Controlling the wettability and adhesion of nanostructured poly-(p-xylylene) films

The hydrophobic surface properties of structured poly-(p-xylylene) (PPX) films, as measured by water wettability, are studied as functions of surface chemistry, film composition, and surface roughness. We demonstrate the fabrication of very hydrophobic surfaces and control over adhesion properties via nanoscale modulation of roughness, changes in composition, and alteration of the surface chemistry of PPX films. The formation of superhydrophobic surfaces through the chemisorption of fluoroalkylsiloxane coatings to hydroxyl sites created on the nanostructured PPX surface is also illustrated. The ability to control both hydrophobicity and adhesion using nanostructured PPX films is a promising development because it may lead to a new generation of coatings with applicability ranging from self-cleaning surfaces to robotics.

Gallium-68 PET: a new frontier in receptor cancer imaging

Neuroendocrine tumours (NET) are rare tumours that occur most commonly in the GI tract. Various labelled somatostatin analogues are used to image NET expressing somatostatin receptors (SSTR). In traditional nuclear medicine, most peptides used in imaging NET have been labelled with indium-111, the commonest being indium-111-octreotide (111In-octreotide). Unfortunately, the unfavourable physical qualities of In-111 make it unsuitable for detecting small tumour deposits. The recent introduction of gallium-68-1,4, 7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid (gallium-68-DOTA) compounds for positron emission tomography (PET) imaging has significantly improved the quality of imaging NET through improved resolution of PET and higher affinity of the new generation of peptides to SSTR. In the present paper, we discuss the clinical and research applications of PET radio-tracers for evaluating NET, in particular gallium-68-DOTA compounds. The recent introduction of PET imaging with gallium-68 has major bearings in current and future clinical practice. Its labelling with DOTA compounds has cleared the way for somatostatin receptor imaging with a viable PET agent, with all its inherent imaging advantages compared to single photon imaging. The pre-clinical and clinical applications of this technique has been successful in a variety of tumours, particularly NET and its labelling with other ligands and molecules will improve the management of other tumours and the assessment of infection.

Voice-related Quality of Life in Laryngectomees: Assessment Using the VHI and V-RQOL Symptom Scales

The primary purpose of this study was to investigate the effect of the voice impairment across the physical, emotional, and functional domains in patients using valved speech following total laryngectomy with the help of two symptom specific scales. The study design used was a cross-sectional cohort. The setting was the Head and Neck Oncology Unit of a tertiary referral centre. Subjects were 54 patients who had undergone total laryngectomy. Two voice-specific questionnaires, the Voice-Related Quality of Life (V-RQOL-short form) Measure, and the Voice Handicap Index (VHI-long form) were used. The main outcome measure was patient perception of the voice following total laryngectomy in response to specific questions correlated with sociodemographic/treatment factors. Responses were received from 40 males and 14 females (response rate of 85.7%) with a median age of 63.4 years (range: 37-84). The V-RQOL overall analysis showed that 3 patients (5.6%) scored "excellent," 29 patients (53.7%) "fair to good," 14 patients (25.9%) "poor to fair," and 8 patients (14.8%) "poor." Analysis of the VHI revealed that 20 patients (37.0%) had a minimal handicap, 20 patients (37.0%) a moderate handicap, and 14 patients (25.9%) had a serious voice handicap. The individual domain or subscale scores for the VHI revealed a mean (SD) functional score of 15.8 (7.7), a physical score of 13.6 (7.2), and finally an emotional score of 11.6 (8.9). Functional aspects of the voice were significantly affected by age, radiotherapy, and chemotherapy (Spearman rho, P=0.01; Mann-Whitney, P=0.04 and P=0.01). The physical aspects of the voice were significantly affected by age and chemotherapy (Spearman rho, P=0.004; Mann-Whitney, P=0.04). Only age significantly affected the emotional aspects of the voice (Spearman rho, P=0.002). We found a strong correlation (Spearman rho, P<0.001) between the V-RQOL and VHI questionnaires. Our study revealed that the V-RQOL and VHI scores in our series of patients following voice restoration in laryngectomees were consistent with that reported in the literature. Only age, radiation, and chemotherapy were seen to influence the voice handicap scores. In addition, both symptom scales had good correlation between them and either one could be used with reliability in laryngectomees with a few modifications.

