Structural, spectral, linear and nonlinear optical properties of new nonlinear optical L-histidinium trichloroacetate crystals

Single crystals of a new histidinium salt: L-histidinium trichloroacetate {abbreviated as LHTCA; [(C(3)N(2)H(4))CH(2)CH(NH(3))(CO(2))](+)CCl(3)COO(-)} were grown by slow evaporation of an aqueous solution at room temperature. The compound crystallizes in a non-centrosymmetric space group P2(1) of monoclinic system with cell parameters a=5.4505(18) A, b=25.769(8) A, c=9.210(2) A and beta=99.98(2) degrees. The vibrational structure of the compound confirms the presence of various functional groups in the molecule. The UV-vis-NIR spectrum shows a good transparency in the whole of the region from ultraviolet to near IR. The Kurtz powder SHG measurement confirms the frequency doubling of the crystal. Thermal behaviour of the crystals has been investigated by DSC analysis. These preliminary results suggest that LHTCA crystal can act as a potential and promising candidate for frequency doubling applications even from the near UV region to the near IR.

Comparison between external fixation and sliding hip screw in the management of trochanteric fracture of the femur in Nepal

We conducted a randomised controlled trial to compare external fixation of trochanteric fractures of the femur with the more costly option of the sliding hip screw. Patients in both groups were matched for age (mean 67 years, 50 to 100) and gender. We excluded all pathological fractures, patients presenting at more than one week, fractures with subtrochanteric extension or reverse obliquity, multiple fractures or any bone and joint disease interfering with rehabilitation. The interval between injury and operation, the duration of surgery, the amount of blood loss, the length of hospital stay and the cost of treatment were all significantly higher in the sliding hip screw group (p < 0.05). The time to union, range of movement, mean Harris hip scores and Western Ontario and McMaster University knee scores were comparable at six months. The number of patients showing shortening or malrotation was too small to show a significant difference between the groups. Pin-track infection occurred in 18 patients (60%) treated with external fixation, whereas there was a single case of wound infection (3.3%) in the sliding hip screw group.

Pathophysiology of Acute Ischaemic Stroke: An Analysis of Common Signalling Mechanisms and Identification of New Molecular Targets

Stroke continues to be a major cause of death and disability. The currently available therapies have proven to be highly unsatisfactory (except thrombolysis) and attempts are being made to identify and characterize signalling proteins which could be exploited to design novel therapeutic modalities. The pathophysiology of stroke is a complex process. Delaying interventions from the first hours to days or even weeks following blood vessel occlusion may lead to worsening or impairment of recovery in later stages. The objective of this review is to critically evaluate the major mechanisms underlying stroke pathophysiology, especially the role of cell signalling in excitotoxicity, inflammation, apoptosis, neuroprotection and angiogenesis, and highlight potential novel targets for drug discovery.

Occurrence of overlooked zoonotic tuberculosis: detection of Mycobacterium bovis in human cerebrospinal fluid

The paucibacillary nature of the cerebrospinal fluid (CSF) has been a major obstacle in the diagnosis of human tuberculous meningitis (TBM). This study shows that with molecular techniques direct precise determination to the species level of mycobacterial pathogens can be made. The present report describes the utility of a nested PCR (N-PCR) assay (A. Mishra, A. Singhal, D. S. Chauhan, V. M. Katoch, K. Srivastava, S. S. Thakral, S. S. Bharadwaj, V. Sreenivas, and H. K. Prasad, J. Clin. Microbiol. 43:5670-5678, 2005) in detecting M. tuberculosis and M. bovis in human CSF. In 2.8% (6/212) of the samples, M. tuberculosis was detected, and in 17% (36/212), M. bovis was detected. Mixed infection was observed in 22 samples. Comparative analysis of clinical diagnosis, smear microscopy, and N-PCR in 69 patients (TBM, 25; non-TBM, 44) showed that the sensitivity of N-PCR (61.5%) was greater than that of smear microscopy (38.4%). Determination to the species level is important from the viewpoint of determining the prevalence of these mycobacteria in a community and would influence strategies currently adopted for the prevention of tuberculosis.

