Cell cycle-dependent regulation of the bi-directional overlapping promoter of human BRCA2/ZAR2 genes in breast cancer cells

Background

BRCA2 gene expression is tightly regulated during the cell cycle in human breast cells. The expression of BRCA2 gene is silenced at the G0/G1 phase of cell growth and is de-silenced at the S/G2 phase. While studying the activity of BRCA2 gene promoter in breast cancer cells, we discovered that this promoter has bi-directional activity and the product of the reverse activity (a ZAR1-like protein, we named ZAR2) silences the forward promoter at the G0/G1 phase of the cell. Standard techniques like cell synchronization by serum starvation, flow cytometry, N-terminal or C-terminal FLAG epitope-tagged protein expression, immunofluorescence confocal microscopy, dual luciferase assay for promoter evaluation, and chromatin immunoprecipitation assay were employed during this study.

Results

Human BRCA2 gene promoter is active in both the forward and the reverse orientations. This promoter is 8-20 fold more active in the reverse orientation than in the forward orientation when the cells are in the non-dividing stage (G0/G1). When the cells are in the dividing state (S/G₂), the forward activity of the promoter is 5-8 folds higher than the reverse activity. The reverse activity transcribes the ZAR2 mRNA with 966 nt coding sequence which codes for a 321 amino acid protein. ZAR2 has two C4 type zinc fingers at the carboxyl terminus. In the G0/G1 growth phase ZAR2 is predominantly located inside the nucleus of the breast cells, binds to the BRCA2 promoter and inhibits the expression of BRCA2. In the dividing cells, ZAR2 is trapped in the cytoplasm.

Conclusions

BRCA2 gene promoter has bi-directional activity, expressing BRCA2 and a novel C4-type zinc finger containing transcription factor ZAR2. Subcellular location of ZAR2 and its expression from the reverse promoter of the BRCA2 gene are stringently regulated in a cell cycle dependent manner. ZAR2 binds to BRCA2/ZAR2 bi-directional promoter in vivo and is responsible, at least in part, for the silencing of BRCA2 gene expression in the G0/G1 phase in human breast cells.

Endorsing the declining indigenous ethnobotanical knowledge system of seabuckthorn in Central Himalaya, India

AIM OF THE STUDY

Based on research findings this study is aimed to generate database on ethnobotanical aspects, sustainable utilization by value addition and awareness generation through outreach programme related to Hippophae salicifolia D. Don. (Elaeagnaceae) in the higher Himalayan zone of Uttarakhand in Central Himalaya, India.

MATERIALS AND METHODS

An in-depth survey from June 2004 to July 2006 followed by 480 interviews with the help of semi-structured questionnaires was carried out in 24 Hippophae growing locations in 12 different valleys of Uttarakhand.

RESULTS

Plant has immense multipurpose properties and is traditionally utilized for food (20(Min)-90%(Max)), medicine (10(Min)-60%(Max)), veterinary (20(Min)-100%(Max)), fuel (10(Min)-80%(Max)), fencing (20(Min)-80%(Max)), agricultural tools (20(Min)-50%(Max)) and dye mordant (60%). Besides, awareness programmes and value added product demonstration resulted in economical upliftment of local inhabitants of Central Himalaya.

CONCLUSION

The present manuscript will certainly provide an ethnobotanical statistics' impact on the modern scientific societies regarding conservation, cultivation and popularization of this underutilized wild edible species at mass scale. Simultaneously, these findings have important connotations in light of upcoming organic food and nutraceutical industries in the country.

A hypothesis and model of reduced fetal movement as a common pathogenetic mechanism in clubfoot

BACKGROUND

Clubfoot or Talipes equinovarus is characterised by an adducted forefoot, hindfoot varus, and ankle equinus deformity, varying in severity and ease of correction. It is one of the most common congenital defects, with a prevalence of around 1 per 1000. Ambiguity still surrounds the classification and pathogenesis of clubfoot.

METHODS

A literature search was performed using Pubmed, Ovid, and the Cochrane Databases, using search terms in isolation or combination: clubfoot, Talipes equinovarus, congenital foot deformities and joint development, identified articles were further hand searched and relevant references identified.

CONCLUSION

We propose that the underlying unifying factor in all cases of clubfoot is a lack of fetal movement. Fetal movement is a key developmental signal in the development of joints, and we suggest that this applies to the morphogenesis of the forefoot. Theories exist to explain specific individual features of clubfoot in certain cases and to explain experimental studies, however no common final pathway has been described. We believe that our hypothesis brings together key elements of these and will simplify understanding and classification of clubfoot.