Design and realization of an all-fiber broadband tunable gain equalization filter for DWDM signals

Design and fabrication of a tunable gain equalization filter for dense wavelength division multiplexed (DWDM) signals through erbium doped fiber amplifiers (EDFA) is reported. It is based on a side-polished fiber (SPF) half-coupler block loaded with a displaceable tapered multimode overlay waveguide (MMOW). A simple and accurate normal mode analysis is employed to design this filtering device for its subsequent realization. Equalization of a typical EDFA gain spectrum in the C-band within +/-0.35 dB or even less in the presence of various ITU standard C-band DWDM signal channels is demonstrated under varied operating conditions like add/drop of signals. Tunability of the filter notch is achieved through displacement of the SPF relative to the MMOW.

Primitive neuroectodermal tumour of the prostate gland: ultrasound and MRI findings

We report a rare case of primitive neuroectodermal tumour (PNET) of the prostate occurring in a 26-year-old man with a mass replacing the prostate gland in the absence of any lesion involving the bone and soft tissues. To our knowledge, there is no radiological literature that has described the imaging findings in a case of PNET of the prostate. Imaging findings in cases of PNET of the kidney are described in the literature. On ultrasound, the mass appeared multilobulated and multinodular with intratumoural heterogeneity. No brightly reflective echoes with posterior acoustic shadowing to suggest calcification were noted. MRI revealed a heterogeneous lobulated mass with irregular septae within. The mass showed low signal intensity on T(1) weighted images and appeared heterogeneous on T(2) weighted images. Haemorrhage and necrosis were also seen in the tumour.

Efficacy of application of vegetable seed oils as grain protectant against infestation by Callosobruchus chinensis and its effect on milling fractions and apparent degree of dehusking of legume-pulses

The solvent extracted vegetable seed oils of Cucurbitaceae family viz. Bitter gourd (Momordica charentia), Small bitter gourd (Momordica dioica), Bottle gourd (Lagenaria siscraria) and Ridge gourd (Luffa acutangula) were evaluated as grain protectant against callosobruchus chinensis on the stored legume-pulse grains. All the vegetable seed oils were found effective as legume-pulse grain protectant, which provided, negligible weight loss at the oil-application rate of 6-8 mL/kg in legume-pulse grain after 60 days storage at laboratory conditions. The milling yield and degree of dehusking gets improved after the oil application. The use of solvent extracted Small bitter gourd seed oil at the level of 6-8 mL/kg of legume-pulse grain sample resulted in the improved apparent degree of dehusking from 40.0 to 72.59, 59.88 to 92.44, 63.39 to 87.50 and 57.0 to 79.43 for Pigeonpea (Canjanus cajan), Chickpea (Cicer arietinum), Urdbean (Phaseolus mungo) and Mungbean (Phaseolus radiatus), respectively.

Anatomic and functional imaging in the management of lymphoma

Lymphoma has become one of the most successfully treated malignancies. The success of treatment and long-term prognosis depend on accurate staging in which imaging plays a pivotal role. In addition to staging, imaging assists in the evaluation of early and late response to therapy, detecting disease activity in a residual mass and locating sites of recurrence. The mainstay of imaging remains computed tomography (CT), which has replaced lymphangiography, and staging laparotomy. Magnetic resonance imaging (MRI) has additional value in detecting disease in bone marrow, the musculoskeletal and central nervous system. Recent technical developments in CT and MRI have improved acquisition times and resolution, but the main drawback of cross-sectional imaging techniques is their reliance on size criteria to define disease, with consequent failure to detect disease in small lymph nodes and exclude disease in large, but treated, masses. Diffuse visceral involvement is likewise difficult to detect by both modalities. Functional imaging with nuclear medicine techniques offers an answer to these problems. Imaging with the fluorinated glucose analogue, [18F]FDG positron emission tomography (PET), can detect metabolically active disease by its increased glycolysis that is proportional to mitotic activity. It can separate high from low-grade tumors and aid in prognostication. Recent publications suggest that imaging with [18F]FDG PET should be an important component in staging; assessment of response to therapy and restaging. Like other imaging modalities, it has its own drawbacks including inability to detect very small lesions (<5 mm) and reduced specificity due to increased uptake in metabolically active inflammatory and infective tissues. The new generation of hybrid PET-CT combines anatomical and functional imaging and is considered the state-of-the-art imaging technique for the assessment of lymphoma and other malignancies.

