of formalin-fixed tissues in optical histopathology, especially from Raman spectroscopy point of view, it also indicates feasibility of discriminating tissues with minute biochemical differences such as malignant and after-2-fractions of radiotherapy.

Effect of raloxifene and its interaction with human PTH on bone formation

We studied the of effects raloxifene alone or in combination with human PTH (hPTH) 1-34 in mineralizing cultures of SaOS-2 cells. Raloxifene (10(-8)-10(-6) M) increased bone nodule formation in cultures of SaOS-2 cells when added intermittently from day 8 to day 17. A single 24-h treatment with 10(-8) M hPTH (1-34) at day 8 reduced the nodule area by 75.6% at day 17, and raloxifene added concomitantly with hPTH (1-34) reduced this inhibitory effect in a dose-dependent manner. Raloxifene also reduced the hPTH (1-34)-induced inhibition of alkaline phosphatase (ALP) activity. The 10-fold stimulation of c-fos mRNA expression by hPTH (1-34) was not influenced by raloxifene co-treatment. The protein kinase A (PKA) inhibitor 6-22 amide (1.7 nM) and the protein kinase C (PKC) inhibitor-bisindolylmaleimide 1 (10 nM) did not influence the separate effects of PTH and raloxifene on mineralized bone nodule formation. This is the first report on the interaction of PTH and raloxifene in an osteoblast culture system.

Autofluorescence of oral tissue for optical pathology in oral malignancy

Pulsed laser-induced-fluorescence studies of pathologically certified oral tissues are carried out at different excitations and time delays. Among the several excitations used, 325 nm produced noticeably different spectral profile for normal and malignant tissues. Extensive curve analysis was carried out in order to understand changes in biochemical composition of tissue based on spectral profiles. Curve resolution and principal component analysis (PCA) show that the fluorescence intensity changes from normal to malignant tissue samples are not completely explained in terms of simple collagen and NAD(P)H intensity changes. The spectra require at least five components to be fully accounted for. Several discrimination methodologies based on PCA and intensity differences between different emission peaks (resultant peaks of curve analysis) were also evaluated. The results obtained indicate PCA using Mahalanobis distance and spectral residual as discrimination parameters provides best discrimination and can be used for matching unknown samples to standard calibration sets. Intensity ratio of bound NAD(P)H to collagen seems to be more suitable for discrimination between normal and malignant oral tissue, compared to ratio of collagen to total intensity of all the other components together.

Utility of polymerase chain reaction as a diagnostic tool in cutaneous tuberculosis

BACKGROUND

Differentiation of cutaneous tuberculosis from other infective granulomas of the skin is difficult due to paucity of the organisms in tissue biopsies. Polymerase chain reaction (PCR) is a newer technique to identify the DNA of Mycobacterium tuberculosis in the tissues.

AIM

We examined the utility of PCR as a tool for rapid diagnosis of cutaneous tuberculosis especially in cases negative by ZN staining and culture.

MATERIAL AND METHODS

Twenty five random skin biopsies from patients with various types of cutaneous tuberculosis were subjected to PCR.

RESULTS

An overall positivity of 64% was observed, which is comparable to other series. Seventy five percent of lupus vulgaris cases, 62.2% of tuberculosis verrucosa cutis and 50% of scrofuloderma cases showed PCR positivity.

CONCLUSION

Though useful, the cost and the technique involved limit the use of PCR in developing countries like ours.

Chromatographic separation and characterization of hydrolyzed Cr(III) species

Both macroscale and microscale methods to separate hydrolyzed Cr(III) species from acidic to near-neutral pH solutions have been developed. The macroscale approach is based on ion exchange, and involves separating monomeric, dimeric, trimeric, tetrameric, and higher order Cr(III) oligomers from such solutions using a gradient elution with increasing cationic charge. With this approach, the concentration of a given fraction can be maximized, and complete resolution between these species can be achieved. In addition, complete recovery of Cr(III) from the column is achievable. For the microscale approach, capillary electrophoresis with indirect detection is used to isolate and uniquely identify the same smaller oligomers and a fraction of larger Cr(III) species that are not uniquely identified. Capillary electrophoresis also provides indirect structural information for the Cr(III) trimer, suggesting that it exists in a triangular configuration rather than as a linear species. These methods are described in detail, and possible applications are discussed.