Neoplastic diseases of the head & neck in children

Pediatric neoplasm is next only to trauma as the most common cause of death. The cervicofacial malignancies presents a unique challenge owing to potential adverse effects of both the disease process and the treatment employed on critical developing head and neck structures.This study comprised of 106 children below 12 years age group conducted during 1999-2003 at JNMC, Aligarh. Of 106 cases 70 were benign neoplasms and 36 malignant neoplasms. Nasopharynx was the commonest site of involvement. Nasopharyngeal angiofibroma was the commonest benign tumour and lymphoma was the commonest malignant neoplasm. Team approach is required for mitigation of the disease process.

N-(3-Triethoxysilylpropyl)-6-(N-maleimido)-hexanamide: An efficient heterobifunctional reagent for the construction of oligonucleotide microarrays

Synthesis of a new heterobifunctional reagent, N-(3-triethoxysilylpropyl)-6-(N-maleimido)-hexanamide (TPMH), for the preparation of oligonucleotide microarrays is described. Its triethoxysilyl function is specific toward virgin glass surface and maleimide function undergoes conjugate addition to 3'- or 5'-thiol-modified oligonucleotides. The construction of microarrays using TPMH has been realized via two routes. In Route A, TPMH was reacted first with 3'- or 5'-thiol-modified oligonucleotide under microwaves, thereby producing oligonucleotide-triethoxysilyl conjugate in 15min, which was then brought in contact with virgin glass microslide, resulting in immobilization of an oligonucleotide sequence. In Route B, immobilization involves generation of maleimide functions on virgin glass surface by the reaction with TPMH, followed by coupling with thiol-modified oligonucleotides under microwaves in 15 min to produce surface-bound oligonucleotides. The microarrays constructed using both routes were analyzed by hybridizing with tetrachlorofluorescein-labeled complementary oligonucleotide. Subsequently, these microarrays were successfully used in the discrimination of single and double nucleotide mismatches based on fluorescence intensity.

DRB3.2 gene polymorphism and its association with pashmina production in Changthangi goat

PstI and TaqI restriction fragment length polymorphism (RFLP) of caprine DRB3.2 revealed three genotypes under each RFLP in Changthangi goat. The genotypic and allelic frequency in PstI RFLP was calculated as 0.07, 0.72 and 0.20 for PP, Pp and pp genotypes and 0.43 and 0.57 for P and p alleles. In TaqI RFLP the frequencies were observed as 0.11, 0.61 and 0.27 for TT, Tt and tt genotypes and 0.41, 0.59 for T and t alleles. Alignment study indicates variability of nucleotides and amino acids between alleles and different breeds of goats. The nucleotide sequences reported in this paper have been submitted to the European Molecular Biology Laboratory GenBank and the accession numbers were AY496935, AY496061 and AY496062. A significant affect (P <or= 0.05) of MHC DRB3.2 PstI polymorphism was found on the first and second year of pashmina production.

Intranasal immunization using biphasic lipid vesicles as delivery systems for OmlA bacterial protein antigen and CpG oligonucleotides adjuvant in a mouse model

The nasal mucosa is an important arm of the mucosal system since it is often the first point of contact for inhaled antigens. The ineffectiveness of the simple delivery of soluble antigens to mucosal membranes for immunization has stimulated extensive studies in appropriate delivery systems and adjuvants. We have evaluated biphasic lipid vesicles as a novel intranasal (i.n.) delivery system (designated as vaccine targeting adjuvant, VTA) containing bacterial antigens and CpG oligodeoxynucleotides (ODNs). Results show that administration of antigen and CpG ODNs in biphasic lipid vesicles resulted in greater induction of IgA levels in serum (P< 0.05) and mucosal antibody responses such as IgA in nasal secretions and lung (P< 0.01) after immunization with a combined subcutaneous (s.c.)/i.n. as compared to s.c./s.c. approach. Based on antibody responses, VTA formulations were found to be suitable as delivery systems for antigens and CpG ODNs by the intranasal route, resulting in a Th2-type of immune response, characterized by IgG1 and IL-4 production at the systemic level.

