Bisphosphonate Osteonecrosis in a Case of Langerhans Cell Histiocytosis: Report of a Case and Review of Literature.

Langerhans Cell histiocytosis is a rare multisystem disease originating from dendritic cell lines primarily characterized by osteolytic lesion of the skeleton. Chemotherapy along with bisphosphonates have been used to control the progression of the disease and prevent the osteolysis associated with the disease. Bisphosphonate osteonecrosis of the jaws is a common finding following treatment with bisphosphonates for osteoporosis, metastatic tumors to the bone or the osteolytic lesions of multiple myeloma. The article highlights a rare case of bisphosphonate osteonecrosis of the mandible in a case of long-standing Langerhans cell histiocytosis.

Validity of IL-6 and Arthrocentesis in the Cause and Management of Internal Derangement of TMJ.

Purpose: The aim of this clinical study was to evaluate the level of Interleukine-6 (IL-6), pre and post arthrocentesis to validate it as a biomarker in the Internal Derangement (ID) of TMJ. Material and Methods: This study included 30 patients (20 females and 10 males) of Temporo-Mandibular Dysfunction (TMD) with Disc displacement without reduction (DDwoR) Wilkes stage III, who were refractory to conservative management. Arthrocentesis was performed as a therapeutic modality. Synovial fluid aspirates were obtained prior to arthrocentesis and post arthrocentesis with 300 ml of Ringer Lactate solution into the superior joint compartment for the assessment of level of IL-6. The clinical parameters used for correlating the level of IL-6 were degree of pain (VAS I), chewing ability (VAS II), Maximal Mouth Opening (MMO) in both pre and post op phase with the follow-up period of 01 day, 01 week, 01 month, 03 month and 06 month and the results were compared. ELISA was performed to analyze the levels of IL-6 in the aspirates. The clinical parameters and the level of IL-6 were recorded and analyzed statistically. Results: The study showed ID of TMJ (Wilkes stage III) s are more prevalent in females especially in the fourth decades of life with the mean age of 38.4 years. The post operative assessment in terms of pain, maximum mouth opening, lateral movements of the mandible and the levels of IL-6 were found to be statistically significant with a P value <0.01. Conclusion: This study validates the role of IL-6 as a definitive biomarker for the pathogenesis of ID of TMJ Wilkes stage III and arthrocentesis proved to be a minimally invasive therapeutic modality for its management.

Bony bridge resorption after secondary alveolar grafting and correlation with success of orthodontic treatment: A prospective volumetric cone beam computed tomography (CBCT) study.

BACKGROUND: Cleft lip/palate is the second most observed congenital defect which constitutes a serious dental-medical-social problem. Successful uptake and stability of alveolar graft is required to achieve closure of the oro-nasal fistula and continuity of the dental arches. Resorption of bone graft may compromise the results achieved. This study determined the bony bridge volume required for successful repair of alveolar cleft, evaluated the resorption after 3 months of grafting and correlated the success of orthodontic treatment. METHODS: 30 patients with unilateral cleft lip and palate requiring secondary alveolar bone grafting and orthodontic correction were included in the study. After arch expansion and before alveolar grafting using cone beam computed tomography (CBCT) of maxilla was recorded and was repeated after 3 months of alveolar bone grafting to estimate the volume of grafted bone in the cleft. RESULTS: The bridge bone volume resorption after 3 months post-operative ranged from 14% to 100% with a mean of 36.46%. The percentage of resorption of alveolar bone graft after 3 months of surgery was statistically significant. Success of orthodontic treatment was statistically significant when correlated with percentage of resorption. CONCLUSION: The accurate localization and estimation of the size and extent of alveolar cleft area is important for treatment planning. Post-operative it is important to analyze the outcome of transplanted bone as early as possible. Early evaluation can help to predict the outcome of transplanted bone and may guide to re-grafting of the site immediate or to restart any interrupted orthodontic procedure, if necessary.

Retromandibular transparotid approach compared with transmasseteric anterior parotid approach for the management of fractures of the mandibular condylar process: a prospective randomised study.

