Midrapidity antiproton-to-proton ratio in pp collisons at sqrt[s]=0.9 and 7 TeV measured by the ALICE experiment

The ratio of the yields of antiprotons to protons in pp collisions has been measured by the ALICE experiment at sqrt[s]=0.9 and 7 TeV during the initial running periods of the Large Hadron Collider. The measurement covers the transverse momentum interval 0.45<p_{t}<1.05  GeV/c and rapidity |y|<0.5. The ratio is measured to be R_{|y|<0.5}=0.957±0.006(stat)±0.014(syst) at 0.9 TeV and R_{|y|<0.5}=0.991±0.005(stat)±0.014(syst) at 7 TeV and it is independent of both rapidity and transverse momentum. The results are consistent with the conventional model of baryon-number transport and set stringent limits on any additional contributions to baryon-number transfer over very large rapidity intervals in pp collisions.

Variation of resistance in barley against biotypes 1 and 2 of the Russian wheat aphid (Hemiptera: Aphididae)

The Russian wheat aphid, Diruaphis noxia (Kurdjumov) (Hemiptera: Aphididae), is globally one of the most devastating pests of bread wheat, Tritium aestivum L.; durum wheat, Triticum turgidum L.; and barley, Hordeum vulgare L. Host plant resistance is the foundation for cereal insect pest management programs, and several sources of D. noxia resistance have been incorporated in cultivars to manage D. noxia damage. The emergence of D. noxia North American biotype 2 (RWA2) in Colorado has made all known Dn genes vulnerable except the Dn7 gene from rye, Secale cereale, and has warranted exploration for sources of resistance to both RWA1 and RWA2. The category of resistance in resistant donor plants may exert selection pressure over the aphid population to form a new virulent population. In the current study, we report tolerance and antibiosis resistance to RWA1 and RWA2 in the barley genotype 'Stoneham'. The rate and degree of expression of resistance in Stoneham against RWA1 and RWA2, although not similar, are greater than the partial resistance in 'Sidney'. Antixenosis resistance to RWA1 or RWA2 was not observed in Sidney or Stoneham. The tolerance identified in Stoneham is encouraging because it may delay D. noxia biotype selection and fits well in a dryland barley cropping system.

An updated checklist of species of Aedes and Verrallina of northeastern India

A mosquito faunistic survey conducted during 1999-2005 in 7 different states of the northeastern (NE) region of India revealed that the region is very rich in mosquito fauna, particularly of the genus Aedes. From the present survey and earlier published reports, a total of 48 species of Aedes and a related genus Verrallina were recorded. The state of Assam contributed the highest number of species compared to the other 6 states, namely Arunachal Pradesh, Manipur, Meghalaya, Mizoram, Nagaland, and Tripura. Larvae of 46 species were collected from 16 different habitats and for some species the habitats were species specific. The known dengue vectors, Aedes aegypti and Ae. albopictus, were recorded from all 7 states, although Ae. aegypti was not known earlier from Mizoram, Nagaland, and Tripura states. Aedes albotaeniatus was a new addition to the Aedes fauna of the region.

Prevalence of obesity in Indian women

Comparison of two major studies conducted by National family health survey (NFHS-2) in 1998-1999 and NFHS-3 in 2005-2006 shows that prevalence of obesity among Indian women has elevated from 10.6% to 12.6% (increased by 24.52%). The prevalence is more profound in the women of age between 40-49 years (23.7%), residing in cities (23.5%), having high qualification (23.8%), belonging to Sikh community (31.6%) and households in the highest wealth quintile (30.5%). Highest percentage of obese women is found in Punjab (29.9%). Although this number seems small in the international perspective, it is significant because of the sheer size of population in India. While the problem of under-nutrition still exists in many parts of India, the additional burden of obesity due to increasing sedentary lifestyle, junk food habits in some urban and economically sound areas is really alarming. Prevention and control of this serious problem through awareness programmes to adopt diversified nutritional food and healthy lifestyle are strongly recommended.

Testicular torsion: a review

Torsion of the testis, also referred to as torsion of the spermatic cord, is a subject of debate among physicians and surgeons. Testicular torsion is an acute vascular event causing the rotation of the vascular pedicle of the testis, thereby impeding the blood flow to the testis and the scrotal contents. It could be either within or outside the tunica vaginalis. Testicular torsion causes immediate circulatory changes and long-term sequelae such as testicular function and fertility. It is considered a surgical emergency, as a delay causes irreversible testicular damage. The diagnosis and treatment of testicular torsion are discussed in this review, which also illustrates an algorithm and a scoring system for the diagnosis and management of this condition based on current literature.

