Plasma selenium level in cancer patients

Selenium has been shown to be a cancer preventive agent. A few studies have shown that increased selenium level is associated with decreased cancer incidence and decreased cancer mortality. The present study was carried out to find out the relationship of selenium level with site, extent of disease, recurrence of disease, histopathological diagnosis, anaemia and serum protein level of cancer patients. Plasma selenium level were studied in 100 patients and mean selenium level of 75.35 ng/ml in cancer patients was significantly less than control values (116.99 ng/ml) in normal healthy individuals (P < 0.003). The strongest association of plasma selenium level and cancer was found in cancer breast (70.50 ng/ml) and gastrointestinal tract (73.05 ng/ml) cancer. Selenium level decreased with the progress of disease and recurrence of disease. No significant association between histopathological diagnosis and selenium level was observed. Anaemia and hypoproteinemia was also not found to be related with selenium level.

A new method for testing the functional dependence of unfolding free energy changes on denaturant concentration

Denaturations of ribonuclease A, lysozyme, and cytochrome c by guanidine hydrochloride (GdnHCl), urea, and GdnHCl-urea mixture were studied at constant temperature and pH to assess the functional dependence of denaturational free energy change (delta GD) on denaturant concentration over an extended GdnHCl concentration range. Conventional analysis of GdnHCl-induced transition curve exhibits a linear plot of delta GD versus [GdnHCl] in the transition zone. To extend delta GD measurements beyond this narrow concentration range, GdnHCl-induced unfolding was measured in the presence of different concentrations of urea. delta GD values from these measurements were corrected for the effect of urea on the free energy change using the appropriate relation. The corrected delta GD data were mapped onto the delta GD versus [GdnHCl] plot. For each protein, the dependence of free energy change on denaturation was found to be linear over the full GdnHCl concentration.

Acid phosphatase and lipid peroxidation in human cataractous lens epithelium

The anterior lens epithelial cells undergo a variety of degenerative and proliferative changes during cataract formation. Acid phosphatase is primarily responsible for tissue regeneration and tissue repair. The lipid hydroperoxides that are obtained by lipid peroxidation of polysaturated or unsaturated fatty acids bring about deterioration of biological membranes at cellular and tissue levels. Acid phosphatase and lipid peroxidation activities were studied on the lens epithelial cells of nuclear cataract, posterior subcapsular cataract, mature cataract, and mixed cataract. Of these, mature cataractous lens epithelium showed maximum activity for acid phosphatase (516.83 moles of p-nitrophenol released/g lens epithelium) and maximum levels of lipid peroxidation (86.29 O.D./min/g lens epithelium). In contrast, mixed cataractous lens epithelium showed minimum activity of acid phosphatase (222.61 moles of p-nitrophenol released/g lens epithelium) and minimum levels of lipid peroxidation (54.23 O.D./min/g lens epithelium). From our study, we correlated the maximum activity of acid phosphatase in mature cataractous lens epithelium with the increased areas of superimposed cells associated with the formation of mature cataract. Likewise, the maximum levels of lipid peroxidation in mature cataractous lens epithelium was correlated with increased permeability of the plasma membrane. Conversely, the minimum levels of lipid peroxidation in mixed cataractous lens epithelium makes us presume that factors other than lipid peroxidation may also account for the formation of mixed type of cataract.

Do umbilical vein catheterization and sepsis lead to portal vein thrombosis? A prospective, clinical, and sonographic evaluation