Fractures of the mandibular condyle lead to displacement of the condyle and loss of the height of the ramus. A retromandibular approach is the most commonly used for open reduction and internal fixation (ORIF) of such fractures. We aimed to compare the complications associated with a retromandibular transparotid approach with a retromandibular transmasseteric anterior parotid (TMAP) approach for their management. Thirty patients were randomly selected into two groups (15 in each): Group A comprised the retromandibular transparotid approach and Group B the retromandibular TMAP. The variables evaluated were: operating time, facial nerve injury, occurrence of Frey syndrome, and sialocoele at one week, four weeks, three months, and six months. The mean (SD) age in group A and B was 33.93 (17.97) years and 33.53 (16.15) years, respectively, and there were 28 men and two women. Mean (SD) exposure time in the transparotid approach was 26.93 (5.19) minutes and 25.4 (8.35) minutes in the TMAP approach. The incidence of facial nerve injury was 2/15 patients in the transparotid group and 3/15 in the TMAP group, all of which resolved within six months. The incidence of sialocoele was 2/15 in the transparotid group. The results did not show any significant difference in complications between the two approaches, but the retromandibular transparotid approach provided straight-line access in fractures of the condylar neck, with fewer incidences of nerve injury. The anterior parotid approach, on the other hand, provided easier access for fractures that were medially dislocated or of the condylar base but had an increased incidence of facial nerve injuries.

Does methylprednisolone improve postoperative outcomes after mandibular third molar surgery? A systematic review and meta-analysis.

This systematic review and meta-analysis was performed to investigate whether methylprednisolone (MP) administered via any route improves postoperative outcomes (pain, trismus, and oedema) following mandibular third molar surgery. An electronic search of the PubMed, Scopus, Cochrane CENTRAL, and Google Scholar databases was performed to identify studies published in English up until January 2018. A total of 28 studies were included in the review: 25 randomized clinical trials (RCTs) and three controlled clinical trials. Studies were grouped according to the route of administration of MP for qualitative and quantitative analysis. Three studies were of 'high' quality and 22 were of 'medium' quality; three studies had a high risk of bias. Within the purview of the limitations of this review, the results showed that MP administered via any route significantly improves oedema in the early postoperative period, but has no effect on late postoperative oedema. Oral and intra-masseteric MP also seems to reduce pain and trismus in the early postoperative period. The results also indicate that oral MP may reduce late postoperative pain, while intra-masseteric MP may improve the late trismus outcome. More high quality RCTs are required to provide stronger evidence on the use of MP in third molar surgery.

A new multi-line cusp magnetic field plasma device (MPD) with variable magnetic field.

A new multi-line cusp magnetic field plasma device consisting of electromagnets with core material has been constructed with a capability to experimentally control the relative volume fractions of magnetized to unmagnetized plasma volume as well as accurate control on the gradient length scales of mean density and temperature profiles. Argon plasma has been produced using a hot tungsten cathode over a wide range of pressures 5 × 10-5 -1 × 10-3 mbar, achieving plasma densities ranging from 109 to 1011 cm-3 and the electron temperature in the range 1-8 eV. The radial profiles of plasma parameters measured along the non-cusp region (in between two consecutive magnets) show a finite region with uniform and quiescent plasma, where the magnetic field is very low such that the ions are unmagnetized. Beyond that region, both plasma species are magnetized and the profiles show gradients both in temperature and density. The electrostatic fluctuation measured using a Langmuir probe radially along the non-cusp region shows less than 1% (δIisat/Iisat < 1%). The plasma thus produced will be used to study new and hitherto unexplored physics parameter space relevant to both laboratory multi-scale plasmas and astrophysical plasmas.

Direct one-pot synthesis of glutathione capped hydrophilic FePt-CdS nanoprobe for efficient bimodal imaging application.

One-pot synthesis methods for development of hydrophilic imaging nanoprobes have advantages over multi-pot methods due to their simple procedures, less probability for degradation of efficiency, superior control over growth and morphology, cost effectiveness, improved scope for scale-up synthesis etc. Here, we present a novel one-pot facile synthesis of hydrophilic colloidal bimodal nanoprobe (FePt-CdS) prepared through a seed-mediated nucleation and growth technique. In this facile synthesis of complex nanostructure, glutathione (GSH) was used as the capping agent to render biocompatibility and dispersibility. The microstructure, surface, optical, magnetic, biocompatibility, relaxivity and imaging property of the developed nanoprobe have been studied. The microstructural characterizations reveal average size of the particle as ~9-11nm with bleb shaped morphology. Spectroscopic characterization depicts the development of GSH capped CdS QDs on FePt, surface functionalities and their stability. The magnetic measurements confirm the superparamagnetic property in the developed bimodal nanoprobe. In addition, the GSH capping imparts excellent biocompatibility, water dispersibility, and fluorescence property to the probe. In RAW 264.7 macrophage cells, the bimodal nanoprobes exhibit intense green and red fluorescence. The magnetic resonance imaging (MRI) and fluorescence imaging (FI) study depict high transverse relaxivity and visible range fluorescent property in the synthesized FePt-CdS nanoprobe. Hence, the developed bimodal nanoprobe can be used as a potential candidate in simultaneous FI and MR imaging.