Intraperitoneal tension-free repair of small midline ventral abdominal wall hernias with a Ventralex hernia patch: initial experience in 51 patients

Midline ventral hernias are common. Tension-free mesh repair of ventral hernias is becoming popular due to the high recurrence rate with conventional techniques. We have used an open intraperitoneal technique using the Bard Ventralex hernia patch in midline ventral hernias (<or=3 cm). Fifty-one patients were treated (34 males and 17 females) with a mean age of 52.4 years (range 18-82). Forty-three patients were day cases. Operative times, analgesic use, overnight hospital stay and postoperative complications were recorded prospectively. The mean operative time was 30 min (range 10-68). Thirty-six patients required mild/moderate postoperative analgesia. Two patients had minor wound infections and one had seroma. There was one recurrence. Our early experience suggests that Ventralex hernia patch repair of small midline ventral hernias can be performed as a day case with minimal postoperative complications.

An efficient and versatile approach for the construction of oligonucleotide microarrays

A new immobilization chemistry for covalent attachment of phosphorylated oligonucleotides on epoxy-activated glass surface via opening of oxirane ring is described. The proposed strategy results in excellent immobilization efficiency, spot homogeneity, and morphology. The constructed microarray was successfully demonstrated for discrimination of nucleotide mismatches.

Urinary retention and the role of indwelling catheterization following total knee arthroplasty

INTRODUCTION

We aimed to investigate the rate of urinary retention after knee arthroplasty, the various factors involved in predicting those at risk for retention and to assess the impact of retention and catheterization on joint sepsis.

MATERIALS AND METHODS

A retrospective review was conducted of all available case notes of patients undergoing total knee arthroplasty in a consecutive 2-year period (2000-2002). Adequate data was available for 142 patients.

RESULTS

142 patients underwent total knee arthroplasty. 19 patients were catheterized preoperatively for monitoring urine output. 123 patients were not catheterized. Urinary retention occurred in 19.7% (28/142). The mean day of catheterization for retention was 0.66. The mean duration of catheterization in patients developing retention was 3.58 days and was 3 days in the patients catheterized pre- or perioperatively. Deep joint sepsis occurred in 2.1% (3/142)--only one had been catheterized and that was preoperatively. No case of infection had urinary retention or had a symptomatic urinary tract infection. The only factors predicting those at significant risk of retention following knee arthroplasty was a past medical history of urinary retention (p = 0.049) and postoperative morphine requirement (p = 0.035). No patients required urological surgical intervention at mean follow up of 1.97 years.

CONCLUSIONS

This study supports the use of indwelling urinary catheterization for patients developing urinary retention after total knee arthroplasty.

Medial peritalar dislocation in a volleyball player

We report a medial peritalar dislocation, which was treated with closed reduction and cast for 3 weeks. At follow up 12 months later, there was normal range of motion and mild pain after prolonged walking.

Effect of microscopic residual tumor (MRT) at surgical margin of resection (SMR) in ductal carcinoma in-situ (DCIS) on survival of non-Hispanic white women in central Pennsylvania (PA)

10706

Background: Few studies that have investigated the long-term effect of MRT in DCIS, have demonstrated conflicting results. Mount Nittany Medical Center (MNMC) is located in an agricultural, ethnically-homogenous (Non-Hispanic White) county in PA. To the best of our knowledge, there have been no similar studies conducted on such populations. Our study has investigated the effect of MRT at SMR on overall survival (OS) and event-free survival (EFS) of patients with DCIS. Methods: All women diagnosed with DCIS from 04/1992 to 06/2005 at MNMC were deemed eligible. Log-rank statistics and Cox proportional hazard models (CPHM) were used for obtaining survival rates. Results: Of the 266 eligible women analysis were performed on 167 women (age range 33–89 years; median 56 years) with complete data on diagnosis, surgical margins and treatment modalities. With median follow-up time of 4.6 years (range 0.03–11.6years), 148 (88.6%) patients had no residual tumor at SMR. 78 (46.7%) patients received radiation therapy (RT) ± hormonal therapy (HT), 42 (25.2%) received HT ± RT. The CPHM demonstrated no statistical significance of MRT on OS (hazard ratio 2.9, p = 0.19), and EFS (hazard ratio = 1.9, p = 0.43) after adjusting for treatment and age. Univariate 5-year OS rate in patients with no MRT was 93.9% (95% confidence interval (CI) 87.6% to 97.1%), versus 89.2% (95% CI 63.1% to 97.2%) in patients with MRT (p-value = 0.38). Five-year EFS was observed to be 92.6% (95% CI 85.6% to 96.3%) in patients with no MRT, versus 89.2% (95% CI 63.1% to 97.2%) in patients with MRT (p-value = 0.49). Conclusions: In our study, patients with DCIS who have MRT at surgical margin of resection have a 2.9 times the risk of death and 1.9 times the risk of recurrence as compared to patients with no MRT. However, this difference is statistically not significant over time.

