The current status of thermal ablation in the management of T1b renal masses.

The role of thermal ablation in the management of T1b renal masses is not well defined. The purpose of this review is to examine current evidence for cryoablation, radiofrequency ablation, and microwave ablation of T1b renal masses as well as review current AUA and EAU guidelines for thermal ablation of T1b masses. Given the size of these tumors, adjunctive maneuvers are often necessary to ensure patient safety and protect vital adjacent structures.

Determination of role of ceruloplasmin in oral potentially malignant disorders and oral malignancy-A cross-sectional study.

OBJECTIVES: In the process of carcinogenesis, lipid peroxidation and increased oxidative stress lead to changes in certain antioxidants. This study was aimed to assess and co-relate serum levels of ceruloplasmin in oral premalignancies and oral cancer so as to gauge its possible association with the process of carcinogenesis and to determine its role as tumor marker. MATERIAL AND METHODS: The study population comprised of 300 participants, equally divided into six study groups, that is, oral submucous fibrosis (OSMF), oral leukoplakia (OL), nicotina stomatitis (NS), oral malignancy (OM), controls (C), and healthy controls (HC); 5 ml of blood was collected from ante cubital vein from each participant. The serum was analyzed for ceruloplasmin levels using ERBA CHEM 5 PLUS semiautomated chemistry analyzer and diagnostic kit by turbidimetric immunoassay. RESULTS: There were total 242 males and 58 females, who were between 18 and 82 years of age, with a mean of 45.31 ± 13.97 years. The serum ceruloplasmin levels were significantly increased in OM, OSMF, OL, and NS groups as compared to C and HC groups (p < .001). No statistically significant difference was found in intragroup analysis of the disease groups (p > .05). CONCLUSION: Serum ceruloplasmin can be used as diagnostic marker for oral premalignant and malignant lesions.

Magnetic resonance imaging of an equine fracture model containing stainless steel metal implants.

REASONS FOR PERFORMING STUDY: Post operative imaging in subjects with orthopaedic implants is challenging across all modalities. Magnetic resonance imaging (MRI) is preferred to assess human post operative musculoskeletal complications, as soft tissue and bones are evaluated without using ionising radiation. However, with conventional MRI pulse sequences, metal creates susceptibility artefact that distorts anatomy. Assessment of the post operative equine patient is arguably more challenging due to the volume of metal present, and MRI is often not performed in horses with implants. Novel pulse sequences such as multiacquisition variable resonance image combination (MAVRIC) now provide improved visibility in the vicinity of surgical-grade implants and offer an option for imaging horses with metal implants. OBJECTIVES: To compare conspicuity of regional anatomy in an equine fracture-repair model using MAVRIC, narrow receiver bandwidth (NBW) fast spin echo (FSE), and wide receiver bandwidth (WBW) FSE sequences. STUDY DESIGN: Nonrandomised in vitro experiment. METHODS: MAVRIC, NBW FSE and WBW FSE were performed on 9 cadaveric distal limbs with fractures and stainless steel implants in the third metacarpal bone and proximal phalanx. Objective measures of artefact reduction were performed by calculating the total artefact area in each transverse image as a percentage of the total anatomic area. The number of transverse images in which fracture lines were visible was tabulated for each sequence. Regional soft tissue conspicuity was assessed subjectively. RESULTS: Overall anatomic delineation was improved using MAVRIC compared with NBW FSE; delineation of structures closest to the metal implants was improved using MAVRIC compared with WBW FSE and NBW FSE. Total artefact area was the highest for NBW FSE and lowest for MAVRIC; the total number of transverse slices with a visible fracture line was highest in MAVRIC and lowest in NBW FSE. CONCLUSION: MAVRIC and WBW FSE are feasible additions to minimise artefact around implants.

Fatal 'Bhang' poisoning.

A young adult male of about 25 years of age consumed a glass (about 300 ml) of Bhang on the holy occasion of ShivRatri. The deceased died within 24 hours of consuming the Bhang. The deceased had suffered from rheumatic heart disease with multiple valvular involvements. He had also undergone open-heart surgery in the past. Fatality due to Bhang is extremely rare and therefore the case is presented. An attempt is made to review the literature. Bhang is one of the Indian preparations of Indian hemp (Cannabis sativa). It is prepared by the wet grinding of the leaves of the plant. The bolus is then consumed in various ways. Water is used as a vehicle. In the present case a bolus of about 1 to 2 gm was mixed in a glass of water. ShivRatri is a Hindu festival. On this day prayers are offered to Lord Shiva, who is the god of all evils and poisons. Bhang is a special article, which is offered to Lord Shiva on this auspicious day. Then, the devotees consume it as the God. Gujrat is a dry state (possession, consumption, sale, etc. of alcohol, Bhang, opium and other psychotropic substance, etc. is governed by particular laws), but on the holy occasion of ShivRati, for a day, the law is relaxed for the use of Bhang. In most other parts of the country, particularly, in northern India, it is a common practice to consume various preparations of Indian hemp like Bhang, Charas, Ganja, sweetmeat, etc. The bolus mentioned above is probably the minimum single dose.

Trichomonas vaginalis: analysis of a heat-inducible member of the cytosolic heat-shock-protein 70 multigene family.