Custom-made mouth prop for TMJ arthrocentesis: a technical note.

INTRODUCTION: TMJ arthrocentesis involves lavage of the upper joint space which forces the disc apart from the fossa and washes away the inflammatory components of the joint. To increase the joint space during arthrocentesis, the patient is usually asked to open the mouth and deviate it to the opposite side so as to distract the condyle from the glenoid fossa thereby increasing joint space. METHOD: The authors describe a simple and rapid technique of preparing a custom-made mouth prop to hold the mandible in eccentric position during arthrocentesis. FINDINGS: The custom-made mouth prop is an effective tool to help relax the patient in an eccentric position during the duration of arthrocentesis procedure.

Spread and exchange of bla NDM-1 in hospitalized neonates: role of mobilizable genetic elements.

To investigate the mobilizable elements associated with bla NDM-1 in Enterobacteriaceae isolated from septicaemic neonates at a NICU in India, during December, 2008-2011. An attempt was also made to understand whether there was a pattern in the temporal acquisition of bla NDM-1 within the unit. Transferability of carbapenem resistance was tested by conjugation and transformation. Plasmid types and addiction systems were analysed. The genetic background of bla NDM-1 and association with class 1 integron were evaluated by PCR mapping. RFLP was carried out to discriminate plasmids of same incompatibility group. Transfer of carbapenem resistance was successful in 13/15 cases. bla NDM-1 was associated with different plasmid scaffolds (IncFII, IncL/M, IncN, IncR, IncHIB-M/FIB-M), IncF type being the prevalent one. Addiction systems ccdAB and hok/sok were associated with transferable plasmids. Genetic structures surrounding bla NDM-1 showed its association with at least a remnant of ISAba125 at its 5'-end. The spread of NDM-1 was not related to class 1 integron which possessed resistance determinants against trimethoprim (dfrA12, dfrA1, dfrA5), streptomycin (aadA2, aacA4), and rifampicin (arr-3). RFLP showed that three isolates possessed the same FII/FIIs plasmid; two of these three isolates were from a single neonate, implying interspecies transfer of bla NDM-1. The predominance of FII plasmids and ISAba125 along with bla NDM-1 was noted, but no specific pattern in the temporal acquisition of mobile genetic elements could be identified. To the best of our knowledge, this report is the first to inform the in-vivo interspecies plasmid transfer event of bla NDM-1 in a neonate.

A comparative study of sheath potential profile measurements with laser-heated and current-heated emissive probes.

Emissive Langmuir probe is one of the most efficient diagnostic tools available for plasma potential measurements. Extensive studies have been carried out in designing different kinds of conventional (electrically heated) emissive probes (CEPs) to estimate the plasma potential. Laser heated emissive probe (LHEP) has been developed with certain advantages over the conventional probes such as low evaporation rate of the probe material, high lifetime, and high emission levels. Most importantly, the LHEP uses laser to heat the probe-tip and does not require electric current to heat the probe-tip like in CEP. The heating current in CEP substantially affects the plasma potential measurements, especially in the regions of plasma where high electric and magnetic field gradients are present. In this paper, we studied the plasma potential structures in sheath-presheath region using both LHEP and CEP in an unmagnetized dc-filament discharge plasma. Measurements of sheath spatial potential profile using laser heated emissive probe are compared with those obtained using conventional emissive probe.

Hybrid 3D structures of ZnO nanoflowers and PdO nanoparticles as a highly selective methanol sensor.

