The development of nanodevices for agriculture and plant research will allow several new applications, ranging from treatments with agrochemicals to delivery of nucleic acids for genetic transformation. But a long way for research is still in front of us until such nanodevices could be widely used. Their behaviour inside the plants is not yet well known and the putative toxic effects for both, the plants directly exposed and/or the animals and humans, if the nanodevices reach the food chain, remain uncertain. In this work we show that magnetic carbon-coated nanoparticles forming a biocompatible magnetic fluid (bioferrofluid) can easily penetrate through the root in four different crop plants . They reach the vascular cylinder, move using the transpiration stream in the xylem vessels and spread through the aerial part of the plants in less than 24 hours. Accumulation of nanoparticles was detected in wheat leaf trichomes, suggesting a way for excretion/detoxification. This kind of studies is of great interest in order to unveil the movement and accumulation of nanoparticles in plant tissues for assessing further applications in the field or laboratory. Several areas, such as medicine, materials science and electronics, have begun to benefit and apply nanotechnology for their research since some decades ago. However, only during the recent years, researchers from other disciplines start to see the potential applications of nanoscience, as it is the case of agriculture . NanosenDuring the last years, some works have been published about absorption and uptake of nanoparticles by plants, but mainly dealing with and focused on their putative adverse effects -8. NeverCucurbita pepo) [In a previous research, we analyzed the penetration and transportation of magnetic carbon-coated nanoparticles through the leaves and aerial part of the plant in cucumber (ta pepo) ,10. The ta pepo)  applyingta pepo) . Furtherta pepo)  might beHelianthus annuus) from the family Compositae; tomato (Lycopersicum sculentum) from the Solanaceae; pea (Pisum sativum), from the Fabaceae; and wheat (Triticum aestivum), from the Triticeae.In the present work, we have studied the absorption and translocation of magnetic carbon-coated nanoparticles through the root in four crop plants belonging to different families: sunflower  allowing visualizing the roots . When thFirstly we assessed that bioferrofluid was able to penetrate into the treated roots and to reach the vascular cylinder in a short period of time. Study of the samples taken at the point of application showed that after only 24 hours of exposure to the bioferrofluid, nanoparticles were able to leak into the vascular tissues of the tested crops Figure . This inAt this point, there are no studies about the real mechanism by which nanoparticles can penetrate into the plant cells. However, there is a recent work dealing with internalization of gold nanoparticles using tobacco protoplasts . In suchNanoparticles were detected easily in the xylem vessels of the four crops studied, but some differences were observed among species. Pea roots accumulated higher contents of bioferrofluid Figure  than sunAfter a successful uptake of the nanoparticles by the plant roots, we monitored the translocation of such nanoparticles into the aerial part. Figure Subsequent sections of upper parts of the plants confirmed that nanoparticles had spread and reached most of the aerial part after 24 hours of exposure to the bioferrofluid. Following the same pattern, accumulation of nanoparticles was detected in xylem vessels corresponding to the first Figure  and secoIt is remarkable that nanoparticles strongly accumulated in leaf trichomes of wheat plants Figure . The preFinally, the presence of nanoparticles in roots not exposed directly to the bioferrofluid was checked Figure . The chaBecause these microscopic techniques allow observation only with low resolution, the bioferrofluid was usually visualized inside xylem vessels where big accumulations of nanoparticles took place. However, 48 hours after roots exposure to bioferrofluid, nanoparticles were also detected in vascular and cortical parenchimatic cells of the plants Figure . As statIn summary, in this work we have presented results showing how carbon-coated magnetic nanoparticles can be absorbed by the root system of four different crop plants and spread using the vascular system to reach the whole plant. There are differences in the speed of absorption and distribution of the nanoparticles depending on the species, being faster in pea and wheat than in tomato and sunflower. In addition, it seems that sunflower shows a lower capability for radial movement of bioferrofluid outside the vascular tissues than the other crops. Within the first 24 hour of exposure to the suspension, the nanoparticles can reach the upper part of the plants, and in the case of wheat they accumulate inside leaf trichomes. After 48 hours of exposure, the bioferrofluid is located outside the vascular tissues  and has moved downwards to non treated roots. This fast movement of the nanoparticles inside the plants can have an important impact for the development of nanoparticles as smart delivery systems inside the plant and further studies about their distribution and accumulation. It seems clear that root application is faster and more reliable than leaf treatments ,10. ThisThe authors declare that they have no competing interests.ZC carried out the nanoparticle treatments to the plants and the microscopy study, the processing of plant samples, and wrote the first manuscript draft. LC carried out the synthesis of nanoparticles and the bioferrofluid suspension. CM and MRI participated in the design of the nanoparticle synthesis and preparation of the suspension, in the design of the study and to the writing of parts of the manuscript. JMF contributed to the experimental design of nanoparticle synthesis and to the writing of parts of the manuscript. DR participated in the design of the study and helped in experiments of nanoparticle treatments to the plants. APL conceived the study, participated in the design and coordination of the work and helped to draft the manuscript. All authors read and approved the final manuscript.Hydrodynamic size. The data show the hydrodynamic size of the nanoparticles measured by Dynamic Light Scattering technique.Click here for file


