Isolated pulmonic valve endocarditis caused by group B streprococcus (Streptococcus agalactiae)--a case report and literature review

The pulmonic valve is the least commonly involved valve in infective endocarditis. Pulmonic valve endocarditis is usually associated with tricuspid valve endocarditis, and isolated pulmonic valve endocarditis is exceedingly rare. The predisposing factors for developing pulmonic valve endocarditis include a congenitally anomalous pulmonic valve, intravenous drug abuse, and the presence of indwelling intravenous or flow-directed pulmonary artery catheters. More cases of group B streptococcus endocarditis are being reported. The risk factors for group B streptococcus endocarditis include diabetes mellitus, cancer, alcoholism, malnutrition, immunocompromised status, intravenous drug abuse, postpartum and postabortion states, and underlying valvular disease. The vegetations of this type of endocarditis are usually large and have a higher tendency to result in embolism. The presentation of group B streptococcus endocarditis is usually acute and may result in rapid valve destruction if not treated promptly. A case of isolated pulmonic valve endocarditis caused by group B streptococcus, Streptococcus agalactiae, is presented that was diagnosed with multiplane transesophageal echocardiography in a 40-year old, alcoholic, malnourished man, who was successfully treated with intravenous penicillin G. The literature on the isolated pulmonic valve endocarditis caused by group B streptococcus is reviewed.

Laser-capture microdissected schwannian and neuroblastic cells in stage 4 neuroblastomas have the same genetic alterations

BACKGROUND

Neuroblastoma (NB) is a heterogeneous tumor composed of mixed populations of neuroblastic, Schwannian, and gangliocytic cells.

PROCEDURE

We examined the genetic lineage of Schwannian and neuroblastic cells in stage 4 NB using laser-capture microdissection (LCM) and allelic analysis of microsatellite markers of chromosomes 1p, 11q, and 14q.

RESULTS

In 18 out of 19 cases, individual cell types exhibited the same allelotype.

CONCLUSION

Our results provide evidence that the majority of Schwannian and neuroblastic cells in stage 4 NB are of neoplastic origin, and support the hypothesis of a tumor stem cell capable of development along multiple lineages.

Process stability assessed by selecting Shewhart's psi statistical analysis technique of the influence of matrix modifier and furnace program in the optimization and precision of zinc determinations by graphite furnace atomic absorption spectroscopy

The method previously used in the Toxicology Laboratories of King Faisal Specialist Hospital and Research Center for determining the zinc concentration in serum by Zeeman atomic absorption spectrometer was improved by modifying the matrix modifier and by changing the heated graphite furnace atomization (HGA) program. After trying several methods we failed to achieve the required precision and the accuracy of methods for serum zinc determination. We changed the matrix modifier to a fifty percent mixture (v/v) of 3.90 grams per liter of ammonium phosphate in Type 1 water with 0.2% nitric acid and 1.0 gram per liter of magnesium nitrate in acidic water (0.2% HNO3) with 0.1% triton X-100 was used as matrix modifier. A twenty-five fold dilution of the sample in matrix modifier was injected on the L'vov's platform of the furnace. In order to reduce the high sensitivity of Zn the furnace program was modified. The method is found very robust. The average reproducibility between inter-runs and intra-run is less than 1.59% with a high degree of accuracy. We used two levels of controls i.e. normal or low level and abnormal or high level. The linearity and the detection limit of the assay were 0.9992 and 0.010 micromol/L respectively. Average recovery of the analyte was 98.65%. The X-Bar and R charts were constructed by using Shewhart's statistical analysis technique to assess the test methodology. It was found that the assay is capable and stable for routine clinical and research analysis. The capability index (C(P)) of the assay, an indicator of the precision, was calculated.

Non-Hodgkin's lymphoma in Pakistan: a clinicopathological profile of 175 patients

OBJECTIVE

Non-Hodgkin's Lymphomas (NHL) are common in Southeast Asia, Middle East and Africa. The study was primarily undertaken to establish the demographic and clinicopathologic features of NHL in Pakistan. A secondary aim was to determine the applicability of the International Prognostic Index (IPI) developed by the international lymphoma task force in a developing country.

METHODS

A retrospective and prospective analysis was performed on 175 patients over 14 years age who presented to the Department of Oncology between August 1994 and December 1996. All patients underwent initial staging according to Ann Arbor Staging System. Histopathologic classification was done according to the International Working Formulation. The IPI was applied to patients with aggressive lymphomas and age adjusted index to patients < 60 years, complete remission (CR), disease free survival (DFS) and overall survival (OS) were calculated.

RESULTS

All 175 patients were evaluable. Median age of our patients was 45 years. Male to female ratio was 1.9:1. Seventeen (9.7%) patients were classified as low grade lymphomas while 158 (91.3%) had intermediate and high grade NHL. Large cell lymphoma was present in 30.9% patients. CHOP (cyclophosphamide 650 mg/m2 day 1, vincristine 1.4 mg/m2 day 1, doxorubicin--45 mg/m2 day 1 and prednisone 100 mg/m2 day 1-5) was the most common chemotherapy regimen used. Advanced stage (74.9%) > B symptoms (51%) and extranodal involvement (74.3%) were present. One hundred sixty-seven patients were evaluable for response of which 42.8% achieved CR. Median DFS was 19 months and median OS was 22 months. The IPI was applicable to 153 patients and age adjusted IPI to 124 of 153 patients.

CONCLUSION

Aggressive histology, extranodal diseases, B symptoms and advanced disease are common. International index and age adjusted international index predicted outcome accurately in various risk groups.

Investigation of the Alkaloid Content of Rauwolfia serpentina Roots from Regenerated Plants

The indole alkaloid content of RAUWOLFIA SERPENTINA roots from regenerated plants (from stem-and root-callus) was compared with the parental stock. Although the total alkaloid content seems to be slightly higher in the roots from regenerated plants, HPLC-analysis of individual alkaloids indicated that the contents of the alkaloids ajmaline ( 1), serpentine ( 2), and reserpine ( 3) are lower than in the roots of the parental stock. The glucoalkaloid raucaffricine ( 4) was identified as a constituent of all samples, thus providing the first evidence for its occurrence in roots of RAUWOLFIA SERPENTINA.

Growth And Yield Components Of Wheat Under Water Stress Of Different Growth Stages

A field experiment was conducted to determine the sensitivity of wheat to water stress and changes in water relations and yield of wheat (Triticum aestivum L.) under water stress conditions applied at different growth stages. The experiment comprised of two wheat cultivars and four water stress treatments, maintained by withholding water at tillering, anthesis, and at both stages. Water stress caused reduction in leaf relative water contents, water potential, osmotic potential, turgor potential, growth and yield components of both the wheat cultivars. The results indicated that high value of relative water contents were associated with increased yield and yield components. Consecutive stresses at both growth stages caused severe reduction in yield and yield components in both cultivars of wheat. Keywords: Water stress; water relations; growth; Triticum aestivum; yield components. DOI: http://dx.doi.org/10.3329/bjar.v36i3.9264 BJAR 2011; 36(3): 455-468