Predominance of G to A codon 12 mutation K-ras gene in Dukes' B colorectal cancer

INTRODUCTION

K-ras gene mutations in codons 12 and 13 are one of the earliest events in colon carcinogenesis.

METHODS

DNA was extracted from 25 mg of tumour tissue (n = 70) that were taken from tumour mass and pairs with normal epithelial tissue distant from the tumour of colorectal cancer patients. Exon 1 and exon 2 of the K-ras gene were amplified. Hotspot mutations were detected using polymerase chain reaction-based single-strand conformation polymorphism method and confirmed by direct DNA sequencing analysis.

RESULTS

Mutations were identified in 14 out of the 70 (20%) colorectal carcinoma tissues. Single-base transition from GGT to GAT (glycine to aspartate) in codon 12 was detected in nine samples, while three samples presented with GGC to GAC transition in codon 13. Patients with large adenoma had a 12-fold higher likelihood of K-ras mutations (odds ratios [OR] 12.31; 95% confidence intervals [CI] 1.81-83.76). Tumours located at the left colon were more likely to present with K-ras mutations (OR 4.54; 95% CI 0.96-21.54).

CONCLUSION

Our study showed a high frequency of G to A transition of codon 12 mutation of the K-ras gene, with significant correlation with tumour size and tumour location.

A report of three patients with MMP2 associated hereditary osteolysis

Osteolysis syndromes are rare hereditary disorders characterized by destruction and resorption of affected bones. The current study adds three new patients from two unrelated consanguineous families with a severe form of inherited osteolysis. Clinical examination, radiological, biochemical, ultrastructural and molecular studies were conducted. Clinical and radiological studies suggested the diagnosis of Torg-Winchester syndrome. The three affected patients were homozygous for novel MMP2 gene mutations which confirmed the diagnosis. Our patients are the first to be reported from Egypt thus, supporting the pan ethnic nature of the disease.

Mayer-rokitansky-kuster-hauser syndrome: surgical management of two cases

The Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome is a rare anomaly characterized by congenital aplasia of the uterus and vagina in women showing normal development of secondary sexual characters and normal 44 XX karyotype. We report our experience in the management of two patients with congenital absence of the vagina due to the MRKH syndrome. The first case was a 24-year-old student, who presented with primary amenorrhea, uterovaginal agenesis, right pelvi-ureteric junction obstruction, and left renal agenesis. The second patient was a 24-year-old housewife, who presented with primary amenorrhea and inability to achieve penetrative sexual intercourse. She had vaginal atresia and a grossly hypoplastic uterus. Both had successful sigmoid colovaginoplasty and are sexually active. Vaginal reconstruction using the sigmoid colon saw an immediate and satisfactory outcome in both patients.

Analgesic activity, toxicity study and phytochemical screening of standardized Cinnomomum iners leaves methanolic extract

Cinnomomum iners standardized leaves methanolic extract (CSLE) was subjected to analgesic, toxicity and phytochemical studies. The analgesic activity of CSLE was evaluated using formalin, hot plate and tail flick tests at doses of 100, 200 and 500 mg/kg. CSLE showed significant activity (P < 0.05) in the formalin model (late phase) on the rats at doses of 200 and 500 mg/kg. However, CSLE did not show activity in the hot plate and tail flick tests. The results obtained suggest that CSLE acts peripherally to relieve pain. For the toxicity study, CSLE was orally administered to the Swiss albino mice according to the Organization for Economic Co-Operation and Development (OECD) guideline 423. There was no lethality or toxic symptoms observed for all the tested doses throughout the 14-day period. Phytochemical screening of CSLE showed the presence of cardiac glycoside, flavonoid, polyphenol, saponin, sugar, tannin and terpenoid.

In vitro and in vivo anticandidal activity of Swietenia mahogani methanolic seed extract

Swietenia mahogani crude methanolic (SMCM) seed extract was investigated for the antifungal activity against Candida albicans which has not been evaluated previously. The antifungal activity was evaluated against C. albicans via disk diffusion, minimum inhibition concentration (MIC), scanning electron microscope (SEM), transmission electron microscope (TEM) and time killing profile. The MIC value of SMCM seed extract is 12.5 mg/ml. The SEM and TEM findings showed there is morphological changes and cytological destruction of C. albicans at the MIC value. Animal model was used to evaluate the in vivo antifungal activity of SMCM seed extract. The colony forming unit (CFU) were calculated per gram of kidney sample and per ml of blood sample respectively for control, curative and ketaconazole treated groups. There was significant reduction for the CFU/ml of blood and CFU/g of kidney. This indicated that the extract was observed to be effective against C. albicans in vitro and in vivo conditions.