The present study concerns the enhancement of methanol selectivity of three dimensional (3D) nanoflowers (NFs) of ZnO by dispersing nickel oxide (NiO) and palladium oxide (PdO) nanoparticles on the surface of the nanoflowers to form localized hybrid nano-junctions. The nanoflowers were fabricated through a liquid phase deposition technique and the modification was achieved by addition of NiCl and PdCl2 solutions. In addition to the detailed structural (like X-ray diffraction (XRD), electron dispersive spectroscopy (EDS), X-ray mapping, XPS) and morphological characterization (by field emission scanning electron microscopy (FESEM)), the existence of different defect states (viz. oxygen vacancy) was also confirmed by photoluminescence (PL) spectroscopy. The sensing properties of the pristine and metal oxide nanoparticle (NiO/PdO)-ZnO NF hybrid sensor structures, towards different alcohol vapors (methanol, ethanol, 2-propanol) were investigated in the concentration range of 0.5-700 ppm at 100-350 °C. Methanol selectivity study against other interfering species, viz. ethanol, 2-propanol, acetone, benzene, xylene and toluene was also investigated. It was found that the PdO-ZnO NF hybrid system offered enhanced selectivity towards methanol at low temperature (150 °C) compared to the NiO-ZnO NF and pristine ZnO NF counterparts. The underlying mechanism for such improvement has been discussed with respective energy band diagram and preferential dissociation of target species on such 3D hybrid structures. The corresponding improvement in transient characteristics has also been co-related with the proposed model.

The impact of HLA class I and EBV latency-II antigen-specific CD8(+) T cells on the pathogenesis of EBV(+) Hodgkin lymphoma.

In 40% of cases of classical Hodgkin lymphoma (cHL), Epstein-Barr virus (EBV) latency-II antigens [EBV nuclear antigen 1 (EBNA1)/latent membrane protein (LMP)1/LMP2A] are present (EBV(+) cHL) in the malignant cells and antigen presentation is intact. Previous studies have shown consistently that HLA-A*02 is protective in EBV(+) cHL, yet its role in disease pathogenesis is unknown. To explore the basis for this observation, gene expression was assessed in 33 cHL nodes. Interestingly, CD8 and LMP2A expression were correlated strongly and, for a given LMP2A level, CD8 was elevated markedly in HLA-A*02(-) versus HLA-A*02(+) EBV(+) cHL patients, suggesting that LMP2A-specific CD8(+) T cell anti-tumoral immunity may be relatively ineffective in HLA-A*02(-) EBV(+) cHL. To ascertain the impact of HLA class I on EBV latency antigen-specific immunodominance, we used a stepwise functional T cell approach. In newly diagnosed EBV(+) cHL, the magnitude of ex-vivo LMP1/2A-specific CD8(+) T cell responses was elevated in HLA-A*02(+) patients. Furthermore, in a controlled in-vitro assay, LMP2A-specific CD8(+) T cells from healthy HLA-A*02 heterozygotes expanded to a greater extent with HLA-A*02-restricted compared to non-HLA-A*02-restricted cell lines. In an extensive analysis of HLA class I-restricted immunity, immunodominant EBNA3A/3B/3C-specific CD8(+) T cell responses were stimulated by numerous HLA class I molecules, whereas the subdominant LMP1/2A-specific responses were confined largely to HLA-A*02. Our results demonstrate that HLA-A*02 mediates a modest, but none the less stronger, EBV-specific CD8(+) T cell response than non-HLA-A*02 alleles, an effect confined to EBV latency-II antigens. Thus, the protective effect of HLA-A*02 against EBV(+) cHL is not a surrogate association, but reflects the impact of HLA class I on EBV latency-II antigen-specific CD8(+) T cell hierarchies.

Imprecise knowledge based design and development of titanium alloys for prosthetic applications.

Imprecise knowledge on the composition-processing-microstructure-property correlation of titanium alloys combined with experimental data are used for developing rule based models for predicting the strength and elastic modulus of titanium alloys. The developed models are used for designing alloys suitable for orthopedic and dental applications. Reduced Space Searching Algorithm is employed for the multi-objective optimization to find composition, processing and microstructure of titanium alloys suitable for orthopedic applications. The conflicting requirements attributes of the alloys for this particular purpose are high strength with low elastic modulus, along with adequate biocompatibility and low costs. The 'Pareto' solutions developed through multi-objective optimization show that the preferred compositions for the fulfilling the above objectives lead to ß or near ß-alloys. The concept of decision making employed on the solutions leads to some compositions, which should provide better combination of the required attributes. The experimental development of some of the alloys has been carried out as guided by the model-based design methodology presented in this research. Primary characterizations of the alloys show encouraging results in terms of the mechanical properties.