Fas gene is frequently reduced or lost during the development of colorectal carcinoma. However, loss of heterozygosity at the Fas locus or Fas gene rearrangements do not account for the loss of expression of Fas, raising the possibility that methylation of the Fas promoter may inhibit gene expression in colorectal carcinomas. We have examined the Fas promoter region CpG island for evidence of hypermethylation in colorectal tumours. Forty-seven specimens of colorectal adenoma and carcinoma, as well as six samples of normal colonic mucosa, were examined by Southern blotting for methylation at Hpa II and Cfo I sites in this region. No methylation was detected in any of the specimens, suggesting that hypermethylation is not primarily responsible for the loss of expression of the Fas gene during colorectal tumorigenesis. © 2000 Cancer Research CampaignExpression of the apoptosis-promoting


Optimized methods for extraction and enzyme assay in crude tissue preparations were used to determine the amounts of terminal deoxnucleotidyl transferase (TdT) in malignant lymphomas. The TdT concentration was increased only in lymphoblastic lymphomas (LL) and was as high in these tumours as in the white blood cells from untreated patients with acute lymphoblastic leukaemia (ALL). The enzymes extracted from such lymphomas and from the leukaemic lymphoblasts had the same properties. Moreover, forms of TdT with low and high mol. wt were found in the LL tumours, similar to other reports of TdT-positive leukaemias. The overall study points at some basic biochemical identity of certain lymphoblastic malignancies, irrespective of whether the transformed cells are in solid tumours or are disseminated in the blood.