Angioplasty for Renal Artery Fibromuscular Dysplasia in Older Hypertensive Patients

Aim: To describe the outcomes of treating patients with angioplasty who are older than 40 years with symptomatic/labile/refractory hypertension (HTN). Methods: Between1999 and 2005, 28 patients underwent angioplasty for renal fibromuscular dysplasia (FMD). Patients were excluded if they had concomitant atherosclerotic renal artery stenosis (n = 4) or less than 1 month follow-up (n = 8). Results: The study group included 16 Caucasians (21 procedures; mean age 65.5 10.8 years; females = 88%). The cardiovascular risk factors include HTN (n = 13), smoking (n = 1), diabetes (n = 2), dyslipidemia (n = 8). The HTN was characterized as refractory (n = 15, 12 were symptomatic) and new-onset in 1 patient. The technical success rate was 100%. Over a median period of 12.8 months (range: 1.0-85.8), 18 (95%) procedures ‘‘failed,’’ of which 8 (42%) within 1 month and the rest in 1 year. Conclusions: Angioplasty in symptomatic renal FMD in patients >40 years is associated with poor outcomes possibly due to early restenosis.

Evaluation of genotoxic effects of oral exposure to aluminum oxide nanomaterials in rat bone marrow

Nanomaterials have novel properties and functions because of their small size. The unique nature of nanomaterials may be associated with potentially toxic effects. The aim of this study was to evaluate the in vivo genotoxicity of rats exposed with Aluminum oxide nanomaterials. Hence in the present study, the genotoxicity of Aluminum oxide nanomaterials (30 and 40 nm) and its bulk material was studied in bone marrow of female Wistar rats using chromosomal aberration and micronucleus assays. The rats were administered orally with the doses of 500, 1000 and 2000 mg/kg bw. Statistically significant genotoxicity was observed with Aluminum oxide 30 and 40 nm with micronucleus as well as chromosomal aberration assays. Significantly (p < 0.05 or p < 0.001) increased frequency of MN was observed with 1000 and 2000 mg/kg bw dose levels of Aluminum oxide 30 nm (9.4 +/- 1.87 and 15.2 +/- 2.3, respectively) and Aluminum oxide 40 nm (8.1 +/- 1.8 and 13.9 +/- 2.21, respectively) over control (2.5 +/- 0.7) at 30 h. Likewise, at 48 h sampling time a significant (p < 0.05 or p < 0.001) increase in frequency of MN was evident at 1000 and 2000 mg/kg bw dose levels of Aluminum oxide 30 nm (10.6 +/- 1.68 and 16.6 +/- 2.66, respectively) and Aluminum oxide 40 nm (9.0 +/- 1.38 and 14.7 +/- 1.68, respectively) compared to control (1.8 +/- 0.75). Significantly increased frequencies (p < 0.05 or p < 0.001) of chromosomal aberrations were observed with Aluminum oxide 30 nm (1000 and 2000 mg/kg bw) and Aluminum oxide 40 nm (2000 mg/kg bw) in comparison to control at 18 and 24 h. Further, since there is need for information on the toxicokinetics of nanomaterials, determination of these properties of the nanomaterials was carried out in different tissues, urine and feces using inductively coupled plasma mass spectrometry (ICP-MS). A significant size dependent accumulation of Aluminum oxide nanomaterials occurred in different tissues, urine and feces of rats as shown by ICP-MS data. The results of our study suggest that exposure to Aluminum oxide nanomaterials has the potential to cause genetic damage.

Mode of action of the retrogene product SNAI1P, a SNAIL homolog, in human breast cancer cells

SNAI1P, a protein coded by a retrogene, is a member of the SNAI family of E2-box binding transcriptional repressors. To evaluate whether the mode of action of SNAI1P is similar to those of the other predominant members of the SNAI family, we studied its action on human claudin 7 (CLDN7) gene promoter which has seven E2-boxes. We over-expressed FLAG-tagged SNAI1P in MCF7 and MDA-MB-468 cells. SNAI1P inhibited the expression of CLDN7 in these recombinant cells. SNAI1P also inhibited cloned CLDN7 gene promoter activity in human breast cancer cells. ChIP assays revealed that SNAI1P is recruited on the CLDN7 gene promoter along with the co-repressor CtBP1 and the effector HDAC1. Treatment of the cells with trichostatin A, an inhibitor of HDAC1, abrogated the repressor activity of SNAI1P. These data suggest that SNAI1P inhibits CLDN7 gene promoter epigenetically in breast cancer cells through chromatin remodeling.