Synthetic nitrogen fertilizers deplete soil nitrogen: a global dilemma for sustainable cereal production

Cereal production that now sustains a world population of more than 6.5 billion has tripled during the past 40 yr, concurrent with an increase from 12 to 104 Tg yr(-1) of synthetic N applied largely in ammoniacal fertilizers. These fertilizers have been managed as a cost-effective form of insurance against low yields, without regard to the inherent effect of mineral N in promoting microbial C utilization. Such an effect is consistent with a net loss of soil organic C recently observed for the Morrow Plots, America's oldest experiment field, after 40 to 50 yr of synthetic N fertilization that substantially exceeded grain N removal. A similar decline in total soil N is reported herein for the same site and would be expected from the predominantly organic occurrence of soil N. This decline is in agreement with numerous long-term baseline data sets from chemical-based cropping systems involving a wide variety of soils, geographic regions, and tillage practices. The loss of organic N decreases soil productivity and the agronomic efficiency (kg grain kg(-1) N) of fertilizer N and has been implicated in widespread reports of yield stagnation or even decline for grain production in Asia. A major global evaluation of current cereal production systems should be undertaken, with a view toward using scientific and technological advances to increase input efficiencies. As one aspect of this strategy, the input of ammoniacal N should be more accurately matched to crop N requirement. Long-term sustainability may require agricultural diversification involving a gradual transition from intensive synthetic N inputs to legume-based crop rotations.

Tuberculosis of the hand: clinical presentation and functional outcome in 32 patients

A prospective series of 32 cases with tuberculosis of the hand and wrist is presented. The mean age of the patients was 23.9 years (3 to 65), 12 had bony disease and 20 primarily soft-tissue involvement. The metacarpal of the little finger was the most commonly involved bone. Pain and swelling were the usual presenting features and discharging sinuses were seen in three cases. All patients were given anti-tubercular chemotherapy with four drugs. Operative treatment in the form of open or arthroscopic debridement, or incision and drainage of abscesses, was performed in those cases where no response was seen after eight weeks of ATT. Hand function was evaluated by the modified score of Green and O'Brien. The mean was 58.3 (25 to 80) before treatment and 90.5 (80 to 95) at the end. The mean follow-up was for 22.4 months (6 to 43). Conservative treatment was successful in 24 patients (75%). Eight who did not respond to chemotherapy within eight weeks required surgery. Although tuberculosis of hand has a varied presentation, the majority of lesions respond to conservative treatment.

Inheritance and categories of resistance in wheat to Russian wheat aphid (Hemiptera: Aphididae) biotype 1 and biotype 2

The Russian wheat aphid, Diruaphis noxia (Kudjumov) (Hemiptera: Aphididae), is globally one of the most devastating pests of wheat, Tritium aestivum L., and barley, Hordeum vulgare L. Host plant resistance is the foundation of cereal insect pest management programs, and several D. noxia resistance (Dn) genes from wheat have been introduced in commercial cultivars of wheat to manage Russian wheat aphid (RWA). Emergence of D. noxia biotype 2 (RWA2) in Colorado has made all known Dn genes, except the Dn7 gene from rye, Secale cereale L., vulnerable and has warranted exploration for sources of resistance to RWA1 and RWA2. Here, we report antibiosis resistance to RWA1 and RWA2 identified in the wheat breeding line KS94H871. Additional experiments indicated that tolerance and antixenosis are not operating in KS94H871. Segregation studies involving F2-derived F3 families indicated that KS94H871 resistance to RWA1 is controlled by one dominant gene and one recessive gene, whereas resistance to RWA2 is controlled by only one dominant gene. This new genetic resource may serve as a good source of resistance in future breeding programs with proper understanding of the genetics of resistance.

The stimulation of rat Leydig cell steroidogenesis by human ovarian steroidogenesis-inducing protein (SIP) may not require endogenous cAMP

Recently a protein from ovarian follicular fluid was isolated which stimulates steroid production in different cells (Khan et al., 1990). The present study was performed to further characterize the short term effects of this steroidogensis-inducing protein (SIP) on steroid production in isolated rat Leydig cells and to compare the effects with LH/hCG and LHRH. SIP stimulated testosterone production in a dose-dependent manner. In Leydig cells isolated from adult rats the degree of stimulation was much higher than that obtained with hCG, dibutyryl cAMP (db cAMP) or LHRH. Moreover, the stimulated steroid production in the presence of hCG or db cAMP was further enhanced by SIP. The time courses of hCG and SIP action on testosterone production were comparable and maximal stimulation of steroid production was obtained within one hour. In contrast to hCG, SIP did not stimulate cAMP production. An antagonist of LHRH action was unable to block the effects of SIP on Leydig cells indicating that SIP does not act via LHRH receptors. Neither SIP nor LH could further stimulate the steroid production in the presence of 22-R-OH-cholesterol, illustrating that both stimulators control the availability of cholesterol as substrate. An inhibitor of mitochondrial cholesterol side chain cleavage (CSCC), aminoglutethemide, completely blocked the stimulatory effects of SIP and LH/hCG. Thus the effects of SIP on steroid production are not the result of conversion of contaminating steroids in the SIP-preparation. SIP and LH/hCG actions were also blocked when the cells were incubated in the presence of cycloheximide.(ABSTRACT TRUNCATED AT 250 WORDS)