No significant financial relationships to disclose.

Effect of microscopic residual tumor (MRT) at surgical margin of resection (SMR) in invasive breast cancer (IBC) on survival of non-Hispanic white women in central Pennsylvania (PA)

10569

Background: Few studies that have investigated the long-term effect of MRT in IBC, have demonstrated conflicting results. Mount Nittany Medical Center (MNMC) is located in an agricultural, ethnically-homogenous (Non-Hispanic White) county in PA. To the best of our knowledge, there have been no similar studies conducted on such populations. Our study has investigated the effect of MRT at SMR on overall survival (OS) and event-free survival (EFS) of patients with IBC. Methods: All women diagnosed with IBC from 04/1992 to 06/2005 at MNMC were deemed eligible. Log-rank statistics and Cox proportional hazard models (CPHM) were used for obtaining survival rates. Results: Of the 939 eligible women analysis were performed on 651 women (age range 27–94 years; median 62 years) with complete data on diagnosis, surgical margins and treatment modalities. With a median follow-up time of 4 years (range 0.01–11.3 years), 390 (59.9%), 214 (32.8%), 47 (7.2%) women had stage I, II and III tumor respectively; 540 (83%) patients had no residual tumor at SMR. 484 (74.4%) patients received radiation therapy (RT) ± chemotherapy (CT) and/or hormonal therapy (HT), 383 (58.8%) received HT ± CT and/or RT and 229 (35.2%) received CT ± RT and/or HT. The CPHM demonstrated no statistical significance of MRT on OS (hazard ratio 1.54, p = 0.07), and EFS (hazard ratio = 1.54, p = 0.07) after adjusting for treatment, stage and age. Univariate 10-year OS rate in patients with no MRT was 72.7% (95% confidence interval (CI) 63.1% to 80.1%), versus 61.2% (95% CI 45.3% to 73.8%) in patients with MRT (p-value = 0.07). Ten-year EFS was observed to be 68.9% (95% CI 59.1% to 76.8%) in patients with no MRT, versus 60.8% (95% CI 45.1% to 73.2%) in patients with MRT (p-value = 0.08). Conclusion: In our study, patients with IBC with MRT at SMR have a 1.5 times the risk of death or recurrence as compared to patients with no MRT. However, this difference is statistically not significant over time.

No significant financial relationships to disclose.

Status of geriatric oncology in India: A national multicentric survey of oncology professionals

16035

Background: Elderly cancer patients are underrepresented in cancer services utilization and clinical research in India. National data on providers’ knowledge, attitude and practices with regard to elderly cancer patients is sparse and is urgently required to address needs of this vulnerable and growing population. Methods: A self administered questionnaire was mailed to nationally representative sample of practicing oncologists all over India. 112 Oncologists (Medical Oncologists-51%; Radiation Oncologists-25%; Surgical Oncologists-20%; allied fields-4%) responded out of 250 mailed Questionnaires. Results: A designated Geriatric Oncology unit is in existence in very few (<5%) centers. Majority (51%) considered patients with chronological age of >60 years as elderly for India. Although 75% of elderly patients receive some therapy, only 50% of potentially curable patients and a similar percentage of potentially incurable patients receive standard of care. Also, 50% patients require modification in their treatment and only two-third of treated patients complete therapy. The existent barriers to treatment included poor performance status (53%), advanced stage (16%), and co-morbidities (15%). Only 51% Oncologists always discussed and 28% always enrolled elderly patients in clinical trials. Standard of care and evidence based recommendations for elderly patients were felt to be lacking by 49% and 92% of respondents respectively. The need of separate trials for elderly and a separate discipline of Geriatric Oncology was voiced by 93% and 89% of respondents respectively. Major differences in treatment practice between medical oncologists and non medical oncologists are shown in table . Conclusions: Treatment practices and accrual of elderly cancer patients in clinical trials in India is far from optimal. Formation of a National Geriatric Oncology society and creation of designated Geriatric oncology services at key centers may enhance the understanding and clinical care of this population.