Cryoglobulinemia presenting as acute polyneuropathy

A 48 years male presented with acute axonal neuropathy and palpable purpura over bilateral lower limb, RA factor, and cryoglobulins were present in the serum. Nerve biopsy revealed myelinated fibre loss, axonal degeneration and necrotizing vasculitis of epineural vessels.

The importance of organ geometry and boundary constraints for planning of medical interventions

Realistic modeling of medical interventions involving tool-tissue interactions has been considered to be a key requirement in the development of high-fidelity simulators and planners. Organ geometry, soft-tissue constitutive laws, and boundary conditions imposed by the connective tissues surrounding the organ are some of the factors that govern the accuracy of medical intervention planning. In this study it is demonstrated that, for needle path planning, the organ geometry and boundary constraints surrounding the organ are the most important factors influencing the deformation. As an example, the procedure of needle insertion into the prostate (e.g. for biopsy or brachytherapy) is considered. Image segmentation is used to extract the anatomical details from magnetic resonance images, while object-oriented finite element analysis (OOF) software is used to generate finite element (FE) meshes from the segmented images. Two-dimensional FE simulations that account for complex anatomical details along with relative motion between the prostate and its surrounding structure using cohesive zone models are compared with traditional simulation models having simple organ geometry and boundary constraints. Nodal displacements for these simpler models were observed to be up to 14 times larger than those obtained from the anatomically accurate models.

Sero-prevalence of Bovine Johne's disease in buffaloes and cattle population of North India using indigenous ELISA kit based on native Mycobacterium avium subspecies paratuberculosis ‘Bison type’ genotype of goat origin

Present pilot study is the first attempt in the country to estimate sero-prevalence of Bovine Johne's disease (BJD) by screening cattle and buffaloes representing large population belonging to farmer's and farm herds in the home tracts (Uttar Pradesh (UP) and Punjab) of Hariana cattle and Murrah buffaloes in North India. Indigenous and in-house plate ELISA kit (using protoplasmic antigen from native Mycobacterium avium subsp. paratuberculosis 'Bison type' strain of goat origin), originally developed for goats and sheep was standardized in bovines and used for screening. For this study, 33 villages of south and west UP were randomly selected and surveyed from 2001 to 2003. There were 7943 farmer's families having 38,251 livestock, including cattle, buffaloes, goats and sheep (per family 4.8% livestock). Numerically, buffaloes and cattle were 54.7% and 22.1%, respectively. Serum samples were collected from 726 animals (4.2% of 16, 981 livestock with 4375 farmer's families) located in 33 randomly surveyed villages. Serum samples (699), submitted to Epidemiology Department of Veterinary College (Punjab Agricultural University, Ludhiana), in the year 2004 by farmer's and organized farm herds (Buffaloes, 372, Cattle, 327), were screened by this ELISA kit. Soluble protoplasmic antigen was prepared from Map (S 5) 'Bison type' strain isolated from a terminally sick goat with Johne's disease. Of the total 1425 bovine (Buffaloes and cattle) serum samples screened using indigenous ELISA kit, sero-prevalence of Johne's disease was 29.0% (28.6% in buffalo and 29.8% in cattle) in Northern India. State-wise sero-prevalence was 31.9% and 23.3% in UP and Punjab, respectively. In UP, of the 601 randomly sampled buffaloes, sero-prevalence was 40.3% (16.6% in young and 40.9% adults) and 25.5% (10.5% in young and 26.3% adults) in south and west UP, respectively. Of the 125 cattle screened, sero-prevalence was 42.6% (nil in young and 44.4% adults) and 30.0% (nil in young and 30.6% adults) in south and west UP, respectively. Of the 699 serum samples screened from Ludhiana, Punjab, sero-prevalence of BJD was 23.0%. Sero-prevalence was 23.3% (12.1% in young and 24.4% in adults) and 26.9% (27.2% in young and 26.8% in adults) in buffaloes and cattle, respectively. High prevalence of BJD in buffaloes in native tract of Murrah breed, and Hariana breed of cattle correlated with poor per-animal productivity and BJD may be the major cause. Indigenous ELISA kit was rapid, economic and sensitive test for large-scale screening of buffaloes and cattle population against incurable BJD.