Extrahepatic portal vein obstruction (EHPVO) affects 20-30% of all patients with portal hypertension in India. The etiopathogenesis of this disease is unknown. In retrospective studies, umbilical vein cannulation and sepsis have been alleged to cause portal thrombosis. This prospective study was undertaken to detect clinically and by serial sonography whether thrombosis and consequent obstruction of the splenoportal venous system develops after umbilical vein catheterization and sepsis. Forty-seven children who had undergone exchange transfusion for hyperbilirubinemia, belonging to two different age groups, were studied. Twenty-two new-borns (Group A) were studied within 4 weeks of birth and later at 3-month intervals until the age of 12 months and subsequently at 24 months. Another group of 25 children (Group B), 1- to 5-year-olds who had earlier undergone exchange transfusion and 15 healthy newborns (Group C) were also screened. In Group A, seven (29%) neonates had septicemia, and in five, the splenic vein could not be initially visualized. The splenic vein was not seen in five of the 15 newborns in Group A who had no umbilical sepsis. Twenty-one of the 22 neonates in Group A were followed-up, and the splenic vein was well visualized and found patent on subsequent ultrasound in all of them. In Group B, four (16%) children had umbilical sepsis. None of these or the other Group B children showed any thrombosis or obstruction of the splenoportal system. The portal vein and its branches and the splenic vein were visualized in all healthy (Group C) neonates.(ABSTRACT TRUNCATED AT 250 WORDS)

Role of transfusion-mediated viral infections on the lymphocyte subset profile in multi-transfused children

A total of 74 multitransfused (MT) children of beta thalassaemia major were analysed for prevalent viral markers transmitted through transfusion. A higher incidence of serological markers for Hepatitis B virus (HBV), cytomegalovirus (CMV) could be observed in the group of MT children compared to control group. There was a significant trend (chi 2 = 33.4; P < 0.001) in the increase in prevalence of viral markers along with the increase in the number of transfusions. MT children receiving more than 50 transfusions were found to have evidence for at least one or multiple viral infections transmitted through blood. Children receiving more than 50 transfusions were characterized by marked alteration of T3, T8, and B cells while T4/T8 ratio was found to be significantly decreased (P < 0.001) only in the group of children receiving more than 100 transfusions. Relative assessment of the alteration of lymphocyte subsets in various groups of viral infection showed that cases with CMV IgM to have more marked influence on the alteration of T8 cells, T4/T8 ratio, and B cells compared to other groups of viral infections. Reassessment of the lymphocyte subset profile in MT children in the light of CMV IgM positive cases revealed that in children receiving more than 50 transfusions significant alterations of lymphocyte subjects were influenced by the presence of CMV IgM positive cases in these groups. Our study points out that the correlation between the alteration of lymphocyte subset profile and number of transfusion in MT children need to be reassessed in the light of acute CMV infection in the form of CMV IgM.

Histopathologic correlates of structures seen on dermoscopy (epiluminescence microscopy)

Dermoscopy (epiluminescence microscopy) is an in vivo technique that enables the clinician to visualize a variety of structures in pigmented cutaneous lesions that are not discernible by naked-eye examination. To identify the histologic correlates of these structures, a series of 71 pigmented neoplasms was documented photographically with and without dermoscopy. These lesions then underwent total excision and careful step-sectioning so that the resulting histologic slides could be correlated with the dermoscopic photographs. The histologic correlates of the pigment network, brown globules, black dots, blotches, hypopigmented areas, white areas, grey-blue areas, and whitish veil are identified. The structures seen under dermoscopy have specific histologic correlates. Understanding these histopathologic correlates will allow clinicians to better evaluate the dermoscopic features of pigmented lesions.

Diagnostic value of maternal serum alpha fetoprotein for predicting pregnancy outcome in high risk pregnancies: an epidemiological perspective

This study was conducted on high risk pregnancies, between 6-40 weeks of gestation, to evaluate the difference in maternal serum alphafetoprotein (MSAFP) levels in normal and abnormal pregnancies. It's predictive value for pregnancy outcome was calculated. Age and parity matched, normal pregnant women with normal pregnancy outcome were taken as controls. It was determined that the overall sensitivity (75.6%) and specificity (83.7%) was not very good for diagnostic purposes. On the contrary in patients with neural tube defects, congenital anomalies, early pregnancy complications leading to fetal death, still birth, neonatal deaths, Rh incompatibility and preterm deliveries the specificity was (96%-100%), due to very few false positives but sensitivity was comparatively low (75%-89%) due to many false negatives. As a result the predictive value of a negative test in these conditions was very high (80%-100%), though that of a positive test was comparatively low (60%-89%). This establishes a diagnostic value of MSAFP, especially in high risk pregnancies as opposed to its use as a screening test for all pregnancies. This is of special value for a poor country like India, where it is not possible to screen total pregnant population due to economic and logistic reasons.

