Recent Improvements in Adult Wilms Tumor Diagnosis and Management: Review of Literature.

Wilms tumor, also denoted as nephroblastoma, an embryonal type of renal cancer, is the most common cancer that affects children in the first 5 years of life. Wilms tumor is very rarely seen in adults. Both adults and children showcase varied clinical symptoms. The metastasis of tumor in both adults and children are not uncommon. Though histological differences between children and adults are insignificant, the prognosis of adult Wilms tumors compared to children is abysmal. Despite remarkable advancements in oncology, no standard treatment protocol exists for Wilms tumor in adults. Children Wilms tumor treatment protocol is currently followed for adults with some changes. In this article, we reviewed the available treatment options for Wilms tumor in adults and protocols followed widely.

High linoleic waste sunflower oil: A distinctive recycled source of self-healing agent for smart metal coatings.

High Linoleic Waste Sunflower Oil (HLWSO) is a new self-healing agent viable to be encapsulated. Meanwhile, the unique mechanism behind the synthesis of microcapsules is deeply illustrated; the emulsification process of HLWSO by anionic surfactant and microencapsulation of HLWSO. In addition, the application of microencapsulated HLWSO in the coating matrix by the layering method is presented followed by a detailed explanation of the self-healing mechanism of a smart coating incorporating the polymerization mechanism of HLWSO developed by the diene structure. Microencapsulation of high linoleic waste sunflower oil (HLWSO) is a wall formation process in which urea-formaldehyde (UF) is attached with emulsified HLWSO to form a microcapsule. In this study, the HLWSO from recycled cooking oil is uniquely bonded with a diene structure, thus possessing the ability to dry fast and be encapsulated via the in-situ polymerization method. The microencapsulated HLWSO was characterized using Field Emission Scanning Electron Microscopy (FESEM) and Fourier Transformation Infra-Red Spectroscopy (FTIR). The optimum microcapsules synthesized from HLWSO resulted in a smooth shell structure with 2.88 µm diameter microcapsules at 0.31 µm shell thickness and 66% core content. It was demonstrated that increased stirring speed decreases the size, shell thickness, and core content of the microcapsules. The FTIR results indicated that HLWSO as a core, while urea-formaldehyde acted as a shell of microcapsules. The scratch on the coating matrix embedded with HLWSO was healed after five days. The corrosion rate of optimum sample was 0.0574 mm/year, with an optimum reduction of 58% from the reference sample. This study revealed that the HLWSO from recycled sources is a viable self-healing agent to be microencapsulated. The smart coating embedded with HLWSO also displayed self-healing performance, reduced corrosion rate and beneficial for the advancement of corrosion control technology.

Self-sampling in Human Papillomavirus screening during and post-COVID-19 pandemic.

INTRODUCTION: Cervical cancer is the third most common cancer among Malaysian women. Sarawak, the largest state in Malaysia has consistently recorded the highest cervical cancer rate in the country where nearly half of its population still live in the rural areas and is at increased risk of the disease due to inequitable access to healthcare. The countrywide lockdown due to the COVID-19 pandemic had halted the accessibility to cervical cancer screening programme. The aim of the study is to determine the feasibility of providing primary HPV DNA test using the selfsampling method to the hard-to-reach population in the interior of Sarawak during the COVID-19 pandemic. MATERIALS AND METHODS: This is a cross-sectional study where women aged between 20-80 years were recruited via convenient sampling from villages in Long Banga, Sarawak over a five-day outreach programme. Cervicovaginal selfsamples were obtained and screened for the presence of high-risk human papillomavirus DNA (HR-HPV) using the careHPVTM Test. A self-administered questionnaire was also administered to determine the sociodemographic and perception towards the self-sampling method. RESULTS: The 55 women recruited consist of ethnic backgrounds of Penan (58.18%), Kenyah (25.45%), Iban (5.45%), Saban (3.64%), Kelabit (3.64%), Malay (1.82%) and Chinese (1.82%). The prevalence of HR-HPV was 1.85% (n=1/55). Nearly 80% of the women were unemployed, and more than half have had attended primary education. Nine (16.4%) have heard about HPV, and seven (13%) knew HPV infection could cause cervical cancer. Three of them had HPV vaccination, and only one (1.85%) knew the brand of the HPV vaccine. Although 40% preferred self-sampling over clinician-collection, only ten (18.2%) women have completed the self-collection perception questionnaire. CONCLUSION: Primary HPV DNA screening using the selfsampling method can be carried out in the remote areas during the COVID-19 pandemic without compromising mobility restriction.