Jejunogastric intussusception

Retrograde Jejunogastric Intussusception (RJGI) is a rare but potentially very serious complication of gastrectomy or gastrojejunostomy. It was first described by Bozzi in 1914 in a patient with gastrojejunostomy. Clinically it is of two types acute and chronic. Anatomically it is of three types. The acute form is a surgical emergency. In the acute form there is chance of strangulation of the intussuscepted loop if early intervention is not done. To avoid mortality, early diagnosis and prompt surgical intervention is mandatory. There is no medical treatment for jejunogastric intussusception and surgical intervention is required for the definite treatment. It usually presents with abdominal pain, nausea, vomiting, haematemesis and a palpable diffuse lump in the upper abdomen. A history of gastric surgery can help in making a diagnosis. X-ray can occasionally be diagnostic. Endoscopy performed by someone familiar with this rare entity, is certainly diagnostic. We herein report a case of jejunogastric intussusception who presented with acute abdomen, haematemesis and abdominal lump.

Xanthogranulomatous cholecystitis: a clinicopathological study from a tertiary care health institution

BACKGROUND

Xanthogranulomatous cholecystitis is an unusual and destructive form of chronic cholecystitis and is indistinguishable from other forms of cholecystitis which makes preoperative diagnosis and surgery difficult.

OBJECTIVES

To review the demographic and clinical aspects of xanthogranulomatous cholecystitis; to study the possibility of preoperative diagnosis and to identify the causes for difficult surgery.

MATERIALS AND METHODS

All cases histopathologically diagnosed as xanthogranulomatous cholecystitis over a period of six years from October 1999 to September 2005 at Kasturba Medical College Hospital, Manipal, India were included in the study. Data of the patients was collected retro and prospectively.

RESULTS

A total of 615 patients underwent cholecystectomy out of which 33 (5.2%) were diagnosed to have xanthogranulomatous cholecystitis. Ultrasound abdomen showed gallbladder wall thickening in 19 (57.5%) cases and gallstones in 32 (96.9%) cases. Thirty (90.9%) underwent open cholecystectomy. Gallbladder could be removed totally in 25 (75.6%) cases whereas five (15.2%) had to undergo partial cholecystectomy and in one patient, only cholecystostomy could be performed due to dense adhesions. Laparoscopic cholecystectomy was attempted in 11 patients but successful only in two patients with a conversion rate of 81.8%. Postoperative wound infection was seen in five (15.1%) patients and one (3%) had minor biliary leak which was treated conservatively. Histologically, xanthogranulomatous cholecystitis was associated with malignancy in one (3.03%) patient. There was no mortality.

CONCLUSION

Clinical presentation of xanthogranulomatous cholecystitis was indistinguishable from chronic cholecystitis. Ultrasonography may reveal only non specific findings of calculi and thickened gall bladder wall. Hence preoperative diagnosis is unlikely. Cholecystectomy was usually difficult owing to dense adhesions of gallbladder and Calot's triangle. Conversion rate of laparoscopic cholecystectomy is higher. Morbidity associated with surgery is significant.

Interim results of protracted low doses of temozolomide in high-risk acute myeloid leukemia

7052

Background: High treatment-related mortality and low response rates often discourage elderly patients with acute myeloid leukemia from receiving treatment. Previous data demonstrate that only patients lacking expression of O6-alkylguanine-DNA alkyltransferase (AGAT) in leukemic blasts are sensitive to temozolomide. Protracted exposure to low doses of temozolomide can significantly inhibit AGAT enzymatic activity. Methods: Phase II clinical trial of tailored temozolomide therapy to high-risk AML patients according to AGAT methylation promoter status. Patients demonstrating evidence of AGAT promoter methylation were stratified to conventional doses of temozolomide at 200 mg/m2 orally x 7 days. Patients demonstrating lack of AGAT promoter methylation (unmethylated) received protracted doses of temozolomide (100 mg/m2 orally x 14 days) followed by conventional doses of temozolomide. Patients who achieved CR were given up to 5 consolidation treatments. Results: Fifteen patients have completed treatment to date. The median age was 78 (68–83) and nine were male. De novo AML was diagnosed in eight patients and five patients had s-AML. Nine patients had a normal karyotype and three patients had a complex karyotype. Two patients had only a NPM1 mutation and one had NPM1mut/FLT3-ITD. In 13 patients, the AGAT promoter was found to be unmethylated. AGAT protein was present in 5/11 patients. All patients had an intact mismatch repair pathway. Thirteen patients had HCT-CI scores of 0–2. Six patients (6/13) achieved a complete remission (CR) after 1 cycle of therapy (1/2 for patients with methylated and 5/11 for patients with unmethylated AGAT promoter). Nonhematologic toxicities were minimal. Drug-related hematologic toxicities were difficult to distinguish from disease-related cytopenias. Three patients remain in CR with a median duration of 22 weeks (14–36 weeks). Seven patients have died from disease progression, while two patients died of neutropenic sepsis (early deaths). With a median follow-up of 38 weeks (10–48), the median overall survival for the entire population is 12 weeks (3.5 - 38) weeks (responders 26.5 weeks). Conclusions: These preliminary results suggest that temozolomide therapy may be individually tailored to elderly patients with AML according to AGAT promoter status.