Validation of Leiden Score in Predicting Progression of Rheumatoid Arthritis in Undifferentiated Arthritis in Indian Population.

BACKGROUND: Leiden Score, is a very useful tool for predicting future development of rheumatoid arthritis (RA), among undifferentiated arthritis (UA) patients. This score has been validated in various western studies but rarely among south east Asian patients. AIMS: To validate the Leiden early arthritis prediction rule in an Indian cohort of patients for predicting rheumatoid arthritis (RA) in undifferentiated arthritis (UA) patients and to formulate any simpler version of prediction score taking only clinical variables of original Leiden prediction rule. SUBJECTS AND METHODS: In a group comparative longitudinal study model, 58 patients with early symmetrical polyarthritis were enrolled and baseline evaluation was done according to Leiden prediction rule and then 3 monthly. After 1 year, Leiden prediction score and chance of evolving into RA were calculated. Patients were divided into two groups: Those who developed RA and who did not. They were selected on random sampling process. Tender joint count (TJC), duration of morning stiffness, and duration of arthritis were selected as clinical variables for linear discriminant analysis with disease outcome being the dependent variable. Discriminant scores (D) for each patient was calculated. A receiver operating characteristic (ROC) curve was constructed with the discriminant score and compared with Leiden prediction score. RESULTS: About 54% (27/50) of patients were diagnosed with RA and 46% (23/50) developed other rheumatologic condition or viral inflammatory arthritis or remained undifferentiated or attained complete remission. None of the patients with UA, who scored the regression coefficients 4 or less progressed to RA, and those who scored 7 or more, almost certainly progressed to RA. Unstandardized canonical discriminant coefficients for TJC (T), duration of morning stiffness (M), and duration of arthritis (A) were calculated. ROC curve was plotted with the formula: D = 0.164 × T + 0.066 × M + 0.012 × A - 2.838. Area under curve (AUC) at 95% confidence interval for our discriminant function was 0.845 (standard error [SE] 0.054). In comparison, AUC of Leiden prediction score was 0.897 (SE 0.043). CONCLUSIONS: Leiden prediction rule is highly applicable to UA patients to predict progression of RA in Indian patients and larger multi-center study with larger cohorts is needed to validate the formulation we derived to predict RA.

Design, development, and results from a charge-collector diagnostic for a toroidal electron plasma experiment.

A suitable charge-collector has been designed and developed to estimate charge-content of electron plasmas in a Small Aspect Ratio Toroidal Experiment in a C-shaped trap (SMARTEX-C). The electrons are periodically injected and held in the trap with the aid of electrostatic end-fields and a toroidal magnetic field. After a preset "hold" time, the trapped charges are dumped onto a grounded collector (by gating it). As the charges flow along the magnetic field lines onto the collector, the integrated current gives the charge-content of the plasma at the instant of dump. In designing such a charge collector, several challenges peculiar to the geometry of the trap and the nature of the plasma had to be addressed. Instantaneous charge measurements synchronised with the E × B drift of the plasma, along with fast transit times of electrons to the collector (few 100 ns or less) (due to the low aspect ratio of the trap) essentially require fast gating of the collector. The resulting large capacitive transients alongside low charge content (few nC) of such plasmas further lead to increasing demands on response and sensitivity of the collector. Complete cancellation of such transients is shown to be possible, in principle, by including the return path in our measurement circuit but the "non-neutrality" of the plasma acts as a further impediment. Ultimately, appropriate shielding and measurement circuits allow us to (re)distribute the capacitance and delineate the paths of these currents, leading to effective cancellation of transients and marked improvement in sensitivity. Improved charge-collector has thus been used to successfully estimate the time evolution of total charge of the confined electron plasma in SMARTEX-C.