Serum and milk concentrations of oxidant and anti-oxidant markers in dairy cows affected with bloody milk.

This study was conducted to determine the serum and milk levels of thiobarbturic acid-reac- tive substances (TBARS), nitric oxide (NO), superoxide dismutase (SOD), glutathione peroxi- dase (GSH-Px), vitamin E and selenium, IL-4 and IL-6 in lactating dairy cows affected with bloody milk using commercially available ELISA kits. Milk and whole blood samples were collected from 60 cows affected with bloody milk and 20 apparently healthy cows for control. In the serum, levels of GSH-Px and SOD were significantly (p˂0.05) higher in healthy cows compared to cows affected with bloody milk while the levels of TBARS and NO were significantly (p˂0.05) higher in affected cows. In the milk, levels of SOD, TBARS and NO were significantly (p˂0.05) higher in affected cows. In the serum, levels of vitamin E were significantly (p˂0.05) lower in affected cows compared to healthy cows, while no significant changes were observed in the levels of this vitamin in the milk between healthy and affected cows. In the serum, levels of selenium were significantly (p˂0.05) lower in affected cows while in milk, selenium levels were significantly (p˂0.05) higher in affected cows compared to healthy ones. Levels of IL-4 were significantly (p˂0.05) lower in the serum and milk of affected cows compared to healthy cows while levels of IL-6 were significantly (p˂0.05) higher in both serum and milk of affected cows. Results of this study suggest a possible role of oxidative stress in the pathogenesis of bloody milk in dairy cows.

Is Procalcitonin more superior to hs-CRP in the diagnosis of infection in diabetic foot ulcer?

INTRODUCTION: Procalcitonin (PCT) has recently emerged as a marker for diagnosing infection. This study aimed to compare the performance of PCT and other infection markers in diagnosing infected diabetic foot ulcer (IDFU). MATERIALS AND METHODS: A total of 128 diabetic patients with foot ulcers were recruited and divided into two groups, consisting of 73 patients in the IDFU group and 55 in the non-infected diabetic foot ulcer (NIDFU). The severity of infection in IDFU patients was graded based on the Infectious Disease Society of America-International Working Group on the Diabetic Foot classification. Blood samples from all the patients were collected for measurement of PCT, high sensitivity C-reactive protein (hs-CRP) and white cell count (WBC). The area under the receiver operating curves (AUC) were then constructed and analysed. RESULTS: PCT, hs-CRP and WBC levels were significantly higher in the IDFU group compared to NIDFU with hs-CRP demonstrated the highest AUC (0.91; p <0.001) followed by PCT (0.814; p < 0.001) and lastly WBC (0.775; p < 0.001). The best cut off value, sensitivity and specificity for the presence of infection in diabetic foot, were 3.47 mg/dL, 80% and 89% for hs-CRP, 0.11 ng/ml, 70% and 87% for PCT and 11.8x109/L, 60% and 90% for WBC. All the infection markers showed significant positive correlations with infection severity of DFU. CONCLUSION: This study showed that hs-CRP is a more sensitive marker for diagnosing IDFU. Although PCT is useful in differentiating IDFU from NIDFU, the use of PCT is not necessary as it adds little value to the current practice.

Cellulitis: An unusual manifestation of Neisseria meningitidis infection.

INTRODUCTION: Neisseria meningitidis infections often cause severe meningitis as well as bacteraemia. However, cellulitis in meningococcal diseases have rarely been described. Here, we report a case of right lower limb cellulitis caused by N. meningitidis. CASE REPORT: A 69-year-old woman presented with fever and lower limb swelling. She had diabetes mellitus, hypertension, dyslipidaemia and a history of surgical resection of vulvar carcinoma. N. meningitidis was isolated from her blood culture. DISCUSSION: This report provides additional evidence in support of N. meningitidis as a cause of cellulitis.