In vivo binding to and functional repression of the VDR gene promoter by SLUG in human breast cells

The regulation of vitamin D receptor (VDR), a key mediator in the vitamin D pathway, in breast cancer etiology has long been of interest. We have shown here that the transcriptional repressor protein SLUG inhibits the expression of VDR in human breast cancer cells. To explore the possibility that SLUG regulates the VDR gene promoter, we cloned a 628bp fragment (-613 to +15) of the human VDR gene promoter. This region contains three E2-box sequences (CAGGTG/CACCTG), the classical binding site of SLUG. SLUG specifically inhibited VDR gene promoter activity. Chromatin-immunoprecipitation (ChIP) assays revealed that SLUG is recruited on the native VDR gene promoter along with the co-repressor protein CtBP1 and the effector protein HDAC1. These data suggests that SLUG binds to the E2-box sequences of the VDR gene promoter and recruits CtBP1 and HDAC1, which results in the inhibition of VDR gene expression by chromatin remodeling.

External ophthalmomyiasis by oestrus ovis: an unknown endemic eye disease in rural parts of central India

SUMMARY

Although much general information has accumulated about ocular myiasis, there are very few reports about the same amongst the Indian population. We present a case series, comprising of 13 documented cases of external ophthalmomyiasis due to Oestrus ovis, detected at regular intervals in a small geographical area of rural central India, which strongly indicated the presence of a previously unknown endemic eye disease of this region.

Prevalence of goitre in 6 -12 years school-going children of Panchmahal district in Gujarat, India

BACKGROUND & OBJECTIVE

Iodine deficiency disorders (IDDs) are one of the worldwide public health problems of today. IDDs are endemic in various districts of Gujarat. We undertook this survey in Panchmahal district of Gujarat to study the prevalence of goiter in a sample of school children, to asses the level of iodine in salt samples, and to determine median urinary iodine concentration in a sample of children.

METHODS

In a cross-sectional study, 15,900 school-going children in the age group of 6-12 yr were studied from 10 talukas. A total of 15 clusters were selected by cluster sampling method. Goitre was assessed in the children and urine and salt samples were studied for iodine concentration.

RESULTS

The overall prevalence of goitre was 20.5 per cent among the children examined. The median iodine concentration was 70 mg/l indicating mild iodine deficiency; also 61 per cent of the urine samples examined showed iodine insufficiency. Iodine content was found to be adequate in 54.3 per cent of salt samples.

INTERPRETATION & CONCLUSION

Our study showed that goitre is still an important public health problem in the district. This calls for identification of factors to strengthen NIDDCP and the need to reimpose ban on sale of non-iodized salt in Gujarat.

Clinico-epidemiological profile and validation of symptoms and signs of severe illness in young infants (< 60 days) reporting to a district hospital

OBJECTIVES

To describe the clinical and epidemiological profile of infants less than 2 months of age reporting to a district hospital and to assess the ability of simple clinical symptoms and signs used by health workers to detect severe illness warranting hospital admission.

METHODS

It was an observational study done at a general district hospital at Chandigarh, North India. Infants less than 2 months of age presenting to this hospital were enrolled. All infants were first evaluated by an auxiliary nurse midwife (ANM) to record a pre-determined set of symptoms and signs. A pediatrician who was blinded to the findings of the ANM did an independent assessment for severe illness needing urgent hospitalization.

RESULTS

A total of 1268 infants were enrolled. Of these, 356 (28%) were below 7 days of age. Overall, regurgitation, vomiting and stool problems (25%) were the most common presenting complaints in the first 2 months of life, followed by jaundice (22%) and respiratory symptoms (15%). 112 (8.8%) infants were classified as having "severe illness requiring urgent hospital management" by the pediatrician. Nearly half (46%) of the admissions were because of jaundice while 17% each were due to sepsis and pneumonia / lower respiratory tract infection (LRTI). A history of not feeding well (OR 14.7, 8.0 and 11.3 in 0-6, 7-27 and 28-59 days age groups, respectively) and a respiratory rate >60/min (OR 21.5, 6.2 and 10.5 in 0-6, 7-27 and 28-59 days age groups, respectively) had significant positive predictive value to predict severe illness (except jaundice) in all the 3 age groups studied. In the second month of life, severe chest in-drawing (OR 4.6) was also a significant predictor.