[Table: see text]

Role of MRI in osteosarcoma for chemotherapy response evaluation and prediction: Correlation with histological necrosis

10540

Background:Histologic necrosis (HN), the current gold standard for response evaluation in osteosarcoma (OS), is accessible only after neoadjuvant chemotherapy (NACT) and may get affected by confounding factors. Thus, it would be useful to have surrogate markers of response evaluation and prognostication using magnetic resonance imaging (MRI) to individualize therapy. Method:Thirty-one treatment naïve OS patients received 3 cycles of NACT followed by surgery during 2006–2008. All patients underwent baseline and post-NACT conventional(C), diffusion-weighted (DW) and dynamic contrast enhanced (DCE) MRI. Taking ‘Huvos grading’ (good response >/= 90% HN) as reference standard, various parameters of MRI were compared with it. Tumor considered as ellipsoidal; volume (V), average tumor plane (ATP) and relative(r)-ATP (ATP/body surface area) were calculated using standard formula for ellipse. Receiver operating characteristic curves were generated to assess the best threshold and predictability. Sensitivity and specificity were calculated along with 95% confidence limits. After deriving thresholds for each parameter in univariable analysis, multivariable analysis was carried out. Results: Both pre-and post NACT, absolute and relative size parameters were well correlated with HN, though post NACT change in parameters did not. Apparent diffusion coefficient (ADC), either pre-and post NACT measurements or change following chemotherapy were not correlating well. However, on adjusting for volume, significant correlation was found. Thus, we could derive a new parameter diffusion per unit volume (DV= ADC /V). Change in shape of time intensity curve did not show significant correlation. Conclusions: In OS, NACT response can be assessed and predicted by conventional and DW- MRI early in the disease course which correlates well with HN. DV seems to be a sensitive substitute for response evaluation. For DCE-MRI, more sophisticated models in future studies might be useful. [Table: see text]

No significant financial relationships to disclose.

Heyde syndrome: a common diagnosis in older patients with severe aortic stenosis

Heyde syndrome is a triad of aortic stenosis, an acquired coagulopathy and anaemia due to bleeding from intestinal angiodysplasia. The evidence that aortic stenosis is the root cause of this coagulopathy is compelling. Resolution of anaemia usually follows aortic valve replacement. This article discusses studies linking aortic stenosis with other conditions in the triad as well as diagnosis and management of this complex pathology.

Recurrent acute pancreatitis due to a santorinicele in a young patient

A cystic dilatation of the terminal portion of the minor pancreatic duct (duct of Santorini) is referred to as a santorinicele. It is usually associated with pancreas divisum and has been suggested to be a cause of relative stenosis of the minor papilla, often leading to recurrent pancreatitis. While this anomaly has been reported in the paediatric population, it is more commonly found in the elderly. We present a 27-year-old woman with recurrent acute pancreatitis attributed to a santorinicele with a dorsal duct-exclusive pancreatic drainage.

Disparity between serum and nipple aspirate fluid (NAF) estradiol concentrations during the menstrual cycle

Abstract #4077

Background: NAF, elicited from healthy women, may provide information about the hormonal environment of the breast and the potential risk for breast cancer. We have studied NAF sex hormone changes across the menstrual cycle and after menopause to determine the relationship to serum concentrations.&#x2028; Methods: Subjects were women attending the Lynn Sage Breast Center at Northwestern Memorial Hospital. Samples of NAF from 20 premenopausal and 23 postmenopausal women were evaluated. Premenopausal women were divided into groups 1 through 4, backdating from the day of menstruation, -28 through -19, -18 through -13, -12 through -6 and -5 through 0, respectively. NAF and venous blood were collected using standard methods. Total protein was measured by a fluorometric procedure. Unconjugated steroids, estradiol (E2), estrone, progesterone (P), and testosterone (T), were extracted into ethyl acetate-hexane (3:2) and were separated by HPLC on a C-18 column with gradient elution before assay. DHEA sulfate, estrone sulfate, and cathepsin D were measured in the aqueous fraction. All analytes were measured by immunoassays. Transformation of the data of all analytes to their natural logarithms normalized the data. Data were analyzed by ANOVA.&#x2028; Results: The protein concentration in the samples was similar among all groups, mean = 128 mg/ml (P=0.904). In NAF only E2 and P differed during the menstrual cycle, P = 0.064 and 0.007, respectively, but the pattern of NAF E2 followed that of NAF P and not serum E2. The figure shows the geometric mean values at each phase of the menstrual cycle. Ovulation should occur in group 2 (-18 through -13 days from menstruation). With the exception of P and DHEA sulfate, which were lower, analytes in samples from postmenopausal women were not significantly different from those from premenopausal women.&#x2028; &#x2028; Comment: The most significant finding is that NAF E2 does not parallel serum levels but follows closely NAF P levels. NAF E2 was actually lowest when serum E2 was highest. Changes in other analytes during the menstrual cycle were minimal. Estradiol, its direct precursors, and the E2-related protein, cathepsin D, were not decreased in NAF after menopause. (Supported by NIH R01 CA 120555-01).