Establishing a multidisciplinary AIDS-associated Kaposi's sarcoma clinic: Patient characteristics, management and outcomes.

BACKGROUND: Kaposi's sarcoma (KS) typically occurs in the setting of immunodeficiency and specifically in the presence of HIV infection, when it is called AIDS-associated KS (AIDS-KS). In spite of impressive gains in the South African (SA) antiretroviral therapy (ART) roll-out programme since 2004, AIDS-KS still causes significant morbidity and mortality, and the treatment of advanced disease can be challenging owing to the centralisation of oncology services and the high incidence of concurrent infections. In 2014, a multidisciplinary AIDS-KS clinic (MKSC) was established at Tygerberg Hospital, Cape Town, with the goal of optimising management of AIDS-KS patients. OBJECTIVES: To report on the characteristics and outcomes of patients seen during the first 6 months after the inception of the MKSC. METHODS: A retrospective observational study was performed of all new cases referred to the MKSC from February to August 2014. RESULTS: Forty-two patients were included in the study. The median age was 34 years (range 20 - 60). Forty-one patients were on ART at time of diagnosis or were initiated by a median of 3 months after diagnosis. The median CD4+ count before diagnosis was 147 cells/µL (range 4 - 811). The HIV viral load was undetectable in 22 cases (52.4%). Thirty-eight patients (90.5%) were classified as AIDS Clinical Trials Group (ACTG) poor risk, 10 patients (23.8%) had visceral KS, 14 patients (33.3%) were on tuberculosis (TB) treatment at time of presentation, and 22 patients (52.4%) received oncological therapy in addition to ART. After median follow-up of 25.6 months, 2-year overall survival (OS) was 61.1%. On univariate analysis, factors significantly associated with poor 2-year OS included ACTG S1 stage (S = systemic illness), visceral KS, being on TB treatment, and Eastern Cooperative Oncology Group performance status score >2. In the T1 (T = tumour extent) subgroup, receiving chemotherapy was significantly associated with improved 2-year OS. CONCLUSIONS: Advanced AIDS-KS significantly affects young people in the Western Cape Province of SA despite 10 years of ART roll-out. There is a high prevalence of concomitant TB infection that could adversely affect adherence and response to treatment. Despite advanced disease at presentation and palliative treatment intent, survival outcomes are encouraging and seem to be positively affected by the increased use of chemotherapy. A multidisciplinary approach to diagnosis, staging and treatment and the exploration of prognostic indices specific to the sub-Saharan setting would be valuable in designing appropriate treatment algorithms.

Prevalence and Risk Factors of Dry Eye Symptoms in a Saudi Arabian Population.

BACKGROUND: The information about dry eye epidemiology in Saudi Arabia is few in literature. PURPOSE: To estimate the prevalence and identify determinants of dry eye symptoms (DES) in Al-Ahsa, Saudi Arabia. METHODS: Using a multi-stage proportionate sampling technique, Saudis of both genders from 6 urban and 4 rural Primary Health Care centers in Al-Ahsa were enrolled. They were interviewed to gather data on sociodemography, symptoms of dry eye, factors potentially related to dry eye, and chronic comorbidities. If one or more of DESs present often or constantly, we labeled the person with DES. RESULTS: We examined 1858 Saudi adults with mean age of 39.3 ± 14.1 years. The age-adjusted prevalence of DES was 32.1% (95% confidence interval [CI] = 30.0-34.3). Multivariate logistic regression analysis showed that female gender (adjusted odds ratio [aOR] = 2.1, 95% CI = 1.7-2.6), older age (>56 years; aOR = 1.5, 95% CI = 1.0-2.1), current smoking (aOR = 1.4, 95% CI = 1.1-1.8) and history of diabetes mellitus (aOR = 1.5, 95% CI = 1.2-2.0) were significantly associated with DES. Nonsignificant variables included residence (urban/rural); work status; wearing contact lenses; multivitamin use; caffeine use; history of trachoma, hypertension, bronchial asthma, coronary artery disease, thyroid disease, arthritis, hemolytic blood diseases (sickle cell-thalassemia), gout, and osteoporosis. CONCLUSION: DES are highly prevalent among the adult population of Al-Ahsa. Females, persons more than 55 years of age, smokers and diabetics were associated to DES.

