Simulation training using cadaver sheep chest in pleuroscopy - A step towards skills enhancement.

OBJECTIVE: For assessing the use of if simulation training on animal cadavers as a useful tool for training in pleuroscopy. METHODS: The email-based cross-sectional study was conducted in December 2014 at Shaikh Zayed Hospital, Federal Postgraduate Medical Institute, Lahore, Pakistan, and comprised respiratory physicians and trainees after their participation in a two-day hands-on training course on pleuroscopy and pleural medical procedures. The responses were analysed and the responses of physicians and trainees were compared. RESULTS: Of the 44 individuals who attended the course and were contacted through emails, 38(86.4%) responded, including 20(52.6%) physicians and 18(47.3%) trainees. All the 38(100%) subjects uniformly accepted the utility of simulation training in enhancing education, improving skill, and improving confidence by repeated practice, and felt that the inclusion of animal models for learning fundamental pleuroscopic procedures can help a lot in teaching. CONCLUSIONS: Animal cadavers can be used as an effective teaching tool for pleuroscopy training.

Invasive aspergillosis complicating treatment with tyrosine kinase inhibitors.

We describe three cases of pulmonary aspergillosis (PA) in three patients without traditional risk factors for invasive aspergillosis infection, such as prolonged neutropenia or high dose systemic corticosteroid therapy. All three patients developed PA while taking tyrosine kinase inhibitors (TKI) and sustained greater clinical improvement once TKI were withdrawn. Our case series supports the theory TKI treatment can increase susceptibility to PA without causing neutropenia. Recognition that TKI treatment may predispose to invasive aspergillosis will allow for rapid recognition of affected patients and more effective management of future cases.

Localization of the zinc binding tubulin polymerization promoting protein in the mice and human eye.

Tubulin Polymerization Promoting Protein (TPPP/p25) modulates the dynamics and stability of the microtubule network by its bundling and acetylation enhancing activities that can be modulated by the binding of zinc to TPPP/p25. Its expression is essential for the differentiation of oligodendrocytes, the major constituents of the myelin sheath, and has been associated with neuronal inclusions. In this paper, evidence is provided for the expression and localization of TPPP/p25 in the zinc-rich retina and in the oligodendrocytes in the optic nerve. Localization of TPPP/p25 was established by confocal microscopy using calbindin and synaptophysin as markers of specific striations in the inner plexiform layer (IPL) and presynaptic terminals, respectively. Postsynaptic nerve terminals in striations S1, S3 and S5 in the IPL and a subset of amacrine cells show immunopositivity against TPPP/p25 both in mice and human eyes. The co-localization of TPPP/p25 with acetylated tubulin was detected in amacrine cells, oligodendrocyte cell bodies and in synapses in the IPL. Quantitative Western blot revealed that the TPPP/p25 level in the retina was 0.05-0.13 ng/µg protein, comparable to that in the brain. There was a central (from optic nerve head) to peripheral retinal gradient in TPPP/p25 protein levels. Our in vivo studies revealed that the oral zinc supplementation of mice significantly increased TPPP/p25 as well as acetylated tubulin levels in the IPL. These results suggest that TPPP/p25, a microtubule stabilizer can play a role in the organization and reorganization of synaptic connections and visual integration in the eye.