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4077.

Differential gene expression associated with estrogen receptor status of breast cancer identified by microarray meta-analysis

Abstract #2041

Introduction: Estrogen receptor (ER) positive breast cancer can be prevented by Tamoxifen. Currently, there are no markers for breast cancer risk that discriminate between the risk of ER positive versus ER negative disease. To identify patients likely to benefit from endocrine chemoprevention, a robust marker predicting ER status is needed. Microarray technology has identified genomic classifiers for breast cancer prognosis and prediction. We therefore conducted a meta-analysis of microarray data to identify individual genes associated with ER status of breast cancer.&#x2028; Methods: Publicly available microarray gene expression data sets were mined using Gene Expression Omnibus (GEO), Oncomine, ArrayExpress, and Stanford Microarray Database (SMD). Study inclusion criteria are no prior drug treatment, known ER status, and raw data files available for at least 50 arrays. All analyses were conducted using Bioconductor Project's (http://www.bioconductor.org) open-source software in R statistical programming language. Packages used include limma, ArrayQualityMetrics, MetaArray, and GOstats. Data sets were individually normalized using rma, and differential gene expression was based on ER status. Meta-analytic test statistic was computed, multiple test correction was performed, and genes above the threshold of |Zscore| = 19.5 were included in further analysis.&#x2028; Results: The search identified 23 publicly available gene expression data sets of primary breast tumors with known ER status, ten of which met inclusion criteria. Four of the ten contained cDNA array data files from SMD and were combined since they contained redundant files. To minimize platform and methodology discrepancies, we chose to focus our analysis on the six data sets which utilized the Affymetrix U133A array. The six data sets each contain 99-245 arrays, and represent a total of 644 ER+ and 268 ER- breast tumors. Bioinformatic analysis of the 86 differentially expressed genes associated with ER status using the criteria described above was then performed. To enrich for gene expression changes in pre-neoplastic lesions, genes known to be involved in progression and metastasis were eliminated from further study. The remaining genes were searched in Oncomine for differential expression according to ER status, in PubMed for previous association with breast cancer, and with our unpublished data for Gene Ontology annotations associated with ER status in breast cancer. We further narrowed the resulting list of 22 to 15 (ESR1, TFF1, AGR2, SCUBE2, CYP21A2, PIP, DACH1, BCL2, PROM1, RARES1, TMSL8, SRD5A1, SLC39A6, SCGB2A2, and FOXA1) based on functional redundancy.&#x2028; Conclusion: Over the next 4 months, this gene set (along with 5 house-keeping genes) will be tested for differential expression in samples that we have collected from the contralateral unaffected breasts of women with ER positive and ER negative breast cancer. These studies are likely to identify candidate genes that may serve as markers of ER-specific risk.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2041.

Induction of hepatic peroxisomal beta-oxidation of fatty acids by dehydroepiandrosterone (DHEA) in male F-344 rats

Pharmacological administration of dehydroepiandrostenone (DHEA, 300 mg/kg, p.o.) for 2 weeks significantly increased (P < 0.01) the activity of hepatic peroxisomal beta-oxidation of fatty acids in male F-344 rats. Similar effects were observed following 8 week administration of DHEA. These results are discussed in the light of oxidative stress-mediated hepatocarcinogenesis.

Supporting limb reconstruction patients: a fine-wire circular fixator support group

INTRODUCTION

External fixator frames are widely used in limb reconstruction surgery. They are used for relatively long periods and the multidimensional impact on patients is documented. We examined the role of a nurse-led specialist group when supporting patients both pre-operatively and postoperatively.

PATIENTS AND METHODS

All patients with external fixators were contacted via postal questionnaire. Questions asked covered regularity of attendance at the specialist group, information received and problems with the frames.

RESULTS

Thirty-seven patients replied. Twenty-one had attended the clinic and nearly all (32) had been offered the opportunity to attend. Most reported being well prepared for surgery and felt that the information given was satisfactory. Problems were generally addressed within the group and patients attended the group with frame-related problems before attending their general practitioner or the accident and emergency department. All patients found the group environment supportive.

CONCLUSIONS

We describe a unique patient support group. To our knowledge, it is the first in the country. It is a valuable resource in equipping patients prior to surgery as well as dealing with problems that arise with the frame in situ. We recommend it to other limb reconstruction units.