Foliar Application of Plant Growth-Promoting Rhizobacteria Increases Antifungal Compounds in Pea (Pisum sativum) Against Erysiphe pisi

Systemic effect of two plant growth-promoting rhizobacterial (PGPR) strains,viz., Pseudomonas fluorescens (Pf4) and P. aeruginosa (Pag), was evaluated on pea (Pisum sativum) against the powdery mildew pathogen Erysiphe pisi. Foliar spray of the two PGPR strains was done on specific nodal leaves of pea and conidial germination of E. pisi was observed on other nodal leaves,distal to the treated ones. Conidial germination was reduced on distant leaves and at the same time,specific as well as total phenolic compounds increased in the leaves distal to those applied with PGPR strains,thereby indicating a positive correlation. The strains induced accumulation of phenolic compounds in pea leaves and the amount increased when such leaves were get inoculated with E. pisi conidia. Between the two strains, Pag was found to be more effective than Pf4 as its effect was more persistent in pea leaves. Foliar application of PGPR strains for the control of powdery mildew of pea is demonstrated in vitro while correlating it with the increased accumulation of plant phenolics.

Trials and tribulations of the current national consent form

The aim of this survey was to evaluate patients' understanding of the current standardised National Health Service consent form. Of the 285 patients, 47% were performed as emergency and 53% as elective procedures. Almost all patients indicated that they understood the consent form. Although the benefits of the procedure were known in 94%, only 69% were aware of the risks associated with the performed operation. Less than 40% claimed to have been informed about the risk of requiring additional surgery. Patients undergoing elective surgery were significantly more likely to be aware of the risks, the likelihood of additional surgery and the fact that the consultant may not be performing the operation. Although the current national consent form introduced by the Department of Health appears to be understood by obstetric and gynaecology patients, there appears to be a need for improved counselling regarding the attendant risks and benefits of surgery, especially for patients undergoing emergency surgery.

Patient-reported health outcomes in a trial of etanercept monotherapy versus combination therapy with etanercept and methotrexate for rheumatoid arthritis: the ADORE trial

OBJECTIVES

This study assessed the relative efficacy of etanercept (ETN) or etanercept and methotrexate (ETN+MTX) for patients with rheumatoid arthritis (RA) who had an unsatisfactory response to MTX, using patient-reported outcomes (PROs) of function, pain, general health, disease activity and morning stiffness.

METHODS

The PROs were secondary assessments in a 16-week, prospective, randomised, parallel-group study conducted at 60 European centres. Patients with RA were randomly assigned either to monotherapy with ETN or combination therapy with ETN+MTX. PRO instruments administered included the Stanford Health Assessment Questionnaire, the pain visual analogue scale, the EuroQoL assessment of current health state (EQ-5D), the EQ-5D visual analogue scale, a patient global assessment of disease activity and an assessment of morning stiffness. Treatment groups were compared by percentage of patients within clinically meaningful categories. The primary endpoint for all PROs was comparison of mean improvement from baseline to week 16 between ETN and ETN+MTX groups.

RESULTS

Three hundred and fifteen patients were randomised to ETN or ETN+MTX. Both treatment arms had similar Health Assessment Questionnaire Disability Index DI, EQ-5D, patient global assessment of disease activity, pain or morning stiffness scores and improvement from baseline to week 16.

CONCLUSIONS

For patients with active RA and intolerance or unsatisfactory response to MTX, substituting ETN for MTX and adding ETN to MTX are both effective ways of reducing disability, pain, disease activity, morning stiffness, and improving general health.

Drug resistance in Leishmania: similarities and differences to other organisms

The main line of defense available against parasitic protozoa is chemotherapy. Drug resistance has emerged however, as a primary obstacle to the successful treatment and control of parasitic diseases. Leishmania spp., the causative agents of leishmaniasis, have served as a useful model for studying mechanisms of drug resistance in vitro. Antimonials and amphotericin B are the first line drugs to treat Leishmania followed by pentamidine and a number of other drugs. Parasites resistant against all these classes of drugs have been selected under laboratory conditions. A multiplicity of resistance mechanisms has been detected, the most prevalent being gene amplification and transport mutations. With the tools now available, it should be possible to elucidate the mechanisms that govern drug resistance in field isolates and develop more effective chemotherapeutic agents.