Survivin siRNA increases sensitivity of primary cultures of ovarian cancer cells to paclitaxel

Purpose. This aim of this study was to use ovarian cancer cells shed in ascitic fluid to establish primary cultures and subsequently use it to detect drug resistance to paclitaxel. Survivin siRNA was used to down regulate survivin expression and effect on paclitaxel resistance was also evaluated. Methodology. Ascitic fluid along with corresponding primary tumor tissue was collected from twenty untreated epithelial ovarian cancer patients. Ten primary cultures were established from ascites obtained from untreated ovarian cancer patients in MCDB 105 and M199 medium (ratio 1:1). Knockdown of survivin was done using siRNA and sensitivity to paclitaxel was evaluated by MTT assay. Results. Grape-like clusters of ovarian cancer cells present in ascites attached and gave a characteristic cobble stone appearance. Treatment with survivin siRNA resulted in a fivefold decrease in survivin expression in primary cultures. Survivin siRNA treatment significantly increased the sensitivity of the primary ovarian cancer cell cultures to paclitaxel. Conclusion. Ascitic cancer cells reflect the molecular profile of tumor and can be used to diagnose resistance to chemotherapy. This study also establishes that high survivin expression is also responsible for resistance to paclitaxel (AU)

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Inverse mirror plasma experimental device­A new magnetized linear plasma device with wide operating range.

Inverse mirror plasma experimental device has been designed and fabricated for detailed experimental investigation of phase mixing and wave breaking of plasma oscillation/wave. The device produces quiescent magnetized plasma over a wide operating range using multifilamentary source with low filament spacing in cusp geometry along with a flexible transition magnetic field region between the plasma source chamber and the main chamber. Argon plasma has been produced in the device over a wide pressure range from 1.7 × 10(-5) mbar to 9 × 10(-4) mbar, achieving plasma densities in the range of ∼10(9) cm(-3)-10(12) cm(-3) and temperatures in the range of ∼1.7 eV-5 eV. To fulfill a desired prerequisite of having quiescent plasma (δn/n ≤ 1%) for realizing phase mixing of nonlinear plasma oscillation and other wave experiments, a quiescent magnetized plasma is obtained: typical quiescence, δn/n ∼ 0.5% at 10(-4) mbar and B(main) ∼ 1 kG. The potential of the multifilamentary plasma source has been experimentally explored using a flexible transition magnetic field and the usual control features of a filament discharge. Probe measurements reveal that the plasma to be axially and radially uniform, an excellent scenario for wave launching and studying its propagating and phase mixing characteristics.

Efficacy of Autogenous Split Thickness Calvarial Graft in the Management of Residual Cranial Defect.

INTRODUCTION: The patients with cranial deformity suffer from headache, dizziness, irritability, loss of concentration, depression, anxiety, intolerance to noise and vibration and neuromotor weakness. It is therefore essential to restore the calvarium. MATERIAL AND METHOD: This study was conducted in the Department of Oral and Maxillofacial Surgery, Armed Forces Medical College, Pune between Oct 2010 and Mar 2012. The study population was selected from the outpatient department and from the referred cases. The aim was to study the uptake of split thickness calvarial graft in the management of residual cranial defect. After applying the inclusion and exclusion criterions, ten cases were selected with residual cranial deformity, operated for cranioplasty using split thickness calvarial graft and evaluated. CONCLUSION: It was concluded that cranioplasty using autogenous split thickness calvarial graft for restoring cranial defects is a useful technique and this procedure allows the surgeon to reconstruct a moderate-to-large cranial defect, without breaching the inner cortical plate.

Survivin siRNA increases sensitivity of primary cultures of ovarian cancer cells to paclitaxel.

PURPOSE: This aim of this study was to use ovarian cancer cells shed in ascitic fluid to establish primary cultures and subsequently use it to detect drug resistance to paclitaxel. Survivin siRNA was used to down regulate survivin expression and effect on paclitaxel resistance was also evaluated. METHODOLOGY: Ascitic fluid along with corresponding primary tumor tissue was collected from twenty untreated epithelial ovarian cancer patients. Ten primary cultures were established from ascites obtained from untreated ovarian cancer patients in MCDB 105 and M199 medium (ratio 1:1). Knockdown of survivin was done using siRNA and sensitivity to paclitaxel was evaluated by MTT assay. RESULTS: Grape-like clusters of ovarian cancer cells present in ascites attached and gave a characteristic cobble stone appearance. Treatment with survivin siRNA resulted in a fivefold decrease in survivin expression in primary cultures. Survivin siRNA treatment significantly increased the sensitivity of the primary ovarian cancer cell cultures to paclitaxel. CONCLUSION: Ascitic cancer cells reflect the molecular profile of tumor and can be used to diagnose resistance to chemotherapy. This study also establishes that high survivin expression is also responsible for resistance to paclitaxel.