Usefulness of immunoperoxidase test for serodiagnosis of genital chlamydial infections

An immunoperoxidase test detecting Chlamydia trachomatis specific serum IgG and IgA antibodies, was carried out to determine its efficacy in establishing chlamydial etiology in 104 clinically diagnosed patients attending a major STD Clinic in Delhi. The patients consisted of 58 with nonspecific urethritis/cervicitis (NSU/NSC), 11 with pelvic inflammatory disease (PID), 23 with primary infertility in either male or female and 12 with lymphogranuloma venereum (LGV). IgG antibodies were tested at a dilution of 1:64 and 1:128 and IgA antibodies at 1:16. Although 27.7 per cent (5 of 18) of the controls had IgG antibodies (> or = 1:128), none had IgA, showing the IgA marker as 100 per cent specific. In 80.8 per cent of all the patients, active infection was detected, 81.0 per cent in NSU/NSC, 81.8 per cent in PID, 76.9 per cent in female infertility, 80 per cent in male infertility and 83.3 per cent in LGV patients. The immunoperoxidase test was found to be an extremely simple and rapid test especially suited for laboratories where facilities are limited.

Risk of another basal cell carcinoma developing after treatment of a basal cell carcinoma

BACKGROUND

There is an increased risk of new basal cell carcinomas (BCCs) developing in a person who has had a BCC.

OBJECTIVE

This study attempts to define the magnitude of this increased risk.

METHODS

The charts of 260 white patients with a histologically proven BCC were reviewed for the occurrence of new BCCs. The cumulative 5-year incidence (modified life-table method) for new BCCs developing in these patients was compared with the 5-year incidence in the general white population of the United States.

RESULTS

Of the 260 patients, new BCCs developed in 137 within an average of 38.3 months, a 5-year cumulative rate of one or more new BCCs of 45.2%. The yearly risk for new BCCs developing in the study population remained high during the 5-year interval. In the general white population of the United States, the maximal 5-year incidence was calculated to be 5% (p < 0.005, chi-square test).

CONCLUSION

Patients with a history of BCC require life-long follow-up because of the high probability of new BCCs developing.

Determining stability of proteins from guanidinium chloride transition curves

The guanidinium chloride (GdmCl) denaturation of RNAase A, lysozyme and metmyoglobin was investigated at several pH values by using absorbance measurements at 287, 300 and 409 nm respectively. From these measurements the free-energy change on denaturation, delta Gapp., was calculated, assuming a two-state mechanism, and values of delta Gapp. at zero concentration of the denaturant were measured. For each protein all delta Gapp. values were adjusted to pH 7.00 by using the appropriate relationship between delta Gapp. and pH. Dependence of the adjusted delta Gapp. value on GdmCl concentration increases for metmyoglobin and decreases for the other two proteins as the denaturant concentration decreases. It has been shown that these are expected results if the presence of the acid-denatured state during the GdmCl denaturation of proteins is considered.

