Transforming growth factor-beta-regulated expression of genes in macrophages implicated in the control of cholesterol homoeostasis.

The regulation of macrophage cholesterol homoeostasis is of crucial importance in the pathogenesis of atherosclerosis, an underlying cause of heart attack and stroke. Several recent studies have revealed a critical role for the cytokine TGF-beta (transforming growth factor-beta), a key regulator of the immune and inflammatory responses, in atherogenesis. We discuss here the TGF-beta signalling pathway and its role in this disease along with the outcome of our recent studies on the action of the cytokine on the expression of key genes implicated in the uptake or efflux of cholesterol by macrophages and the molecular mechanisms underlying such regulation.

Transitory alexia without agraphia: a disconnection syndrome due to neurocysticercosis.

We describe a 65-year-old male who presented with acute onset inability to read, without any difficulty in writing. A clinical diagnosis of alexia without agraphia was made and the patient was subjected to routine investigations including contrast MRI. MRI showed a ring-enhancing lesion in left occipital area, suggestive of neurocysticercosis supported by quantitative enzyme-linked immunosorbant assay from purified cell fraction of taenia solium cysticerci (PCF-ELISA). Patient was treated with albendazole and prednisolone for one week. The clinical manifestation as well as the radiological finding resolved after treatment.

Laparoscopic repair of a right paraduodenal hernia.

BACKGROUND: Laparoscopic repair of a right paraduodenal hernia has never been described in the literature. A 24-year-old woman was admitted after 2 weeks of intermittent abdominal pain associated with nausea and vomiting. Physical examination was normal. Laboratory studies and upper endoscopy were normal. Computed tomography revealed that the small bowel was on the right side of the abdomen and the colon on the left, suspicious for malrotation. Subsequent upper gastrointestinal series with small bowel follow-through revealed the ligament of Treitz on the right with the small bowel encased within a probable hernia sac. A presumptive diagnosis of a right paraduodenal hernia was made. METHODS AND RESULTS: Initial access was obtained with a 10-mm infraumbilical port followed by placement of 5-mm ports in the right and left upper and lower quadrants. The duodenum was identified and the small bowel was found encased within a hernia sac, which was opened widely from the duodenum to the pelvis. The hernia sac was opened laterally to avoid injury to the superior mesenteric vessels. The small bowel was then released from the sac into the peritoneal cavity. The entire bowel was inspected and no other abnormalities were noted. The patient had resolution of her abdominal pain and her postoperative course was uncomplicated. She was discharged home on postoperative day 3 and has since done exceptionally well. CONCLUSIONS: Paraduodenal hernia, a rare cause of small bowel obstruction, can present a diagnostic challenge. However, when the diagnosis is made preoperatively, a laparoscopic repair is a feasible and practical option.

Cauda-conus syndrome resulting from neurocysticercosis.

A 60-year-old male, presented with insidious onset, gradually progressive, burning paresthesia over the saddle area, sphincteric disturbance, impotence and paraparesis. Investigations revealed a ring-enhancing lesion in the conus medullaris suggestive of neurocysticercosis. This was supported by quantitative enzyme-linked immunosorbant assay from purified cell fraction of taenia solium cysticerci. On treatment with steroids he showed marked improvement.

Neurocysticercosis presenting as Weber's syndrome.

This case report describes a rare, non-epileptic manifestation of neurocysticercosis where a 22-year-old male presented with acute onset right 3rd nerve palsy with left hemiplegia (Weber syndrome). Computerized tomography and magnetic resonance imaging revealed cysticercus granuloma. The patient improved and became asymptomatic with steroid treatment. Recognizing this clinical entity would avoid unnecessary antituberculous treatment and surgical intervention.

Role of macrophages in experimental malaria: I. Development of immunobioassay indicators.

The role of macrophages in immunogenic mechanisms of malaria was studied. The first part of the study aimed at development of indicators for assessing immunobioassay. Accordingly, data on the natural course of lethal Plasmodium berghei infection in mice were collected, and baseline estimates of a set of indicators were made. The indicators along with their estimated means are: prepatent period (PP), 2.57 +/- 0.06 days; survival period (SP), 17.63 +/- 0.29 days; median survival day (MSD), 17.20 days; and parasite density 24 h before death (K), 3582.6 infected RBC/10(4)RBCs. The probable role of immunogenic mechanisms judged indirectly by course of parasitaemia in different phases is discussed.

Smoking cessation through cigarette-fading, self-recording, and contracting: treatment, maintenance and long-term followup.

Seven adult subjects, all with extensive smoking histories, participated in a smoking cessation program. Intervention procedures included cigarette-fading, self-recording, and contracting. A changing-criterion analysis showed that six of the seven subjects were able to abstain from smoking within two months of intervention. The seventh subject was able to meet two changes in criterion, but dropped out of the treatment programme during the third. Of the sex remaining subjects, five were able to abstain from smoking during the six-month maintenance period. The sixth subject resumed smoking in the fourth month of maintenance and preferred to continue smoking thereafter. Followup data, collected every three months for two years, showed that the five remaining subjects were able to abstain from smoking for two years following the cessation of the maintenance programme.

Gas chromatographic separation of optically active anti-inflammatory 2-arylpropionic acids using (+)- or (-)-amphetamine as derivatizing reagent.

A method is described for the derivatization of several non-steroidal anti-inflammatory arylalkanoic acids (ibuprofen, ketoprofen, naproxen, fenoprofen, flurbiprofen, pirprofen, cicloprofen, tiaprofenic acid, etodolic acid) with optically active amphetamine. The usefulness of this reagent compared to alpha-methylbenzylamine is described. The enantiomers are separated as diastereoisomers using capillary gas chromatography with nitrogen-phosphorus detection. The procedure is readily applied to the quantification of the enantiomers in urine and plasma samples.

Reflections on the ex-smoker: some findings on successful quitters.

Following the lead of Schachter [(1982). Am. Psychol. 37: 436-444] a questionnaire was developed to assess the process of self-cure among former cigarette smokers and then administered to 63 ex-smokers who had quit on their own. Separate samples of "helped" quitters and current smokers who had tried to quit but failed were also interviewed. Ex-smokers scored higher on Rosenbaum's [(1980). Behav. Ther. 11: 109-121] Self-Control Schedule, which suggests that they may have succeeded because they had better self-control skills initially. Other results underscored the role of peer pressure and curiosity as major reasons for becoming a smoker, of withdrawal symptoms and loss of pleasure as major obstacles to quitting, and of self-confidence and perceived health benefits as factors that were most important in successful quitting. The difficulty associated with quitting was associated with cognitive factors such as beliefs about the addictive properties of nicotine and self-confidence ratings, as well as with a supportive social network and the amount smoked previously.