A 2253-nucleotide (nt) transcript for a Trichomonas vaginalis heat-shock protein 70, TVCHSP70, has been isolated that encodes for a protein of 659 amino acids with a predicted molecular weight of 71.3 kDa. TVCHSP70 has a short (10-nt) 5' untranslated region (UTR), and the 263-nt 3' UTR is the longest reported for a Trichomonas peptide. Amino-acid sequence analysis and phylogenetic comparison identifies TVCHSP70 as a member of the heat-inducible cytoplasmic HSP70 gene family. Southern-blot data indicate that T. vaginalis contains at least four members of the cytoplasmic HSP70 gene family. Members of the TVCHSP70 family are expressed as 2.3-kb transcripts at low levels during 37 degrees C culture, and their expression is significantly up-regulated at 43 degrees C. Slot-blot analysis of seven T. vaginalis clinical isolates demonstrated a 3- to 44-fold up-regulation of TVCHSP70 under conditions of heat shock (43 degrees C) or oxidative stress (500 microm H2O2) as compared with controls (37 degrees C).

Antigenicity of Trichomonas vaginalis heat-shock proteins in human infections.

Patients infected with Trichomonas vaginalis mount humoral and cellular immune responses that often do not protect against reinfection. The oxidative stressors produced by leukocytes may trigger a heat-shock-like response in T. vaginalis trophozoites, helping the parasite to survive host immune defenses. The antigenicity of T. vaginalis heat-shock proteins (HSPs) was examined by immunoprecipitation of T. vaginalis heat-induced proteins with sera from infected patients and controls. When T. vaginalis was heat-shocked, HSPs of 169-167 and 140-137 kDa were specifically recognized by sera from infected male and female patients. However, the majority of T. vaginalis HSPs were also immunoprecipitated by control sera; all sera recognized 72- to 71-kDa, 47- to 45-kDa, 38- to 37-kDa, 35-kDa, and 31-kDa heat-induced proteins. At least 15 proteins from non-heat-shocked T. vaginalis were immunoprecipitated by sera from infected patients and controls, indicating that natural or cross-reacting antibodies could participate in host responses to trichomoniasis. Molecules of 158, 135, 89, and 74-72 kDa were immunoprecipitated from some non-heat-shocked parasites only by patients' sera. A 38-kDa T. vaginalis protein was immunoprecipitated only by sera from infected females and may be specific for infection in women.

Molecular typing of Trichomonas vaginalis isolates by HSP70 restriction fragment length polymorphism.

Subtyping isolates of Trichomonas vaginalis is an essential tool for understanding the epidemiology of this common sexually-transmitted disease. Restriction fragment length polymorphism (RFLP) analysis employing a probe from the heat-inducible cytoplasmic HSP70 gene family hybridized with EcoR I-digested genomic DNA was used in the molecular typing of Trichomonas isolates. Analysis of five American Type Culture Collection (ATCC) reference strains and 31 Jackson, Mississippi, isolates from six male and 21 female patients, revealed 10 distinct RFLP pattern subtypes of Trichomonas. The subtypes were temporally stable and cosmopolitan. The RFLP profiles seen in Maryland, Ohio, Massachusetts, and New York ATCC strains were identical to those of some Mississippi isolates, even though the samples were isolated 10-35 years apart. There was no correlation between metronidazole resistance and RFLP subtype with resistant isolates from eight patients distributed among six different subtypes.

Use of intravaginal microbicides to prevent acquisition of Trichomonas vaginalis infection in Lactobacillus-pretreated, estrogenized young mice.

D2A21, a novel peptide antibiotic has in vitro activity against a wide spectrum of sexually transmitted diseases (STD). In this study we tested the hypothesis that intravaginal D2A21 would interfere with acquisition of Trichomonas vaginalis infection in a modified mouse model. T. vaginalis infections of estrogenized young mice pretreated with Lactobacillus vaginalis or Lactobacillus rhamnosus were more frequent and persistent than those in mice pre-treated with Lactobacillus gasseri or Lactobacillus acidophilus. One hundred percent T. vaginalis infection was achieved for 2-4 days post-challenge when intravaginal L. rhamnosus pre-treatments were given to estrogenized mice 48 hr prior to a single T. vaginalis challenge. Estrogenized mice pre-treated with L. rhamnosus were pre-medicated with intravaginal placebo gel, 0.5% or 2% D2A21 gel, or 500 microg/mL metronidazole gel prior to T. vaginalis challenge. Both 2% D2A21 and metronidazole gels were significantly more efficacious (10% or none infected) than placebo gel (53% infected) in preventing vaginal T. vaginalis infections in mice.

Genomic organization, transcription, splicing and gene regulation in Leishmania.

The parasitic protozoan Leishmania is the aetiological agent of a spectrum of clinical diseases, ranging from disfiguring skin lesions to life-threatening visceral infection, and is a serious health problem in tropical and subtropical areas world-wide. Leishmania parasites undergo a dramatic transformation as they move between the different environments of an extracellular insect stage and an intracellular form in the vertebrate host. In an attempt to develop new strategies for the treatment of leishmaniasis, the techniques of molecular genetics have been utilised to elucidate the mechanisms which direct and control this cyclical differentiation. This review discusses current knowledge concerning the organization and regulation of the Leishmania nuclear genome and includes a discussion of chromosomal organization, genomic arrangement, transcription, transcript processing by trans-splicing and polyadenylation, and post-transcriptional regulation. The salient features as well as the supporting evidence for each topic are briefly reviewed.

Treatment of protracted diarrhea of infancy.

Ten patients with protracted diarrhea of infancy received either 8% or 16% of 130 calories/kg/day as amino acids. Patients were treated initially with total parenteral nutrition (TPN) and subsequently with an elemental diet. Nitrogen balance was better during TPN in those who received the higher amino acid intake. No differences were noted between groups in weight gain or restoration of muscle mass. Higher levels of serum urea nitrogen and alkaline phosphatase were noted in patients with the higher amino acid intake; cholestatic liver injury developed in two of these patients. The patients receiving the higher amount of amino acid demonstrated enhanced calciuria during TPN. Other than better nitrogen balance, no clinical benefits and more undesirable side effects were observed in patients receiving 16% amino acid calories.