Evolution of B-cell lymphoma from pseudolymphoma. A multidisciplinary approach using histology, immunohistochemistry, and Southern blot analysis

Cutaneous B-cell lymphomas are rare neoplasms that can present as lesions involving solely the skin or develop in association with a systemic lymphoma. Histologically they are often difficult to differentiate from pseudolymphomas, and the use of immunohistochemistry may be necessary to correctly classify them. We report a study of multiple skin lesions in a patient who initially presented with multiple pseudolymphomas, apparently associated with an immune response to the dye of his tattoos. Over a period of 4 years his skin lesions evolved from histologically benign and immunologically polyclonal pseudolymphomas to a histologically malignant and immunologically monoclonal B-cell large cell lymphoma. Genotypic analysis with a probe for the heavy-chain immunoglobulin gene demonstrated the presence of clonal B-cell populations in all of the pseudolymphoma biopsy samples as well as in the subsequent lymphoma tissue samples, with a pattern of clonal bands suggestive of evolution of the B-cell clones. These findings suggest that the development of B-cell lymphoma in this patient was related to a persistent abnormal immune response to the chronic antigenic stimulus of the dye of the tattoo. The presence of clonal B-cell populations in pseudolymphoma by Southern blot analysis may be useful in predicting those patients who will subsequently develop overt lymphoma.

Cholesterol and lipid peroxidation in 3 beta-(2-diethylaminoethoxy)- androst-5-en-17-oneHCl (U18666A) induced cataractogenesis in rats

Decrease in cholesterol was observed in precataractous, cataractous, advance nuclear cataractous and non-cataractous lenses when 3 beta-(2-diethylaminoethoxy)-androst-5-en-17- oneHCl (U18666A) was injected, sc, to rats. Significant increase in lipid peroxidation was observed before the onset of any apparent lenticular opacity in U18666A treated rats. The results suggest that decrease in cholesterol is capable of altering the structural integrity of lens fibers. However, 12.5% decrease in cholesterol and 5% increase in lipid peroxidation observed in non-cataractous lenses indicated that these changes are not sufficient for any apparent opacification.

Puerperal tetanus

Fifty cases of puerperal tetanus were studied. It constituted 6.66% of total cases of tetanus with overall mortality of 52% which was higher in cases with incubation period of 14 days or less, period of onset 48 hours or less, higher grades, cases with temperature more than 37.7 degrees C and patients with respiratory complications. Significantly higher mortality rate after 48 hours signifies the need of effective local control of infection to improve prognosis. Prevention, early detection and prompt treatment of respiratory complications which is the main cause of death may further reduce mortality rate in these patients.

Lens epithelial cell density and histomorphological study in cataractous lenses

Human epithelial cell density was determined from flat preparation of 195 cataractous lenses from 108 males and 87 females between 30 and 80 years of age. The mature cataracts had significantly lower cell counts than the other cataracts. Cell density was significantly higher in the females than in the males. Morphohistological study of the epithelia was focused on the following cataract types: (1) nuclear, (2) posterior subcapsular, (3) mature, (4) mixed, (5) hypermature, and (6) black. The major cataractous changes in all types involved vacuolization of the cytoplasm. The mature types of cataractous epithelia showed 56% superimposed cells; the epithelia in nuclear, posterior subcapsular, and black cataracts showed between 6% and 16%. In the hypermature cataracts, four of five tissues analyzed showed superimposed cells. The superimposed areas are probably the source of increased and altered cell activity. We propose that the metaplastic processes leading to posterior capsular opacification originate from these areas. The majority of nuclear and black cataracts were almost similar to the normal human lens epithelium with more or less uniform distribution of cells. Nucleus shrinkage (5 microns) was more evident in nuclear cataracts; in subcapsular cataracts most of the nuclei were large (average 9 microns diameter). Variation in morphological changes like vacuolization of cytoplasm and nuclei, pyknotic nuclei, and superimposed cells was more evident in the mixed type of cataracts.