CONCLUSIONS

Simple clinical signs are useful in hands of health worker for identifying neonates with serious illness warranting hospital admission. These will be of use in the further development of clinical algorithms for the national integrated management of childhood illnesses.

Ferromagnetism in the Mott insulator Ba2NaOsO6

Results are presented of single crystal structural, thermodynamic, and reflectivity measurements of the double-perovskite Ba2NaOsO6. These characterize the material as a 5d1 ferromagnetic Mott insulator with an ordered moment of approximately 0.2microB per formula unit and TC=6.8(3) K. The magnetic entropy associated with this phase transition is close to Rln2, indicating that the quartet ground state anticipated from consideration of the crystal structure is split, consistent with a scenario in which the ferromagnetism is associated with orbital ordering.

Comparison of various breast cancer detection methods with survival rates

17033

Background: The role of mammography (MG) but not of breast self-exam (BSE) and clinical breast exam (CBE) in breast cancer detection and survival is well documented. This study compares the different methods of breast cancer detection and subsequent survival rates, analyzing the differences even within the same stage of the disease. Methods: Retrospective review of 1,259 patients was done using the hospital Tumor Registry data. Only patients with stage I, IIA and IIB are included and were diagnosed between April 1992 to December 2005 with follow up ranging from June 1993 to August 2006. The detection methods studied include BSE, CBE, MG and ultrasonography (USG). Parametric tests were conducted. Results: Mean age of the sample was 62 years (range 24–96). There were 293 BSE, 64 CBE, 885 MG, 17 USG detected breast cancer patients. Mean size of mass at presentation was 19 mm (range 1–110). Mean survival time for patients detected with breast cancer till August 2001 was 76 months (range 1–163). 67% patients survived 5 years or more and 12% survived more than 10 years. Mean survival for BSE/CBE and MG/USG group was 43 and 57 months respectively. This difference in survival is significant p< .05; The average survival time by stages I, IIA, IIB for BSE was 47, 45, 38 months, for CBE it was 43, 39, 51 months, for MG it was 57, 59, 50 months and for USG group it was 52, 47, 95 months respectively. Even within the same stage, the method of detection affected survival with the BSE and CBE group having less survival rates (Tukey Test mean difference 0.54, 95% C.I 42–66 and 0.38, 95% C.I 15–61) respectively than the MG group. Survival time also positively correlated with cancer recurrence (r =.7), family history (r = .06) and negatively correlated with age (r = -.09), size of tumor (r = -.09), estrogen receptor positivity status (r = -.06) all with (p < 0.05). We believe this study underestimates overall survival rate as the last follow up date was taken as an end point and also the survival rates are not disease specific survival. Conclusions: MG/USG group show higher survival rates compared to BSE/CBE across the early stages of breast cancer. Even within the same stage, the method of detection affects survival with MG/USG detected cases having more favorable outcomes. May be our current staging system for breast cancer is inadequate and needs revision.

No significant financial relationships to disclose.

Short course of oral prednisolone on disappearance of lesion and seizure recurrence in patients of solitary cysticercal granuloma with single small enhancing CT lesion: an open label randomized prospective study

OBJECTIVE

To evaluate the effect of a short course of oral prednisolone on disappearance of lesion and seizure recurrence in newly diagnosed patients with single small enhancing CT lesion.

METHODS

In this open-label, randomized, prospective follow-up study, 100 patients of new-onset seizures and a cysticercus granuloma presenting as single enhancing computed tomography detected lesion were randomly divided in two groups to receive either antiepileptic monotherapy (Group A) or antiepileptic drugs with oral prednisolone in a dose of 1 mg/kg body weight for 7 days and tapering off dose in next 3 days (Group B). Repeat CT scan was performed on 8th-12th week to know radiological state of lesion. The patients were followed up for 1 year for seizure recurrence.