Is breast self examination (BSE) still relevant? A study on BSE performance among female staff of University of Malaya

OBJECTIVES

This study aimed to determine the rate of breast self examination (BSE) among the female staff of University of Malaya and to determine the role of BSE in detecting breast abnormalities.

METHODS

A total of 1598 questionnaires were posted to all female staff, aged 35 years and above. Their knowledge on breast cancer, practice of BSE and detection rate of breast abnormality as confirmed by CBE was determined.

RESULTS

The response rate for this study was 45 percent (714 respondents). The rate of respondents having awareness on breast cancer was 98.7 percent. Eighty four percent (598) of the respondents had performed BSE in their lifetime. However, in only 41% was it regular at the recommended time. Forty seven percent (334) had undergone CBE at least once in a lifetime but only 26% (185) had CBE at least once in the past 3 years, while 23% (165) had had a mammogram. There was a significant relationship between CBE and BSE whereby those who had CBE were twice more likely to do BSE. Nineteen percent (84 respondents) of those who did BSE claimed they had detected a breast lump. Of these, 87% (73) had gone for CBE and all were confirmed as such.

CONCLUSION

BSE is still relevant as a screening tool of breast cancer since those who detect breast lump by BSE will most probably go for further check up. CBE should be done to all women, especially those at highest risk of breast cancer, to encourage and train for BSE.

Preparation of niosomes as an ocular delivery system for naltrexone hydrochloride: physicochemical characterization

Recent reports have demonstrated that topical and systemic application of naltrexone markedly improves the characteristic signs of diabetic keratopathy; most notably, impaired corneal sensation and delayed wound repair. The aim of this study was to prepare and characterise non-ionic surfactant vesicles (niosomes) for the ocular drug delivery of naltrexone hydrochloride. The niosomes were prepared using the thin film hydration method and characterised using polarized light microscopy, cryo-scanning electron microscopy (Cryo-SEM), percent drug entrapment efficiency (EE %), laser light diffraction and differential scanning calorimetry (DSC). Two classes of non-ionic surfactants (sorbitan esters and polyoxyethylene alkyl ethers) were investigated. The results revealed that tuning of cholesterol concentrations can significantly alter the niosome's physical properties including sizes, EE% and membrane fluidity (thermo-responsiveness). The prepared vesicles were in the range of 7.0 +/- 1.0 to 14.6 +/- 0.8 microm in size. The prepared niosomes showed different abilities to accommodate cholesterol. This was highly dependent on the structure and continuity of the hydrophobic chains of the used surfactants. Span 60-based vesicles containing 30% mol/mol of cholesterol showed the highest EE%. The microstructure and lamellarity of the niosomes were studied using Cryo-SEM. Typical concentric multilayered structures (onion or rose-like) were seen suggesting the formation of multilamellar vesicles. DSC-studies conducted on Span 60-based niosomes containing 30% mol/mol cholesterol revealed liquid-gel transition (T(m) and entropy of 43.5 degrees C and 0.82 kcal/mol, respectively). Such transition reflects potential thermo-responsive properties, which is desirable for ocular delivery.

A randomised controlled trial comparing TVT, Pelvicol and autologous fascial slings for the treatment of stress urinary incontinence in women

OBJECTIVE

To compare TVT(TM) , Pelvicol(TM) and autologous fascial slings (AFSs).

DESIGN

A multicentre randomised control trial.

SETTING

Four units in the UK.

POPULATION

Women requiring primary surgery for stress urinary incontinence (SUI).

METHODS

A total of 201 women with urodynamically proven stress incontinence were randomised into three groups and assessed at baseline, 6 weeks, 6 months and 1 year.

MAIN OUTCOME MEASURE

The primary outcome was patient-reported improvement rates. Secondary outcomes included operative complications/time, intermittent self-catheterisation (ISC) and re-operation rates. The quality-of-life tools used were the Bristol Female Lower Urinary Tract Symptoms (BFLUTS) and EuroQoL.