Selenium and diabetes in the tropics

We have examined the possibility that selenium deficiency may underlie one or more of the following peculiarities of chronic pancreatitis in tropical as compared to temperate zones: much higher prevalence, propensity for pancreatic calculi, and high frequency of diabetes. Selenium was measured by graphite furnace atomic absorption spectrometry in sera from 20 healthy volunteers, 36 patients with chronic pancreatitis (calcific 35, diabetic 32), and 23 patients with primary forms of diabetes, from Madras, South India; results were compared with data from 41 controls and 37 patients with chronic pancreatitis (calcific 13, diabetes 8) from Manchester, North West, England. We conclude that (a) bioavailability of selenium is equally high in each geographic area; (b) decrement in serum selenium (p less than 0.001) is of a similar order in Manchester and Madras patients, which denies a connection with calculi formation or pancreatic exocrine failure (since the incidence of these two problems was substantially higher in the Madras series); and (c) selenium levels do not account for accelerated course to diabetes in tropical chronic pancreatitis.

Role of proteins and cholesterol in human senile cataractogenesis

Cataracts are a major cause of blindness in man with far reaching personal, social and economic consequences. The clarity of the lens is dependent upon the maintenance of the integrity of the fiber cell plasma membrane whose important component is cholesterol. In the present study, we have demonstrated that cataract formation influences the cholesterol and protein distribution within the lens.

A stress wave propagation technique for bone repair study

The diagnosis of bone fracture and its rate of healing still remains a problem among orthopedic surgeons. An acoustic technique based on stress-wave propagation is developed. The technique is used on laboratory experimental in vitro bones, as well as on in vivo (human) bones, to diagnose a fracture. The rate of healing of the fracture is also studied. The technique developed is quick, economical, reliable, portable, and safe for both the patient and the operator.

Identification of a region of UDP-galactose:N-acetylglucosamine beta 4-galactosyltransferase involved in UDP-galactose binding by differential labeling

The location of regions in the primary structure of UDP-galactose:N-acetylglucosamine beta 4-galactosyl-transferase (GT) that are involved in binding UDP-galactose has been investigated by differential chemical modification with two different reagents in the presence and absence of UDP-galactose. Treatment with periodate-cleaved UDP and NaCNBH3 resulted in a loss of 80% of GT activity, which was largely prevented by UDP-galactose. Stoichiometry of labeling and peptide maps of the modified enzyme samples indicated partial labeling at many sites. A major site of reaction in the absence of UDP-galactose that was essentially unmodified in its presence was found to correspond to Lys341 in the cDNA sequence of GT. As a second approach, the reactivities of the amino groups of GT were compared in the presence and absence of saturating levels of UDP-galactose by trace acetylation with [3H]acetic anhydride. UDP-galactose binding was found to perturb the reactivities of a number of lysines in the C-terminal region of GT, the most pronounced effect being a reduction in the reactivity of Lys351. The two procedures thus identified a region between residues 341 and 351 as being associated with UDP-galactose binding. This region overlaps a small section in the sequence of GT that was previously noted to be similar to part of bovine alpha-1,3-galactosyltransferase (Joziasse, D. H., Shaper, J. H., Van den Eijnden, D. H., Van Tunen, A. J., and Shaper, N. L. (1989) J. Biol. Chem. 264, 14290-14297). Sequence comparisons indicate that extended regions at the C terminus of each enzyme encompassing this area may represent homologous UDP-galactose-binding domains.

Circulating iso and auto antibodies to human spermatozoa in infertility

Blood samples from 50 couples of unexplained primary infertility and 25 healthy fertile couples were tested for antispermatozoa antibodies (ASA) by gelatin agglutination test and sperm immobilising complement dependent cytotoxicity test. The incidence of sperm agglutinating and sperm immobilising antibodies was found to be 14 per cent and 10 per cent respectively in infertile couples. Agglutinating antibodies were detected in 18 per cent males and 16 per cent of females while cytotoxic antibodies were found in 14 per cent males and 10 per cent of females. Only 4 per cent of the normal fertile couples taken as a control group showed positive ASA, hence the difference in incidence of positive ASA between the infertile and fertile couples was found to be statistically significant. Also, the agglutination test was observed to be more sensitive than the cytotoxicity test.