Comparable down-regulation of TYR, TYRP1 and TYRP2 genes and inhibition of melanogenesis by tyrostat, tocotrienol-rich fraction and tocopherol in human skin melanocytes improves skin pigmentation.

BACKGROUND AND OBJECTIVE: Antioxidant has been recognized to inhibit UV-induced melanogenesis. This study aimed to elucidate the molecular mechanism of tyrostat, tocopherol and tocotrienol-rich fraction in inhibiting melanogenesis in human skin melanocytes. MATERIALS AND METHODS: Primary culture of melanocytes was exposed to repeated doses of 0.6 J/cm2 UVA for 6 days and treated with tyrostat, tocotrienol-rich fraction or tocopherol alone or in combination. RESULTS: UVA irradiation increased melanin content and tyrosinase activity and up-regulated TYR, TYRP1 and TYRP2 genes. Treatment with tyrostat, tocotrienol-rich fraction or tocopherol decreased melanin content and down-regulated TYR, TYRP1 and TYRP2 genes with decreased tyrosinase activity. Combined treatment exerted better effects as compared to treatment with single compound in decreasing the melanin content and down-regulating TYR, TYRP1 and TYRP2 genes. These findings indicated that tyrostat, tocotrienol-rich fraction and tocopherol inhibit melanogenesis by modulating the expression of genes involved in the regulation of melanin synthesis and inhibiting tyrosinase activity. CONCLUSIONS: Tyrostat, tocopherol and tocotrienol-rich fraction possessed anti-melanogenic properties and might be useful in improving skin pigmentation caused by UVA exposure.

Group B streptococcal bacteremia in a major teaching hospital in Malaysia: a case series of eighteen patients.

BACKGROUND: Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults. METHODS: We reviewed the hospital records of 18 cases with GBS bacteremia who attended the Universiti Kebangsaan Malaysia Medical Centre from June 2010 to October 2011. We analyzed the clinical findings of both bacteremic adults and neonates and compared them to previous studies of GBS bacteremia. Serotyping was done by latex agglutination test using 10 distinct antisera (Ia, Ib, and II-IX). RESULTS: During the period of 1 year and 4 months, there were 18 patients with GBS bacteremia. Five cases occurred in neonates, one in a parturient woman, and 12 in other adults. All neonates with bacteremia were males and two of them were premature. Septicemia was the most common clinical presentation in neonates. They were treated with intravenous (IV) penicillin G and gentamicin. The adults included nine men (69%) and four women (31%). Their mean age was 60 years and all patients had more than two underlying conditions. The most common clinical syndrome was pneumonia (n=6, 46.5%). The others were peritonitis (n=3, 23.1%), primary bacteremia (n=2, 15.5%), septic arthritis (n=2, 15.5%), skin and soft tissue infection (n=1, 7.7%), meningitis (n=1, 8%), urinary tract infection (n=1, 8%), and intravascular device infection (n=1, 7.7%). Cardiovascular diseases (n=7, 53.8%) were the most common underlying conditions, and diabetes mellitus (n=5, 38.5%) was second. The other co-morbid conditions were hyperlipidemia (n=3, 23.1%), renal disease (n=3, 23.1%), liver disease and/or alcohol abuse (n=3, 23.1%), autoimmune disease or immunosuppressive condition (n=2, 15.5%), malignancy (n=2, 15.5%), respiratory disease (n=1, 8%), and postpartum condition (n=1, 8%), as well as miscellaneous conditions including intravenous drug abuse, HIV infection, and trauma (n=2, 15.5%). Polymicrobial bacteremia was found in five (45.4%) cases and Staphylococcus aureus was the most common concurrent bacterial isolate. Of the 18 GBS isolates in both adults and neonates, serotype Ia was predominant (38.9%), followed by VI (27.8%), V (11.1%), and III (5.5%); the remaining 16.7% were non-typeable. CONCLUSIONS: GBS bacteremia is a significant problem and is associated with serious underlying disease, which may result in a high rate of mortality, not only in neonates and pregnant women, but also in non-pregnant adults.