RESULTS

The majority of patients were in second decade. Male: female ratio 1.56:1. Mean number of seizure episodes was 4.33 +/- 3.50 in group A and 4.23 +/- 3.97 in group B. Partial seizure were the most common presentation (85%). 72% patients presented with single seizure or seizure in cluster. Solitary ring lesion was the commonest (69%) CT finding, most of them were located in parietal lobe (52%). Follow up CT scan showed complete resolution of lesion in 60.86% of total [group A (n = 47), 32 patients, 68.08%; group B (n = 45), 24 patients, 53.33%]. Significant difference in group A and B regarding lesion resolution was observed (chi2 = 5.926, d.f. = 1) p < 0.05. Clinical follow up showed seizure recurrence in group A - 5 patients (10.63%), in group B - 12 patients (26.66%). Statistically significant higher number of seizure recurrences were noted in group B as compared to group A (chi2 = 3.93, d.f. = 1) p < 0.05.

CONCLUSIONS

Short-term oral prednisolone along with antiepileptic drugs helps in rapid resolution of single small enhancing lesions in patient with newly diagnosed seizure disorder with good clinical outcome.

Isolation and antimicrobial evaluation of isomeric hydroxy ketones in leaf cuticular waxes of Annona squamosa

A novel natural compound, 11-hydroxy-16-hentriacontanone, has been isolated from the leaf cuticular wax of Annona squamosa along with its known isomer 10-hydroxy-16-hentriacontanone in a ratio of 67:33. This isomeric mixture of hydroxy ketones constituted together 16.5% of the total cuticular waxes. The new compound was characterised using spectral and chromatographic techniques. The major component was found to be 16-hentriacontanone (palmitone), which constituted up to 48% of the total cuticular wax, together with a homologous series of hydrocarbons, fatty aldehydes, fatty alcohols, fatty acids and sterols as minor components. The antimicrobial activity of the isomeric hydroxy ketones was tested against selected Gram-positive and Gram-negative bacterial strains, and also some selected fungal strains, and compared with palmitone. The antibacterial activity of palmitone was significantly higher than that of the isomeric hydroxy ketones, but their antifungal activities were comparable.

Human SLUG does not directly bind to CtBP1

SLUG is a transcriptional repressor protein implicated to have major role in the oncogenesis and metastasis of human breast cells. We previously have shown by chromatin immunoprecipitation assay that human SLUG (hSLUG) is co-localized with the co-repressor protein CtBP1 as bound to the BRCA2 gene silencer [M.K. Tripathi, S. Misra, S.V. Khedkar, N. Hamilton, C. Irvin-Wilson,, C. Sharan, L. Sealy, G. Chaudhuri, J. Biol. Chem. 280 (2005) 17163-17171]. hSLUG was predicted to be binding directly to CtBP1 because of an apparent presence of CtBP1 binding site in its amino acid sequences. Here, we provide evidence through yeast two-hybrid and in vitro co-immunoprecipitation analyses that hSLUG does not directly interacts with hCtBP1. This observation will help in the study of the mode of action of hSLUG in human cells.

Rural communities' preferences for arsenic mitigation options in Bangladesh

In the context of arsenic contamination of groundwater in Bangladesh, this paper analyses rural people's preferences for arsenic-free drinking water options. A particular focus is on rural households' willingness to pay for piped water supply which can provide a sustainable solution to the arsenic problem, and how the preference for piped water supply compares with that for various other household/community-based arsenic mitigation technologies. The analysis is based on data collected in a survey of over 2700 households in rural Bangladesh. Six arsenic mitigation technologies were selected for the study: three-kolshi (pitcher) method, activated alumina method (household-based and community-based), dugwell, pond sand filter and deep tubewell (handpump). The survey results indicate that, after taking into consideration the initial and recurring costs, convenience, associated risks and the advantages and disadvantages of each selected technology, the preference of the rural people is overwhelmingly in favor of deep tubewells, followed by the three-kolshi method. The analysis reveals a strong demand for piped water in both arsenic-affected and arsenic-free rural areas, and scope of adequate cost recovery. Between piped water and other arsenic mitigation technologies, the preference of the rural people is found to be predominantly in favor of the former.