RESULTS

Fifty women had a Pelvicol(TM) sling, 79 had AFSs and 72 had TVT(TM). At 6 months the Pelvicol(TM) arm had poorer improvement rates (73%) than TVT(TM) (92%)/AFS (95%); P=0.003. At 1 year only 61% of the Pelvicol(TM) slings remained as improved, versus 93% of TVTs and 90% of AFSs (P<0.001). Pelvicol(TM) has poorer dry rates (22%) than TVT(TM) (55%)/AFS (48%) (P=0.001) at 1 year; hence, the Pelvicol(TM) arm was suspended following interim analysis. There is no difference in the success rates between TVT(TM) and AFS. One in five women in the Pelvicol(TM) arm had further surgery for SUI by 1 year, but none required further surgery in the other arms. AFS took longer to do (54 minutes versus 35 minutes for TVT(TM) /36 minutes for Pelvicol(TM) ) and had higher ISC rates (9.9 versus 0% Pelvicol(TM) /TVT(TM) 1.5%). Hospital stay was shortest for TVT(TM) (2 days). Most BFLUTS domains showed improvement in all three arms. The improvement for women in the Pelvicol(TM) arm, however, was less than for women in the other arms in several key domains.

CONCLUSIONS

Pelvicol(TM) cannot be recommended for the management of SUI. TVT(TM) does not have greater efficacy than AFS, but does utilise fewer resources.

Light-harvesting II (B800-B850 complex) structural genes from Rhodopseudomonas capsulata

The light-harvesting II (LHII) structural genes coding for the (B800-B850 complex) beta- and alpha-polypeptides have been cloned and the nucleotide and deduced polypeptide sequences have been determined. This completes the sequencing of all seven structural genes coding for the structural polypeptides of the photosynthetic apparatus that bind the pigments and cofactors participating in the primary light reactions of photosynthesis. Unlike the structural genes coding for the reaction center L, M, and H subunits and the light-harvesting I (LHI) (B870 complex) structural polypeptides, the LHII structural genes are not within the 46-kilobase photosynthetic gene cluster carried by the R-prime plasmid pRPS404. Identical organization of the beta and alpha structural genes for both LHI and LHII and sequence homologies between the two beta-polypeptides and between the two alpha-polypeptides suggests that both complexes arose by gene duplication from a single ancestral light-harvesting complex and that the putative bacteriochlorophyll binding sequence Ala-X-X-X-His has been absolutely conserved.

An unexpected case of primary peritoneal carcinoma

Primary peritoneal carcinoma (PPC) is a rare tumor that is histologically and immunohistochemically indistinguishable from epithelial ovarian carcinoma. The diagnosis is usually made after excluding gross ovarian involvement or the ovarian involvement is only confined to the surface. A 68-year-old lady presented with right iliac fossa pain and increasing CA125. The CT scan showed bilateral pelvic adnexal masses with peritoneal deposits within the right side of abdomen. She was initially diagnosed as carcinomatosis peritonei from the omental cake removed after exploratory surgery. She was managed as advanced ovarian tumor with peritoneal metastasis and was then administered six cycles of chemotherapy. Surgical intervention included debulking surgery consisting of total abdominal hysterectomy, bilateral salpingooophorectomy and omentectomy and also with right hemicolectomy. The histopathological findings were of primary peritoneal serous carcinoma with only minimal involvement of the serosal surface of the right ovarian capsule. No microscopic invasion into underlying ovarian cortex and stroma was observed. Multiple tumor deposits were also seen over the right paratubal and paraovarian tissue, both parametrium as well as serosal surface of the terminal ileum and periappendicular tissue. Immunohistochemically, the malignant cells were positive to CA125, focally positive to CK7 and negative to CD20 and Calretinin. PPC is one of important differential diagnosis which needs to be considered in cases of advanced ovarian tumor, although the former can only be ascertained after excluding the ovarian involvement microscopically.

Phytochemical and antimicrobial activity of Swietenia mahagoni crude methanolic seed extract

The present study was designed to evaluate the antibacterial activities of Swietenia mahagoni crude methanolic (SMCM) seed extract. The antimicrobial activity of the oily extract against Gram-positive, Gram-negative, yeast and fungus strains was evaluated based on the inhibition zone using disc diffusion assay, minimal inhibition concentration (MIC) and minimal bactericidal concentration (MBC) values. The crude extract was subjected to various phytochemicals analysis. The demonstrated qualitative phytochemical tests exhibited the presences of common phytocompounds including alkaloids, terpenoids, antraquinones, cardiac glycosides, saponins, and volatile oils as major active constituents. The SMCM seed extract had inhibitory effects on the growth of Candida albicans, Staphylococcus aureus, Pseudomonas aeroginosa, Streptococcus faecalis and Proteus mirabillase and illustrated MIC and MBC values ranging from 25 mg/ml to 50 mg/ml.