Anti-cancer gene expression profile of curcumin identifies new therapeutic targets in squamous cell lung carcinoma in vitro

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Background: Lung cancer is notorious for early metastasis and very high mortality, worldwide. Curcumin, a chemopreventive has also shown chemotherapeutic potential but its mechanisms are still not well understood. In this study, the genes targeted by Curcumin were investigated to identify new targets for the therapy of squamous cell lung carcinoma (SCC) in vitro. Methods: Lung squamous cell carcinoma cells (H520) were cultured in DMEM with 10% FCS. They were treated with Curcumin (25μM) for 24 hours. Apoptosis was detected by morphological examination, MTT assay, flowcytometry and TUNEL assay. Microarray analysis of gene expression profiles on curcumin treatment was done. Real time quantitative RT-PCR confirmed the results. Results: Curcumin (25μM for 24 hours) caused 29.8 ± 2.1% cytotoxicity (MTT assay). Apoptosis was corroborated by flowcytometry (23.7 ± 1.4%) and TUNEL (21.6 ± 1.8%). Using microarray analysis, 34 genes were seen to be upregulated and 31 genes downregulated after curcumin treatment. Several apoptosis related genes were upregulated including GADD45a (3.36 fold), transcription factor Egr-1 (2.2 fold) and Peroxiredoxin-I (2 fold). In addition, Angiopoietin-2 (Ang-2), an angiogenic factor that promotes angiogenesis and tumor invasion was downregulated (1.7 fold). Real time quantitative RT-PCR confirmed the results. Conclusions: This study helps to identify novel putative intervention sites as targets for curcumin in the therapy of squamous cell lung carcinoma (SCC) in vitro and can contribute to better understanding of lung tumorigenesis and anticancer therapy.

No significant financial relationships to disclose.

Postlaryngectomy vocal rehabilitation: assessment using a validated questionnaire in 51 patients

BACKGROUND

This study aimed to assess valved speech and related issues in total laryngectomy patients with the help of the validated Voice Prosthesis Questionnaire (VPQ).

PATIENTS AND METHODS

We identified 61 patients who had undergone a surgical voice restoration with a valve following total laryngectomy and who were sent the VPQ by mail.

RESULTS

Fifty-one patients (37 males) completed the questionnaire giving a response rate of 83.6%. Fifty-three percent of the patients (n = 27) were fully aware of the dimensions of their valve including the length and diameter, whilst 25% (n = 13) were aware of only one of the two. There was a strong correlation between the patient's perception of tone and their gender with the tone scores significantly lower in women as compared to men (Mann-Whitney test, p = 0.04). Ten patients (19.6%) had had leakage-related issues during the previous 7 days.

CONCLUSIONS

This questionnaire provided a significant amount of valuable data. Based on our experience, we recommend the VPQ for prospective use in the serial monitoring and audit of total laryngectomy patients.

Polyphasic approach of bacterial classification - An overview of recent advances

Classification of microorganisms on the basis of traditional microbiological methods (morphological, physiological and biochemical) creates a blurred image about their taxonomic status and thus needs further clarification. It should be based on a more pragmatic approach of deploying a number of methods for the complete characterization of microbes. Hence, the methods now employed for bacterial systematics include, the complete 16S rRNA gene sequencing and its comparative analysis by phylogenetic trees, DNA-DNA hybridization studies with related organisms, analyses of molecular markers and signature pattern(s), biochemical assays, physiological and morphological tests. Collectively these genotypic, chemotaxonomic and phenotypic methods for determining taxonomic position of microbes constitute what is known as the 'polyphasic approach' for bacterial systematics. This approach is currently the most popular choice for classifying bacteria and several microbes, which were previously placed under invalid taxa have now been resolved into new genera and species. This has been possible owing to rapid development in molecular biological techniques, automation of DNA sequencing coupled with advances in bioinformatic tools and access to sequence databases. Several DNA-based typing methods are known; these provide information for delineating bacteria into different genera and species and have the potential to resolve differences among the strains of a species. Therefore, newly isolated strains must be classified on the basis of the polyphasic approach. Also previously classified organisms, as and when required, can be reclassified on this ground in order to obtain information about their accurate position in the microbial world. Thus, current techniques enable microbiologists to decipher the natural phylogenetic relationships between microbes.

Preparations and limitations for prevention of severe acute respiratory syndrome in a tertiary care centre of India

This short-term observational study of infection control practice was performed in the medical emergency outpatient department (EMOPD) of a tertiary-care hospital in India when threatened by an outbreak of severe acute respiratory syndrome (SARS). An investigator attended the lobby daily to screen patients with symptoms for SARS. Patient/attendant load, patient flow, medical staff working practices and position in the EMOPD were observed. Infection control measures such as fumigation and cleaning were noted, as was the EMOPD laboratory function, use of personnel protection and display of information on infectious diseases. A total of 162 (7.4%) of the 2165 patients surveyed had respiratory symptoms but no cases of SARS were found. The flow of patients and their attendants was not systematic. No laboratory tests for SARS were available, and no educational material on SARS was displayed. The EMOPDs in key hospitals need be able to screen for infectious diseases, especially in view of the threats from SARS and Avian influenza.