BRAVO I: A pilot study of vascular brachytherapy in polytetrafluoroethylene dialysis access grafts

Hemodialysis vascular access dysfunction owing to stenosis and thrombosis in polytetrafluoroethylene dialysis access grafts is a huge clinical problem for which there are currently no long lasting durable therapies. Vascular brachytherapy has been used successfully for the prevention of coronary restenosis following angioplasty and stent placement. The Beta Radiation for Treatment of Arterial-Venous Graft Outflow I study was a pilot study of vascular brachytherapy in hemodialysis patients with patent but dysfunctional grafts. Twenty-five patients were randomized to receive either radiation therapy (a single dose of 18.4 Gy) or sham radiation, following angioplasty. The primary efficacy end point of the study was target lesion primary patency at 6 months. The primary safety end point was a composite of death, emergency surgery on the graft, venous rupture, or aneurysm formation. Forty-two percent of the radiated grafts achieved the target lesion primary patency end point at 6 months as compared to 0% of the control group (P = 0.015), but this did not translate into an improvement in secondary patency at either 6 or 12 months. Radiation therapy was found to be safe in the setting of hemodialysis vascular access dysfunction. Our results suggest that vascular brachytherapy is an intervention that is worthy of further examination in the setting of non-thrombosed dialysis access grafts.

Etiological spectrum of non-traumatic myelopathies: experience from a tertiary care centre

AIM

This study aimed to identify the clinical and radiological profile of non-traumatic myelopathies and various etiologies associated with them.

MATERIAL AND METHODS

Two hundred and four patients of non-traumatic myelopathy were prospectively studied in different wards of Sir Sundar Lal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, from September 2002 to March2004. Patients underwent a detailed clinical evaluation followed by laboratory investigation and neuroimaging studies.

RESULTS

Among 204 patients of non-traumatic myelopathy, 108 patients presented with paraplegia and 96 patients with quadriplegia. Tuberculosis was the commonest cause of compression paraplegia in this series and was observed in 42 cases (33.33%) while quadriplegia was seen in only 3 cases (2.38%). In the present study, acute transverse myelitis formed the major bulk of non-compressive myelopathy.

CONCLUSION

Tuberculosis of spine was the most common cause of compressive myelopathy and among the non-compressive group acute transverse myelitis and SACD were the important etiology.

Molecular characterization of a human BRCA2 homolog in Leishmania donovani

The breast cancer susceptibility protein BRCA2 is implicated in the DNA double-strand break (DSB) repair pathway through its association with Rad51. It is almost a ubiquitous eukaryotic protein; homologs of the BRCA2 gene (BRH2) have been identified in many mammals, as well as nonmammals. As a part of our quest to understand the DNA damage, repair, and recombination process in the parasitic protozoan, Leishmania sp., we have cloned and characterized a BRCA2 homolog from Leishmania sp. (LBRH2). LBRH2 is coded by a single-copy gene (ORF = 3,498 bp) located at the 700-kb chromosome 16. The transcripts in both the promastigotes and the amastigotes are approximately 3.9 kilonucleotides (knt) in size, corresponding to a protein with a calculated molecular mass of 128 kDa. The primary transcript of the gene is alternatively trans-spliced to produce 3 distinct mRNAs with altered folded structures at their 5' ends. This study will contribute toward the understanding of a potential RAD51-mediated DNA recombination/repair pathway in Leishmania sp.

Outcome of short-term antiepileptic treatment in patients with solitary cerebral cysticercus granuloma

OBJECTIVES

The duration of antiepileptic drug (AED) therapy in cases of solitary cerebral cysticercus granuloma (SCCG) presents a major dilemma and the efficacy of short-term (6 months) vs long-term (2 years) AED therapy has been studied.

MATERIALS AND METHODS

Prospective randomized study of short-term vs long-term AED treatment with SCCG has been undertaken. A total of 206 subjects with new onset seizures with SCCG were randomized into two groups: group A (98 patients) were treated for 6 months and group B (108 patients) were treated for 2 years with AED therapy. The patients were evaluated periodically during and at least 18 months after the tapering of drugs.

RESULTS

Partial seizures with or without secondary generalization has been found to be the commonest manifestation occurring in 80.6% of patients with SCCG. In group A 66.3% and in group B 57.4% patients showed complete resolution of computerized tomographic lesion and rest had punctated residual calcification. Statistically, no significant difference in the recurrence of seizures was found in two groups with disappearance of lesion but the difference between calcified residua and complete resolution subset was significant. In patients having residual calcification, 42.2% in group A and 21.7% in group B had recurrence of seizures and the difference was statistically significant (Z = 1.97, P < 0.05).

CONCLUSIONS

The study revealed that SCCG with epilepsy is a benign self-limiting disease. A longer duration of therapy is not warranted in patients having total resolution of lesion. Calcified lesion was found to be the most common cause of recurrence of seizures. Higher recurrence rate was observed in short-term therapy in patients having calcified lesions and may require long-term AED treatment.