Respiratory complication in tetanus

Six hundred cases of tetanus were studied to find out incidence of respiratory complications and to evaluate factors predisposing such complications in tetanus. The incidence of complications was 41 per cent. Infants, patients of more than 40 years of age, smokers, cases with grossly contaminated injuries, short incubation period and short period of onset were more vulnerable. Patients with dysphagia, spasm, associated respiratory diseases and the patients in higher grades were also found to be more susceptible to respiratory complications.

Role of natural frequency of bone as a guide for detection of bone fracture healing

The natural frequency of bone is studied in normal and fractured bones, in vitro as well as in vivo, by recording the outputs of microphone pick-ups, attached at proximal and distal ends to the bone defect. Natural frequency of bone is determined for an optimum output displayed on a cathode ray oscilloscope with respect to different stress wave frequencies. A comparative study of normal and fractured bone in vivo in 25 patients was made to diagnose the size of the fracture and its rate of healing. The natural frequency and intensity of sound in the injured bone was reduced while the output voltage increased with respect to the normal bone. The investigation reports a simple, reliable and rapid technique for the assessment of bone fracture.

Single-eyed infantile esotropia-abductional nystagmus syndrome (unilateral convergent squint following enucleation)

Three infants underwent enucleation of one eye for different indications. This was followed by the development of esotropia of varying degree within one to four months in all the three cases, and was associated with a coarse nystagmus present in abduction, but absent in the primary and adducted positions of gaze. There was a face turn to the side of remaining eye. This appears to be a separate clinical entity and not early onset esotropia. Possible mechanisms and medicolegal implications are discussed.

Oral manifestations associated with human immunodeficiency virus infection in 200 Indian patients

Objective: To determine the pattern and prevalence of oral lesions in HIV infected 200 costal Andhra Pradesh patients. Patients and methods: the study population comprised 200 consecutive HIV seropositive patients presented to regional ART center at Andhra Pradesh, India. The oral lesions were diagnosed based on clinical appearance and were entered in to the database for analysis. Results: 30-39 yrs age group was most commonly affected and 87% of the patients had acquired infection via heterosexual contact. Oral lesions were seen in 66% of the patients. Gingivitis (36.7% males & 33.9% females) was the most common lesion followed by candidiasis (21% males & 26.4% females), periodontitis (6.8% males & 7.5% females), pigmentation (36.7% males & 33.9% females), ulcers (2.7% males & 0% females) and leukoplakia (1.3% males & 0% females). Conclusion: The pattern of oral lesions associated with HIV infection was not markedly different form those reported in the literature, the prevalence of each type of lesion differ slightly. Key words: CD4 lymphocyte count; Female; HIV infections; Male; Humans.DOI: 10.3329/bjms.v9i3.6470Bangladesh Journal of Medical Science Vol.09 No.3 July 2010, pp.150-153

Study of acute encephalitis syndrome in children

Objective: To determine the profile and outcome of children admitted with Acute Encephalitis Syndrome (AES) and to find out the prevalence of Japanese Encephalitis (JE) IgM antibodies positive cases among these patients with their case fatality rate (CFR). Materials and methods: Study consist of retrospective analysis of hospital records of children up to 15 years of age admitted with diagnosis of AES in pediatric wards of College of Medical Sciences-Teaching Hospital, Bharatpur from January 2007 to December 2008. Results: During two years, 61 patients of AES were admitted. Male and female patients were 33 and 28 respectively. Meningitis accounted for 29 and encephalitis for 32 patients. JE IgM seropositive cases contributed for 18% of all AES cases. Case fatality for JE was 16.6%. Conclusions: Japanese Encephalitis is endemic in catchment area of the hospital. JE has significant morbidity and mortality which can be prevented by immunization and mortality can be reduced if supportive interventions are provided in time. Key words: AES; JE; CFR. DOI: 10.3126/jcmsn.v6i1.3596 Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 1, 7-13