A fluid mechanical explanation of the spontaneous reattachment of a previously detached Descemet membrane.

Descemet membrane detachment (DMD) is a rare but potentially serious surgical complication that arises most often during cataract surgery. A recent study (Couch, S. M. & Baratz, K. H. (2009) Cornea, 28, 1160-1163) cited the case of a patient with DMDs in both eyes, noting that though one detachment was surgically repaired, the other spontaneously reattached and needed no further treatment. A fluid mechanical model of buoyancy-driven aqueous humour flow in the anterior chamber around a DMD is developed to explain this phenomenon. The analytical model is based on the lubrication theory limit of the Navier-Stokes equations. The flow is determined for a fixed geometry and the possible motion of the DMD is then analysed. Numerical calculations are also carried out (using COMSOL© Multiphysics) to confirm the lubrication theory results. The analytical and numerical results both show that, under the correct conditions, either spontaneous reattachment or worsening of the tear may occur. We conclude that it is possible that clinical outcomes for DMDs may be controlled by adjusting the temperature difference across the eye and/or the orientation of the patient.

Cat's whiskers tea (Orthosiphon stamineus) extract inhibits growth of colon tumor in nude mice and angiogenesis in endothelial cells via suppressing VEGFR phosphorylation.

Cat's whiskers (Orthosiphon stamineus) is commonly used as Java tea to treat kidney stones including a variety of angiogenesis-dependent diseases such as tumorous edema, rheumatism, diabetic blindness, and obesity. In the present study, antitumor potential of standardized 50% ethanol extract of O. stamineus leaves (EOS) was evaluated against colorectal tumor in athymic mice and antiangiogenic efficacy of EOS was investigated in human umbilical vein endothelial cells (HUVEC). EOS at 100 mg/kg caused 47.62 ± 6.4% suppression in tumor growth, while at 200 mg/kg it caused 83.39 ± 4.1% tumor regression. Tumor histology revealed significant reduction in extent of vascularization. Enzyme-linked immunosorbent assay showed EOS (200 mg/kg) significantly reduced the vascular endothelial growth factor (VEGF) level in vitro (211 ± 0.26 pg/ml cell lysate) as well as in vivo (90.9 ± 2 pg/g tissue homogenate) when compared to the control (378 ± 5 and 135.5 ± 4 pg, respectively). However, EOS was found to be noncytotoxic to colon cancer and endothelial cells. In vitro, EOS significantly inhibited the migration and tube formation of human umbilical vein endothelial cells (HUVECs). EOS suppressed VEGF-induced phosphorylation of VEGF receptor-2 in HUVECs. High performance liquid chromatography (HPLC) analysis of EOS showed high rosmarinic acid contents, whereas phytochemical analysis revealed high protein and phenolic contents. These results demonstrated that the antitumor activity of EOS may be due to its VEGF-targeted antiangiogenicity.

Primary non-hodgkin B cell lymphoma in a man.

Malignant breast lymphoma is a rare condition and primary breast lymphoma is extremely rare in the male population. We present a case of a 26-year-old man (transgender) who presented with a large palpable mass in the right breast. This mass was rapidly growing in size associated with right axillary lymphadenopathy. Ultrasound and MRI findings were consistent with BIRADS IV lesion which was suspicious of malignancy. Core biopsy was performed and histopathology confirmed the diagnosis of primary non Hodgkin B cell lymphoma of the breast.