Gene expression profiling of low selenium status in the mouse intestine: transcriptional activation of genes linked to DNA damage, cell cycle control and oxidative stress

The essential trace mineral selenium (Se) has been shown previously to inhibit intestinal, prostate, lung and liver tumor development and associated mortality in both experimental animals and humans. Although Se is likely to be one of the most powerful cancer chemopreventive agents in the human diet, its mechanism of action is unknown. To better understand the biological consequences of alterations in Se status, the gene expression profile associated with low Se status in the intestine of C57Bl/6J mice was analyzed. Mice were fed either a high fat (14%), torula yeast-based, Se-deficient diet (<0.01 mg/kg) or the same diet supplemented with a high level of dietary Se (1 mg/kg, as seleno-L-methionine) for 90 d. Use of high density oligonucleotide arrays representing 6347 genes revealed that low Se status results in a differential gene expression pattern indicative of activation of genes involved in DNA damage, oxidative stress and cell cycle control, and a decrease in the expression of genes involved in detoxification. These results suggest that suboptimal intake of a single trace mineral can have broad effects on gene expression patterns, providing a framework for understanding the multiple beneficial effects of Se in cancer chemoprevention and human health.

Global comparisons between contact and noncontact mapping techniques in the right atrium: role of cavitary probe size

In the right atrium (RA) we globally investigated: (1) the properties of noncontact electrograms measured by multielectrode cavitary probes, (2) the features of endocardial electrograms computed from the noncontact probe electrograms, and (3) the impact of the probe size on both the noncontact and the computed electrograms. We deployed a custom catheter in the dog RA, which consisted of a cylindrical probe with 64 electrodes on its surface, for measuring noncontact cavitary electrograms, and a concentric endocardial basket carrying an additional array of 64 electrodes, for measuring contact endocardial electrograms (the "gold standard"). Both a 5-mm- and a 10-mm-diam probe (P5 and P10, respectively) were sequentially tested in the same RA of one dog. Unipolar electrograms from both the probe and the basket were simultaneously acquired during normal as well as during paced rhythms (n > or =24 protocols per probe). Boundary element method and numeric regularization were applied to compute endocardial electrograms at the basket electrode locations. We found that noncontact electrograms were attenuated and smoothed, and this effect was exaggerated with the small probe. Computed endocardial electrograms more accurately reconstructed important amplitude distribution and morphological features; peak-to-peak amplitude error, 35% for P5 and 34% for P10. Activation and spatial errors of computed endocardial electrograms were 8.8+/-6.8 ms and 5.1+/-6.1 mm for P5, respectively, and 6.0+/-5.5 ms and 3.2+/-4.4 mm for P10, respectively. In conclusion, global RA activation may be delineated directly from noncontact cavitary electrograms alone, but may be affected by volume attenuation, smoothing, and probe size. Accurate endocardial electrograms, however, can be successfully computed from noncontact electrograms acquired with small probes and be used to reconstruct both electrogram amplitude and detailed morphology.

EXAFS studies of americium (III)-benzimidazole complex in ethanol

The local structures of Am, Nd and Er-Benzimidazole (Biz) in solution were determined by EXAFS. The BIZ molecule coordinated to Am and Nd through two nitrogen atoms in a bidentate fashion. Two nitrogen atoms of BIZ ligated to Am and Nd with the bond distances R(Am-n) N=2.63A and R(Nd-N) = 2.65 A, respectively. The total coordination number of the Am BIZ complexes (at a molar ratio of metal ion to ligand of 1:20) was approximately 10 but that of Nd BIZ complex was approximately 9.

Congenital cervical bronchogenic cyst

A bronchogenic cyst is a rare developmental aberration that occurs in the paediatric age group. Over 50 cases of bronchogenic cysts have been reported in the literature. There is still a possibility of clinically misdiagnosing this condition as a more common congenital neck cyst like a branchial cyst. We report here the case of a 12-year-old female presenting with a neck swelling since birth who was diagnosed to have a bronchogenic cyst based on characteristic clinical and histopathological findings.

Infantile cartilaginous hamartoma of the rib. A case report

BACKGROUND

Infantile cartilaginous hamartoma of the rib is a rare condition occurring in newborn infants, with an incidence of 1 in 3,000 (0.03%) among primary bone tumor cases. Reports of this condition so far have presented the clinical, radiologic and histopathologic features. To the best of our knowledge, reports of the cytopathologic features have not been documented. In the present case report, clinical, radiologic and cytopathologic features and differential diagnosis are enumerated.

