Data management and analysis for gene expression arrays.

Microarray technology makes it possible to simultaneously study the expression of thousands of genes during a single experiment. We have developed an information system, ArrayDB, to manage and analyse large-scale expression data. The underlying relational database was designed to allow flexibility in the nature and structure of data input and also in the generation of standard or customized reports through a web-browser interface. ArrayDB provides varied options for data retrieval and analysis tools that should facilitate the interpretation of complex hybridization results. A sampling of ArrayDB storage, retrieval and analysis capabilities is available (www.nhgri.nih.gov/DIR/LCG/15K/HTML/ ), along with information on a set of approximately 15,000 genes used to fabricate several widely used microarrays. Information stored in ArrayDB is used to provide integrated gene expression reports by linking array target sequences with NCBI's Entrez retrieval system, UniGene and KEGG pathway views. The integration of external information resources is essential in interpreting intrinsic patterns and relationships in large-scale gene expression data.

Oral mucositis in head and neck cancer.

This module explores the risk factors, pathogenesis and development of oral mucositis. It considers the early diagnosis and accurate management of oral mucositis in head and cancer patients undergoing treatment.

Everolimus-associated Acute Kidney Injury in Patients with Metastatic Breast Cancer.

Recently, everolimus (Evl) has been introduced in the management of hormone receptor-positive metastatic breast cancer, in combination with aromatase inhibitors. Evl-induced acute kidney injury has hitherto been described in other malignancies, especially renal cell cancer, but only once before in a patient with breast cancer. We describe two cases of Evl-associated nephrotoxicity in patients with breast cancer, one of whom underwent a renal biopsy showing acute tubular necrosis. Both our patients improved after withdrawal of the offending agent and have normal renal functions on follow-up.

Achalasia cardia: A study of 113 patients managed with indigenous dilator.

BACKGROUND: Endoscopic dilatation of achalasia cardia is an effective nonsurgical management option. It requires costly pneumatic dilators which are used under fluoroscopic guidance. This study assesses the efficacy and safety of an indigenous pneumatic dilator used without fluoroscopic guidance. METHODS: Over a period of eleven years, 113 patients (69M, 44F) ofachalasia cardia underwent dilatation with indigenous pneumatic dilators without fluoroscopic guidance. The dilatation was performed under endoscopic vision. RESULTS: The procedure was successful in all patients. After six weeks following dilatation, there was significant improvement in the mean dysphagia score 3.63 + 0.61 to 0.53 + 0.93 (P<0.01). The response was still significant (0.78 + 1.03, P <0.05) at the end of one year. Excellent response with single dilatation was seen in 70.7% patients. After two dilatation sessions 92% of patients showed an excellent response. One patient had perforation. There was no mortality. CONCLUSION: Pneumatic dilatation under endoscopic vision without fluoroscopic assistance with the indigenous dilator is very effective and safe for short term treatment of achalasia carida.

Effect of variation in temperature on development of Plasmodium berghei (NK 65 strain) in Anopheles stephensi.

Effect of temperature on the sporogonic cycle of Plasmodium berghei (NK 65) has been studied in vector Anopheles stephensi. To determine the optimum temperature for development of parasite, fed mosquitoes were kept at 16 +/- 1 degree C, 19 +/- 1 degree C and 26 +/- 1 degree C temperature. The temperature 19 +/- 1 degree C was found to be optimum for normal development of parasite within the vector. Sporulated oocysts were observed on the 10th day post feed and salivary glands were loaded with thousands of sporozoites on day 14. Temperature 16 +/- 1 degree C, though did not exert any deleterious effect on the morphology of parasites it delayed the development of sporozoites in the oocysts by 5 days as compared to control group. In the case of long exposure to this temperature, the sporozoites obtained from salivary glands became non-infective. Temperature 26 +/- 1 degree C was responsible for deterioration of all the stages of sporogonic cycle and it also checked the formation of sporozoites in the oocysts.

Studies on the infectivity of gametocytes of Plasmodium berghei (NK 65) in Anopheles stephensi.

The infectivity of gametocytes of Plasmodium berghei (NK 65) has been studied in laboratory bred Anopheles stephensi. Mosquitoes were fed daily on infected male and female Mastomys natalensis and subsequent development of the oocysts was monitored in the midguts. Maximum number of oocysts were found in mosquitoes which were fed on infected female mastomys on D8 and in male mastomys on D7 post-inoculation. During the next peak of gametocytaemia, very few oocysts developed. These findings suggest that gametocytes are maximally infective only during the first peak, later on their infectivity declines although having sufficient number of gametocytes in the circulation.