Computed tomography-guided radiofrequency ablation of osteoid osteomas

PURPOSE

To report on 14 patients with osteoid osteomas treated by computed tomography-guided radiofrequency ablation.

METHODS

Nine males and 5 females aged 13 to 45 (mean, 25) years with osteoid osteomas were included. The proximal tibia was the commonest site involved. A bipolar 18-gauge radiofrequency probe with a 9- mm active tip was used. A 4.5-mm hollow drill was introduced into the nidus. Energy application was started at 2 W and increased to a maximum of 5 W. Heat was applied for 4 to 6 minutes at 90 degrees Celsius.

RESULTS

12 (86%) of the 14 patients had prompt pain relief; the remaining 2 underwent a repeat ablation. After a mean follow-up period of 19 (range, 9-25) months, no patient had pain recurrence.

CONCLUSION

Radiofrequency ablation is a minimally invasive and cost-effective treatment for osteoid osteomas.

Pilimiction

Per urethral hair growth or passage of hair in the urine is a rare urological problem. It is pathognomonic sign of urinary bladder dermoid. Primary bladder dermoid is very rare problem. It could be managed endoscopically when it is limited to detrusor muscle. Secondary dermoid in the urinary bladder is not uncommon among the female specially during their reproductive life. It is mostly ovarian origin. Ovarian dermoid may grow and invade the urinary bladder wall to discharge its content in the urine. Cystoscopic evaluation followed by laparotomy and excision of ovarian dermoid along its extension to the urinary bladder is a rational approach. However if expertise is available it may be managed laparoscopically. Our patient has benign indolent coarse of pilimiction for last 9 years. Except US scans we did not do MRI or CT scan for financial constrain. Keeping an open mind we did cyst evaluation. Attempt of endoscopic resection seems that the dermoid has invaded bladder wall from out side. We did laparotomy in the same sitting. Lt. ovary was almost buried between the leaf of broad ligament and contain a dermoid cyst invading bladder wall to discharge its contents. So we confirm our diagnosis as secondary bladder dermoids as a cause of pilimiction & excise the whole specimen keeping its safety margin. Histopathologically it appears benign mature cystic teratoma.

Intranasal mucoadhesive buspirone formulation: in vitro characterization and nasal clearance studies

Oral administration is unsuitable for drugs prone to extensive first-pass metabolism, like buspirone. Thus, in the present study an attempt has been made to develop a mucoadhesive intranasal formulation improving permeation characteristics of buspirone HCl. Nasal formulations containing different concentrations of chitosan HCl and hydroxypropyl-beta-cyclodextrins (HP-beta-CD) were prepared and compared with control buspirone HCl solution regarding permeability, in vitro duration of mucoadhesion, in vivo nasal clearance in rats and in vitro cytotoxicity on cell culture. Nearly two fold increase in buspirone permeation was observed with 1% chitosan HCl and a 3.5 fold increase with 1% chitosan HCI and 5% HP-beta-CD. Nasal clearance studies showed retention of 50% radioactivity up to about 3.5 h for formulation F7 containing 1% chitosan HCI compared to 1.5 h for control buspirone solution (F1). Results conclusively demonstrated enhancement in permeation with no cytotoxicity. Thus formulations can be used to improve bioavailability of buspirone HCl.

Human papillomavirus type 16 reduces the expression of microRNA-218 in cervical carcinoma cells

Human papillomaviruses (HPVs) are involved in the pathogenesis of cancer of the cervix (CaCx). MicroRNA (miRNA) expression analysis using Ambion (Austin, TX, USA) arrays showed that three miRNAs were overexpressed and 24 underexpressed in cervical cell lines containing integrated HPV-16 DNA compared to the normal cervix. Furthermore, nine miRNAs were overexpressed and one underexpressed in integrated HPV-16 cell lines compared to the HPV-negative CaCx cell line C-33A. Based on microarray and/or quantitative real-time PCR and northern blot analyses, microRNA-218 (miR-218) was specifically underexpressed in HPV-positive cell lines, cervical lesions and cancer tissues containing HPV-16 DNA compared to both C-33A and the normal cervix. Expression of the E6 oncogene of high-risk HPV-16, but not that of low-risk HPV-6, reduced miR-218 expression, and conversely, RNA interference of E6/E7 oncogenes in an HPV-16-positive cell line increased miR-218 expression. We also demonstrate that the epithelial cell-specific marker LAMB3 is a target of miR-218. We also show that LAMB3 expression is increased in the presence of the HPV-16 E6 oncogene and this effect is mediated through miR-218. These findings may contribute to a better understanding of the molecular mechanisms involved in cervical carcinogenesis.

Dextrose prolotherapy for recalcitrant coccygodynia

PURPOSE

To present the results of dextrose prolotherapy undertaken for chronic non-responding coccygodynia in 37 patients.