Cardiovascular activity of the n-butanol fraction of the methanol extract of Loranthus ferrugineus Roxb

We investigated the vascular responses and the blood pressure reducing effects of different fractions obtained from the methanol extract of Loranthus ferrugineus Roxb. (F. Loranthaceae). By means of solvent-solvent extraction, L. ferrugineus methanol extract (LFME) was successively fractionated with chloroform, ethyl acetate and n-butanol. The ability of these LFME fractions to relax vascular smooth muscle against phenylephrine (PE)- and KCl-induced contractions in isolated rat aortic rings was determined. In another set of experiments, LFME fractions were tested for blood pressure lowering activity in anesthetized adult male Sprague-Dawley rats (250-300 g, 14-18 weeks). The n-butanol fraction of LFME (NBF-LFME) produced a significant concentration-dependent inhibition of PE- and KCl-induced aortic ring contractions compared to other fractions. Moreover, NBF-LFME had a significantly higher relaxant effect against PE- than against high K+-induced contractions. In anesthetized Sprague-Dawley rats, NBF-LFME significantly lowered blood pressure in a dose-dependent manner and with a relatively longer duration of action compared to the other fractions. HPLC, UV and IR spectra suggested the presence of terpenoid constituents in both LFME and NBF-LFME. Accordingly, we conclude that NBF-LFME is the most potent fraction producing a concentration-dependent relaxation in vascular smooth muscle in vitro and a dose-dependent blood pressure lowering activity in vivo. The cardiovascular effects of NBF-LFME are most likely attributable to its terpenoid content.

In vitro biocompatibility of chitosan porous skin regenerating templates (PSRTs) using primary human skin keratinocytes.

Biopolymer chitosan (beta-1,4-d-glucosamine) comprises the copolymer mixture of N-acetylglucosamine and glucosamine. The natural biocompatibility and biodegradability of chitosan have recently highlighted its potential use for applications in wound management. Chemical and physical modifications of chitosan influence its biocompatibility and biodegradability, but it is unknown as to what degree. Hence, the biocompatibility of the chitosan porous skin regenerating templates (PSRT 82, 87 and 108) was determined using an in vitro toxicology model at the cellular and molecular level on primary normal human epidermal keratinocytes (pNHEK). Cytocompatibility was accessed by using a 3-[4,5-dimethyl-2-thiazolyl]-2,5-diphenyl tetrazolium bromide (MTT) assay from 24 to 72h. To assess the genotoxicity of the PSRTs, DNA damage to the pNHEK was evaluated by using the Comet assay following direct contact with the various PSRTs. Furthermore, the skin pro-inflammatory cytokines TNF-alpha and IL-8 were examined to evaluate the tendency of the PSRTs to provoke inflammatory responses. All PSRTs were found to be cytocompatible, but only PSRT 108 was capable of stimulating cell proliferation. While all of the PSRTs showed some DNA damage, PSRT 108 showed the least DNA damage followed by PSRT 87 and 82. PSRT 87 and 82 induced a higher secretion of TNF-alpha and IL-8 in the pNHEK cultures than did PSRT 108. Hence, based on our experiments, PSRT 108 is the most biocompatible wound dressing of the three tested.

Antioxidant, anti-TB activities, phenolic and amide contents of standardised extracts of Piper sarmentosum Roxb.

Ethanol and aqueous extracts of the different parts of Piper sarmentosum were analysed by HPLC for marker compounds to standardise these extracts. The standardised extracts were investigated for antioxidant activity (beta-carotene linoleate model and DPPH model), anti-TB activity (microplate tetrazolium assay), and estimation of total phenolic and amide contents. The extracts of the different parts exhibited different antioxidant activity, phenolic and amide contents (p < 0.01). The ethanol extracts exhibited better antioxidant activity as compared to the aqueous extracts. The leaf ethanol extract was further investigated for dose response relationship and its EC(50) was found to be 38 microg mL(-1). All the extracts have exhibited anti-TB activity with MIC/MBC 12.5 microg mL(-1). The leaf methanol extract was fractionated and the ethyl acetate fraction exhibited anti-TB activity with MIC/MBC 3.12 microg mL(-1) while MIC/MBC of isoniazid (INH) was found to be 0.5 microg mL(-1). A positive correlation was found between antioxidant activity and total polyphenols, flavonoids and amides, in the beta-carotene linoleate model (p = 0.05) and in the DPPH model (p = 0.01). The analytical method was found to have linearity >0.9922, coefficient of variance <5% and accuracy 95.5 +/- 5 to 96.9 +/- 5. This plant possesses promising antioxidant as well as anti-TB properties.