Ontogeny of ookinete of Plasmodium berghei (NK 65): a scanning electron microscopic study.

The ontogeny of ookinete of Plasmodium berghei (NK 65) was studied in vector Anopheles stephensi fed on infected Mastomys natalensis. The round zygote transformed into an ookinete after passing through following stages-1 gram-seed shaped zygote, 2 comma-shaped stage, 3 semilunar and 4 banana shaped ookinete. Each fully formed ookinete had a 'Conule' at the anterior end of the body. In some ookinetes under SEM a depression was observed in the posterior half of the body. The function of the depression was not known.

Scalp meningioma.

Primary extracranial meningiomas occur very rarely. We present a rare case of extracranial meningioma of the transitional variant which was excised satisfactorily. There was no suggestion of any connection to the intracranial compartment or cranial nerves. The underlying galea was uninvolved, suggesting the true extracranial nature of this tumour. This rare diagnosis should nonetheless be kept in the differential diagnosis of scalp tumors.

Dumbbell-shaped paraganglioma of the cervical spine in a child.

Paragangliomas are tumors arising from extra-adrenal paraganglia and account for 0.3% of all neoplasms. The carotid body and temporal bone are the most frequent sites of paraganglioma, though it has been reported to occur in almost every part of the body. Spinal paragangliomas are uncommon and mainly take the form of intradural compression of the cauda equina or thoracic cord. Extradural paragangliomas are still rare; only few cases involving the dorsolumbar spine have been reported. We are reporting an interesting case of a dumbbell-shaped primary extradural paraganglioma of the cervical spine in an 8-year-old boy that presented with progressively increasing spastic quadriparesis.

Neuro-endoscopic management of intraventricular neurocysticercosis (NCC).

OBJECTIVE: Various approaches including endoscopy have been used for the treatment of intraventricular and cisternal NCC. We present our technique of Neuro-endoscopic management of intraventricular NCC. METHODS: Twenty-one cases, 13 females and 8 males (age range 12-50 years; mean, 25.7 years), of intraventricular NCC [lateral (n = 6), third (n = 6), fourth (n = 10) ventricles including a patient with both lateral and third ventricular cysts] producing obstructive hydrocephalus formed the group of study. Gaab Universal Endoscope System along with 4 mm 0 degrees and 30 degrees rigid telescopes were used through a frontal burr-hole for removal of intraventricular including intra-fourth ventricular (n = 10) NCC. Endoscopic third ventriculostomy (ETV) was done for internal cerebrospinal fluid (CSF) diversion. Average follow up was 18 months. RESULTS: Complete (n = 18) or partial (n = 2) removal of NCC was done in 20 patients, while a cyst located at foramen of Monro slipped and migrated to occipital or temporal horn in 1 patient. Thirty-degree 4-mm rigid telescope provided excellent image quality with ability to address even intra-fourth ventricular NCC through the dilated aqueduct using a curved tip catheter. No patient required further surgery for their hydrocephalus. There was no operative complication and post-operative ventriculitis was not seen in any case despite partial removal of NCC. CONCLUSION: Neuro-endoscopic surgery is an effective treatment modality for patients with intraventricular NCC. It effectively restores CSF flow and is capable of removing cysts completely or partially from accessible locations causing mass effect. Partial removal or rupture of the cyst does not affect the clinical outcome of the patients.

Magnetic loop basket: a "two-in-one" instrument.

BACKGROUND AND STUDY AIMS: Ingested coins are the most common foreign bodies encountered in the upper gastrointestinal tract in India and if they remain in the stomach for more than 5 days they need to be removed. Ferromagnetic retrieval instruments only work if the coins are ferromagnetic; and it is difficult to maneuver a loop basket in the fundus of the stomach. A magnetic loop basket was designed in an effort to overcome these difficulties and we assessed its feasibility, safety, and effectiveness in the removal of coins from the fundus of the stomach. PATIENTS AND METHODS: Twenty patients with a history of ingested coins were scheduled for removal of the coins using the magnetic loop basket. The time taken, complications, and failure rates were recorded. RESULTS: Twelve ferromagnetic coins were removed in a mean time of 60 seconds (range 30 - 90 seconds) and eight non-ferromagnetic coins were removed in a mean time of 150 seconds (range 90 - 180 seconds) without any failures or complications. CONCLUSION: The magnetic loop basket is a safe, effective, and quick method for removing both ferromagnetic and non-ferromagnetic metallic coins.