METHODS

14 men and 23 women (mean age, 36 years) with chronic coccygodynia not responding to conservative treatment for more than 6 months were included. 27 of them had received local steroid injections. A visual analogue score (VAS) was recorded for all patients before and after injection of 8 ml of 25% dextrose and 2 ml of 2% lignocaine into the coccyx. In 8 patients with a VAS of more than 4 after the second injection, a third injection was given 4 weeks later.

RESULTS

The mean VAS before prolotherapy was 8.5. It was 3.4 after the first injection and 2.5 after the second injection. Minimal or no improvement was noted in 7 patients; the remaining 30 patients had good pain relief.

CONCLUSION

Dextrose prolotherapy is an effective treatment option in patients with chronic, recalcitrant coccygodynia and should be used before undergoing coccygectomy. Randomised studies are needed to compare prolotherapy with local steroid injections or coccygectomies.

Definite, probable or dubious: antioxidants trilogy in clinical dentistry

Recent years have shown the presence of free radicals in causation and progression of various dental diseases and antioxidant usage in dental therapeutics. Antioxidant micronutrients are important not only for limiting oxidative and tissue damage, but also in preventing increased cytokine production, which is a result of prolonged activation of the immune response. There has been a widespread availability and clinical claims on the safety and efficacy of antioxidants. However, lack of randomised controlled trials in dental research limits their usage. There is a substantial gap between these clinical claims and efficacy/safety of antioxidants in dental therapeutics which needs to be addressed. This article highlights the clinical significance of antioxidant therapy in dental practice and touches upon controversial areas and research lacunae. An evidence based approach for making recommendations about antioxidant usage and efficacy in routine dental practice seems to be the need of the hour.

Epidemiology, risk factors, and pathogenesis of cholangiocarcinoma

Cholangiocarcinoma (CCA) is a fatal cancer of the biliary epithelium, arising either within the liver (intrahepatic, ICC) or in the extrahepatic bile ducts (extrahepatic ECC). Globally, CCA is the second most common primary hepatic malignancy. Several recent epidemiological studies have shown that the incidence and mortality rates of ICC are increasing. This review of the literature on the international epidemiological rates of CCA, both intra- and extrahepatic, explores possible explanations for the trends found. The possible role of epidemiological artifact in the findings is discussed and the known risk factors for CCA are summarized. These include primary sclerosing cholangitis, liver fluke infestation, congenital fibropolycystic liver, bile duct adenomas, and biliary papillomatosis, hepatolithiasis, chemical carcinogens such as nitrosamines, Thorotrast, chronic viral hepatitis, cirrhosis, chronic non-alcoholic liver disease and obesity. Potential pathways involved in the molecular pathogenesis of CCA are also summarized.

The myth of nitrogen fertilization for soil carbon sequestration

Intensive use of N fertilizers in modern agriculture is motivated by the economic value of high grain yields and is generally perceived to sequester soil organic C by increasing the input of crop residues. This perception is at odds with a century of soil organic C data reported herein for the Morrow Plots, the world's oldest experimental site under continuous corn (Zea mays L.). After 40 to 50 yr of synthetic fertilization that exceeded grain N removal by 60 to 190%, a net decline occurred in soil C despite increasingly massive residue C incorporation, the decline being more extensive for a corn-soybean (Glycine max L. Merr.) or corn-oats (Avena sativa L.)-hay rotation than for continuous corn and of greater intensity for the profile (0-46 cm) than the surface soil. These findings implicate fertilizer N in promoting the decomposition of crop residues and soil organic matter and are consistent with data from numerous cropping experiments involving synthetic N fertilization in the USA Corn Belt and elsewhere, although not with the interpretation usually provided. There are important implications for soil C sequestration because the yield-based input of fertilizer N has commonly exceeded grain N removal for corn production on fertile soils since the 1960s. To mitigate the ongoing consequences of soil deterioration, atmospheric CO(2) enrichment, and NO(3)(-) pollution of ground and surface waters, N fertilization should be managed by site-specific assessment of soil N availability. Current fertilizer N management practices, if combined with corn stover removal for bioenergy production, exacerbate soil C loss.

Six cases of permanent alopecia after various conditioning regimens commonly used in hematopoietic stem cell transplantation

Alopecia, a side effect of chemotherapy, is usually temporary and reversible. Irreversible alopecia has been reported after high-dose chemotherapy (HDC) and hematopoietic stem cell transplantation (HSCT) especially related to BuCy containing conditioning regimens; however, the overall incidence is not known. We conducted a retrospective study to identify patients with chemotherapy-induced permanent alopecia after HSCT. We describe six such patients, two males and four females, among 760 patients transplanted between 1997 and 2004. Median age was 45 years (range, 37-65). There were three Caucasians and three African-Americans. Median follow-up was 30 months. Conditioning regimens included BuCy, Bu/Cy and etoposide (VP16) (one of these patients received second autograft after Cy and TBI) and CyVP16 and TBI. Our data show that permanent alopecia is a significant long-term side effect of HSCT and can be seen across the spectrum of diseases and transplant types and with non-busulfan containing regimens. We have observed that patients usually accept permanent alopecia as the price for the cure and therefore true incidence of permanent alopecia may be underestimated. Our findings may also have medico legal and psychosocial implications that need to be taken into consideration when consenting patients for HSCT.