Cytologic analysis of synovial fluid in clinically normal tarsal joints of young camels (Camelus dromedarius).

BACKGROUND: Camels are important in the racing industry and for milk, meat, and hair production in the Middle East. Evaluation of synovial fluid is an important part of the assessment of musculoskeletal injuries in this species. Information in the literature regarding synovial fluid in camels is limited. OBJECTIVES: The objective of this study was to determine the protein and cellular composition of synovial fluid from the tarsal joints of clinically normal, young camels (Camelus dromedarius). METHODS: Thirty clinically healthy, male camels, aged 9 to 12 months, were used in the study. Synovial fluid samples were collected from the right and left tarsal joints. Samples were processed within 60 minutes after collection. Total nucleated cell counts (TNCC) were assessed using a hemacytometer. Total protein concentration was determined using a refractometer. RESULTS: Forty-six samples were analyzed. The TNCC (mean +/- SD) was 175.8 +/- 136.7 cells/microL (range 50-678 cells/microL). Differential cell percentages were obtained for lymphocytes (58.2 +/- 21.55%, range 15-90%), monocyte/macrophages (38.3 +/- 20.8%, range 10-85%), and neutrophils (3.5 +/- 5.1%, range 0-15%). Protein concentration was 2.1 +/- 0.6 g/dL (range 1-3 g/dL). Significant differences were not observed in any parameters between right and left tarsal joints. CONCLUSION: Synovial fluid reference values were established and may be useful in the clinical investigation of joint disease in young camels.

Evaluation of shear strength of oil treated laminated bamboo.

Studies were carried out on heat treatment of bamboo species Gigantochloa scortechinii Gamble using palm oil. The samples were laminated and glued. The adhesion results showed that the delamination of glue line increased as the temperature and duration of oil heat treatment increased. Maximum load and shear strength of the glue line reduced as the heat treatment become more severe. It was found that the palm oil used as the heating medium penetrated in some parts of the cell wall as well as in the cell lumen of the bamboo.

Disclosure of cancer diagnosis and prognosis by physicians in Kuwait.

To analyse preferences for disclosure of cancer diagnosis and prognosis among physicians practising in Kuwait, a cross-sectional survey was conducted in public hospitals in both urban and suburban parts of the country, which included physicians likely to encounter adult cancer patients in their practice. A total of 217 physicians participated, 67% indicating they preferred full and complete disclosure of cancer diagnosis to patients. However, 79% of those would withhold the truth if the patient s family requested them to do so. Preference for concealment was more common among physicians who had experienced cancer directly with a friend or a family member, or who were in medical as opposed to surgical specialties. The belief that patients in Kuwait did not want to hear the truth about cancer diagnosis or prognosis was also significantly associated with concealment preference. Changes in public norms and expectations should be monitored, because they seem to play a major role in physicians preference for disclosure of cancer diagnosis and prognosis.

Potential immunosuppressive and antiinflammatory activities of Malaysian medicinal plants characterized by reduced cell surface expression of cell adhesion molecules.

In the search for agents effective against immune-mediated disorders and inflammation, we have screened Malaysian medicinal plants for the ability to inhibit the expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) on the surface of murine endothelial cells (F-2), and mouse myeloid leukaemia cells (M1), respectively. Of 41 kinds (29 species, 24 genera, 16 families) of Malaysian plants tested, 10 and 19 plant samples significantly downregulated the expression of ICAM-1 and VCAM-1, respectively. Bioassay-directed fractionation of an extract prepared from the bark of Goniothalamus andersonii showed that its ingredients, goniothalamin (1) and goniodiol (2) inhibited the cell surface expression of both ICAM-1 and VCAM-1. The present results suggest that Malaysian medicinal plants may be abundant natural resources for immunosuppressive and antiinflammatory substances.