Gametocytocidal and sporontocidal activity of some standard antimalarials on P. berghei (NK 65) infection M. natalensis.

Three standard antimalarials pyrimethamine, primaquine and quinine were tested against P. berghei (NK 65) for gametocytocidal and sporontocidal action. Pyrimethamine at 7.5, 3.25, 2.5 and 1.25 mg/kg., primaquine at 15, 10 and 7.5 mg/kg, quinine at 225, 168.5, 140.62 and 112.5 mg/kg were given orally to infected M. natalensis for 3 consecutive days i.e., day 6, 7 and 8 post inoculation of sporozoites. To assess sporontocidal action batches of mosquitoes (A. stephensi) were fed on infected-treated and control animals on day 8. Mosquitoes were dissected on day 10 post infective feed to compare the number of oocysts from control groups. Pyrimethamine at 2.5, primaquine at 10 and quinine at 140.62 mg/kg had total sporontocidal action. When mosquitoes were fed on animals treated with 2.5 mg/kg of pyrimethamine and 10 mg/kg of primaquine, very few oocysts were developed and sporozoites from these mosquitoes were not infective to Mastomys. When mosquitoes were fed on Mastomys treated with 140.62 mg/kg of quinine, no oocyst was observed.

Silver nitrate sclerotherapy for 'clinically significant' chyluria: a prospective evaluation of duration of therapy.

OBJECTIVES: To evaluate and compare the results of regimen A (3 instillations at 8-hourly intervals in 1 day) with the control regimen B (9 instillations at 8-hourly intervals in 3 days) of using 1% silver nitrate solution for renal pelvic instillation sclerotherapy in 'clinically significant' filarial chyluria. MATERIALS AND METHODS: Forty-seven patients with clinically significant chyluria attending on 2 different days our urology clinic were prospectively randomized between two groups; the study group received regimen A (n = 21) while the control group received regimen B (n = 26). The variables evaluated included visualization of pyelolymphatic fistulae on retrograde pyelography, hospital stay, outcome and morbidity of the two regimens. RESULTS: Patients in both groups were comparable for age and sex. The morbidity (fever, symptomatic UTI, hematuria) following regimen A was less than that of regimen B although not statistically significant. The average hospital stay was 3 days for regimen A and 5.5 days for regimen B (p = 0.001). The initial success rate was 80.95% in group A and 92.30% in group B (p = 0.47). The mean duration of follow-up was 15 months (range 9-18). There was no significant difference in recurrence between the two groups during follow-up (group A: 21.05% and group B: 22.72%; p = 0.98). CONCLUSIONS: Regimen A was as effective as regimen B. Regimen A had the advantages of having less morbidity and shorter duration of hospital stay. We recommend only a 3-instillation regimen in patients with clinically significant chyluria, particularly those who demonstrate pyelolymphatic fistulae on retrograde pyelography.

A study of the adjustment of patients in relation to their prosthodontic problems.

Patients' self-concept and personality have been shown to deteriorate with an increase in prosthodontic problems. This study determined whether patients with prosthodontic problems varying in severity showed different levels of adjustment. Four groups of patients, including a control group, were studied. The three experimental groups differed from the control group and varied in their adjustment in relation to their prosthodontic problems.

Aberrations in cerebral vascular functions due to Plasmodium yoelii nigeriensis infection in mice.

Plasmodium yoelii nigeriensis infection in mice caused an increase in uptake of 125I-labeled bovine serum albumin, 51Cr-labeled erythrocytes and Evans blue dye from peripheral circulation into the brain. Isolated cerebral microvessels which were characterized in terms of their morphology under scanning electron microscope and enhancement of the specific activities of biochemical markers, viz. alkaline phosphatase, gamma-glutamyl transpeptidase, and monoamine oxidase, showed significant decrease in these activities due to P. yoelii nigeriensis infection. On the other hand, relatively minor (statistically insignificant) changes occurred in the first two enzyme specific activities in the cerebral cortex and monoamine oxidase registered an increase in this tissue due to infection. Histological examination of the cerebral tissue of infected animals by light and electron microscopy showed broken blood vessel walls and leakage of erythrocytes into extravascular space, some of which contained intraerythrocytic malarial parasite in a state of cell division.