[Table: see text]

No significant financial relationships to disclose.

Efficacy and safety profile of oxaliplatin and docetaxel in patients with advanced non-small cell lung cancer (NSCLC)

17061

Background: Platinum-based doublets are used as treatment for advanced or metastatic non-small cell lung cancer (NSCLC), but chemotherapy must be tailored to decrease side effects. Oxaliplatin is more potent than cisplatin, requiring fewer DNA adducts to provide equivalent cytotoxicity in vitro studies. Oxaliplatin was active as a single agent and in combination with vinorelbine, paclitaxel, and gemcitabinein phase II studies of patients with NSCLC. A phase II study was conducted to evaluate the efficacy and safety of oxaliplatin combined with docetaxel for NSCLC. Methods: Patients with stage-IIIB or -IV, chemotherapy-naive NSCLC received docetaxel 70 mg/m2, oxaliplatin 130 mg/m2, and pegfilgrastim 6 mg every 21 days for up to 6 cycles. The primary endpoint was overall response rate (ORR); secondary endpoints were progression-free and overall survival (PFS and OS), and safety. Results: Twenty-nine patients were treated; 15 (51.7%) were women, 25 (76%) were white, 17 (58.6%) were hispanic, 21 (72.4%) had adenocarcinomas, 24 (83%) had a PS ECOG 1, 93% had stage-IV disease and 28% had brain metastases. There were 10 partial responses in 27 evaluable patients for an ORR of 37% (90% confidence interval [CI], 21.7%–54.7%). Median PFS for 29 treated patients was 4.6 months (95% CI, 2.6–6.5 months); 12-month PFS was 14.8% (95% CI, 3.4%– 34.0%). Median OS was 10.9 months (95% CI, 8.9–16.8 months); 12-month OS was 40% (95% CI, 18.5%–60.8%) and 18-month OS was 16% (95% CI, 1.4%–45.7%). There were no unusual or unexpected adverse events. The most common grade-3 and -4 toxicities were anemia (14% of patients) and hyperglycemia (10%). There were only 2 reports of neutropenia; both were grade 1 or 2. Conclusions: These phase II findings suggest that the combination of oxaliplatin and docetaxel is active and well tolerated, and offers a feasible treatment alternative for patients with advanced or metastatic NSCLC.

[Table: see text]

A phase I clinical study of biweekly carboplatin and gemcitabine in patients with advanced solid tumors

12024

Background: Carboplatin (CBDCA) and gemcitabine (GEM) in combination is used commonly in lung cancer and is administered on a 21 day cycle. The purpose of this study was to determine the maximum tolerated dose (MTD) of CBDCA and GEM administered on a biweekly schedule and to assess safety and efficacy of this schedule. Methods: GEM was given intravenously (IV) over 30 minutes followed by CBDCA also given IV over 30 minutes. This combination was given on day 1 every 2 weeks. The dose levels examined are shown in the Table . A total of 26 patients were studied (18 male, 8 female) with median age of 56 (range 41–83 years); ECOG performance status of 24 patients were 0 (5), 1 (16), 2 (2), 3 (1); prior chemotherapy ranged from 0 to 4 regimens; median number of cycles administered per patient was 3 (range 1–9) with a total of 81 cycles. The primary tumors were lung (11), melanoma (4), head and neck (3), squamous cell penile/toe (2), bladder (2), kidney (1), gastric (1), esophageal (1) and ovary (1). Results: No DLTs were seen in any of these patients and the MTD was not reached. Delay in treatment was seen in total of 6 cycles due to myelosuppression and 1 cycle due to nausea and anorexia. Grade 3/4 hematological toxicity rates: anemia - 3/81 cycles (3.7%), neutropenia - 20/81 cycles (25%), and thrombocytopenia - 4/81 cycles (5%). Non-hematological toxicity was mild. The median time to progression was 40 days (range 4–133) and of 18 evaluable patients partial response or stable disease was seen in 7 (38.8%). Conclusions: Even at maximum tested dose of GEM at 2000 mg/m2 and CBDCA at AUC of 3.0, this schedule is well tolerated. Hematological toxicity such as neutropenia and thrombocytopenia was minimal. We plan to study this schedule of GEM and CBDCA in appropriate tumor types in combination with biologic agents.

[Table: see text]

[Table: see text]