External carotid ligation in extensive haemangioma of tongue & lip

Two patients were admitted in the surgical unit of Mymensingh Medical college Hospital on September 2005 & April 2006. The first case was a lady of 18 years presented with sudden huge enlargement of tongue & lower lip for 07 days resulting difficulty in deglutition & respiration. Since childhood she noticed multiple elevated bluish spots over the tongue, cheek & lips. The second case was a young man of 20 years presented with multiple diffuse swelling of lips, left side of face, cheek, lower eyelid since birth, which was gradually increasing in size. Colour Doppler evaluation of the lesions in both the cases revealed features suggestive of haemangioma. Bilateral external carotid artery ligation by skin crease incision at the level of upper border of thyroid cartilage was done in both the cases. In first case, tongue size reduced back to oral cavity in post operative period. After 04 weeks of operation tongue size became almost normal with only multiple bluish residual swelling. In second case, the swelling size gradually reduced in post operative period. Both the patients are under regular follow up.

Personal series with clinical review of fracture penis

Penile fracture is an uncommon Urological emergency. In flaccid state it allows significant degree of deformation without any injury to the vital structures but in erected state it is vulnerable to blunt injury. The tumescent corpora cavernosa may have got injured due to nonphysiological bending of penile shaft. The true incidence of penile fracture is not known even in western countries. It is either under reported or hidden for potential social embracement. We have reviewed all of our cases of penile fracture and has been conducted a retrospective study in the Department of Urology, Bangladesh Medical College, Dhaka. The study period was from October 2001 to January 2006. The sample size was 23. All patients have got classical history of penile fracture. The time between the onset of symptom and seeking of medical care ranges from 02 hours to 07 days. The diagnosis was made on the basis of history and clinical examination only. All the patients were underwent surgery. The potency was well preserved in all of our patients. The local tissue healing process is better among the patients, reported earlier. The overall result is excellent.

Tuberculosis of the sternum

A series of 14 patients suffering from tuberculosis of the sternum with a mean follow-up of 2.8 years (2 to 3.6) is presented. All were treated with antitubercular therapy: ten with primary therapy, two needed second-line therapy, and two required surgery (debridement). All showed complete healing and no evidence of recurrence at the last follow-up. MRI was useful in making the diagnosis at an early stage because atypical presentations resulting from HIV have become more common. Early adequate treatment with multidrug antitubercular therapy avoided the need for surgery in 12 of our 14 patients.

Association between glycaemic control and serum lipids profile in type 2 diabetic patients: HbA1c predicts dyslipidaemia

Impaired lipid metabolism resulting from uncontrolled hyperglycaemia has been implicated in cardiovascular complications in diabetes patients. The aim of this study was to examine the impact of glycaemic control on the lipid profile of diabetic patients. We also determined the ability of glycated haemoglobin (HbA(1c)) as an indirect marker of dyslipidaemia. A total of 1011 type 2 diabetic patients (males, 574; females, 437; mean age, 59.76 years) were included in this study. Venous blood samples were collected from all the subjects after at least 8 h fasting. The sera were analysed for HbA(1c), fasting blood glucose (FBG), total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL). The levels of HbA(1c), FBG and LDL did not differ significantly between males and females. Female patients showed significantly higher serum cholesterol and HDL but significantly lower TG levels as compared to males. There was a highly significant correlation between HbA(1c) and FBG. Both HbA(1c) and FBG exhibited direct correlations with cholesterol, TG and LDL and inverse correlation with HDL; the magnitude of significance for all these lipid parameters being greater with HbA(1c) than FBG. There was a linear relationship between HbA(1c) and dyslipidaemia. The levels of serum cholesterol and TG were significantly higher and of HDL significantly lower in patients with worse glycaemic control as compared to patients with good glycaemic control. The findings of this study clearly indicate that HbA(1c) is not only a useful biomarker of long-term glycaemic control but also a good predictor of lipid profile. Thus, monitoring of glycaemic control using HbA(1c) could have additional benefits of identifying diabetic patients who are at a greater risk of cardiovascular complications.

Intravesical migration of levonorgestrel-releasing intrauterine system (LNG-IUS) with calculus formation

The intrauterine contraceptive device (IUD) has been in use for many years as an effective means of birth control. Migration of the device from the uterus to the pelvic cavity is not uncommon and has been reported previously, however intravesical migration and secondary calculus formation is relatively rare. We report a 28-year-old woman in whom an intrauterine contraceptive device (LNG-IUS) migrated from the uterus to the bladder and resulted in stone formation. This case shows that the newer hormone releasing IUDs may also cause bladder perforation.