CASE

A 1-month-old, male infant presented with a chest wall mass with a clinical diagnosis of osteochondroma. On fine needle aspiration cytology, a diagnosis of infantile cartilaginous hamartoma of the rib was suggested; it was supplemented by the clinical history and radiologic findings.

CONCLUSION

Although rare, this condition ought to be kept in mind while dealing with infantile chest wall masses to avoid an erroneous diagnosis of malignancy, owing to its ominous cytopathologic features.

Granulocytic sarcoma of the head and neck: a case report

A rare case of granulocytic sarcoma of the head and neck region is presented to highlight its unusual clinical presentation and the difficulties encountered in its diagnosis. The risk factors, pathological findings, and treatment modalities are discussed to make head and neck surgeons aware of this condition, which can have a fatal outcome as happened in our case.

[Transthoracic three-dimensional echocardiography for determination of left ventricular mass in patients with dilated cardiomyopathy]

This study was performed to compare left ventricular mass (LVM) measurement by one- (1D), two- (2D) and 3D echocardiography with magnetic resonance imaging (MRI) in patients with dilated cardiomyopathy (DCM). 36 patients with DCM underwent imaging by conventional 1D and 2D echocardiography as well as transthoracic 3D echocardiographic data acquisition. Also patients were imaged with cardiac MRI. LVM was determined. There was no significant correlation (r = 0.42, P > 0.05) for measuring LVM between 1D echocardiography and MRI in patients with DCM. A significant correlation was obtained between 2D echocardiography and MRI (r = 0.64, P < 0.01) and between 3D and MRI (r = 0.78, P < 0.01) in determination of LVM. Compared with 1D and 2D echocardiography, the 3D analysis achieved a significantly higher agreement with the MRI results (1D; 399.2 g, 2D: 285.9 g, 3D: 172.6 g versus MRI: 199.1 g). Interobserver variability was 5.1% for measuring LVM by 3D echocardiography. These results suggest that LVM of patients with DCM can be accurately determined by transthoracic 3D echocardiography and this method could be used in clinical practice.

[Study of spontaneous echo contrast in patients with rheumatic mitral stenosis by transesophageal echocardiography]

Spontaneous echo contrast (SEC) is common in the areas of slow blood flow. This study was conducted to examine the correlation of SEC and left atrial appendage function, atrial fibrillation (Af) and thrombus in patients with rheumatic mitral stenosis. The transthoracic and multiplane transesophageal echocardiograms were performed on 117 patients(mean age 42.22 +/- 10.79 years). Left atrial size, left atrial appendage area, mitral valve area, left atrial appendage flow peak emphatic velocity and full velocity were measured. The presence of SEC and thrombus in the left atrium and appendage was noted. The results showed that among the patients, 57 had normal sinus rhythm, 60 had Af; 19 had thrombus, 98 had no thrombus; 71 had SEC and 46 had no SEC. Compared with the patients without SEC, the patients with SEC showed greater incidence of thrombus (28.76% vs 0, P < 0.05), higher rate of Af (69.01% vs 23.91%, P < 0.05), larger LAD (46.93 +/- 0.85 mm vs. 41.76 +/- 1.05 mm, P < 0.05), larger LAA area (8.06 +/- 0.32 cm2 vs 6.92 +/- 0.31 cm2, P < 0.05), smaller MVA area (1.07 +/- 0.23 cm2 vs 1.32 +/- 0.35 cm2, P < 0.05), lower LAA flow peak emphatic velocity (0.17 +/- 0.01 m/s vs 0.32 +/- 0.02 m/s, P < 0.05), and lower LAA full velocity (0.18 +/- 0.01 m/s vs 0.31 +/- 0.03 m/s, P < 0.05). These findings indicate that the presence of SEC is associated with significantly greater incidence of thrombus, higher rate of Af, larger LAD and LAA area, smaller MVA area, lower LAA flow peak emphatic velocity and full velocity. Atrial fibrillation, the diameter of left atrium and the area of mitral valve are independent predictors of SEC. SEC is significantly associated with LAA function and thrombus formation.