Nanoparticles introduced in living cells are capable of strongly promoting the aggregation of peptides and proteins. We use here molecular dynamics simulations to characterise in detail the process by which nanoparticle surfaces catalyse the self-assembly of peptides into fibrillar structures. The simulation of a system of hundreds of peptides over the millisecond timescale enables us to show that the mechanism of aggregation involves a first phase in which small structurally disordered oligomers assemble onto the nanoparticle and a second phase in which they evolve into highly ordered  Protein misfolding and aggregation are associated with a wide variety of human disorders, which include Alzheimer's and Parkinson's diseases and late onset diabetes. It has been recently realised that the process of aggregation may be triggered by the presence of nanoparticles. We use here molecular dynamics simulations to characterise the molecular mechanism by which such nanoparticles are capable of enhancing the rate of formation of peptide aggregates. Our findings indicate that nanoparticle surfaces act as a catalyst that increases the local concentration of peptides, thus facilitating their subsequent assembly into stable fibrillar structures. The approach that we present, in addition to providing a description of the process of aggregation of peptides in the presence of nanoparticles, will enable the study of the mechanism of action of a variety of other potential aggregation-promoting agents present in living organisms, including lipid membranes and other cellular components. Indeed, it is well known that colloids in vivo, nanoparticles are often covered by peptides and proteins that determine their behaviour in the cell With the advent of nanoscience much interest has arisen about the ways in which nanoparticles interact with biological systems, because of their potential applications in nanotechnology and effects on human health et al. investigated the process of assembly of amphiphatic peptides in the presence of lipid vescicles In this work we use molecular dynamics simulations to investigate the molecular mechanism of peptide self-assembly in the presence of spherical nanoparticles. Although computational studies using full atomistic models have provided considerable insight into the role of fundamental forces in promoting the self-assembly of polypeptide chains, they are restricted to relatively small systems of peptides and short timescales In the present work, we adopted an off-lattice protein model onds see . The majStarting from the experimental observation that amyloid formation is a phenomenon common to most polypeptide chains We first performed molecular dynamics simulations at a peptide concentration, We consistently observe that the presence of this hydrophobic nanoparticle effectively removes the lag-time prior to aggregation , which rncreases . Althougncreases , larger in vivo nanoparticles are always covered by biological molecules.In order to provide a detailed analysis of the structure of the clusters that form on the nanoparticle surface we calculated the liquid crystalline order parameter ordering . To inveordering . The enhIn our simulations the lag time for nanoparticle induced peptide aggregation is about a microsecond which is quite short compared to the lag times typically observed in experiments. The latter range from some hours to several days, but it should be noted that both peptide concentration (3.4 mM) and, especially, nanoparticle concentration (6.5 µM) are much higher than in experiments  less effective as well in reducing aggregation lag times In our model system the binding of peptides to the nanoparticle is stronger for the more hydrophobic surface . As a reWe did not observe an increase of the lag time prior to aggregation by using a smaller nanoparticle diameter, As a final remark, we observe that the molecular mechanism associated with the condensation ordering transition for peptide nanoparticle association described here is independent of particle size and hydrophobicity. The structural reorganization of protein chains in the early disordered oligomeric assemblies from their native or unstructured conformation to the We have characterised the process of nanoparticle-catalysed peptide aggregation in terms of a condensation-ordering mechanism and investigated its dependence on the nanoparticle diameter and the strength of the nanoparticle-peptide interactions. A similar mechanism of aggregation has already been observed in the absence of catalysing factors We used a modified version of the tube model The quasi-cylindrical symmetry of the tube is broken by the geometric requirements of hydrogen bonds. These geometrical requirements were deduced from an analysis of 500 high resolution PDB native structures The energy of hydrogen bonds was set to We performed discontinuous molecular dynamics (DMD) simulations 9, performed in every simulation corresponds qualitatively to 0.78 milliseconds.In order to associate the number of collision steps performed in our simulation to a real time we measured the long time self-diffusion coefficient of our model peptide, Video S1Configurations obtained from the molecular dynamics trajectory that corresponds to (5.47 MB GIF)Click here for additional data file.Video S2Final configuration obtained from the molecular dynamics trajectory shown to (3.25 MB GIF)Click here for additional data file.


Highly specific high-throughput assays will be required to take full advantage of the accumulating information about the macromolecular composition of cells andtissues, in order to characterize biological systems in health and disease. We discussthe general problem of detection specificity and present the approach our grouphas taken, involving the reformatting of analogue biological information to digitalreporter segments of genetic information via a series of DNA ligation assays. Theassays enable extensive, coordinated analyses of the numbers and locations of genes,transcripts and protein.


To the Editor: Recently, Pascal Del Giudice et al. published an interesting article  of dermatitis caused by aterials , panel COur data coincided with those of the French study and reinforce the specificity of this dermatologic sign. However, this was not the only coincidence; cases also occurred among the investigators after contact with the infected material in each of the outbreaks. Perhaps both signs may characteristic this dermatitis: the comet sign and “the sign of the infected investigators” of the outbreaks.


Rehabilitation of patients after surgical removal of carcinomas in facial skeleton is one of the most difficult therapies of the stomatognathic system. Significant deformation of tissues, dysfunctions of the stomatognathic system with concurrent biological imbalance of the oral cavity environment frequently affect the treatment to become arduous. Scars and contraction of the oral crevice may cause serious psychological deficiencies that are another aspect of the treatment schedule.Three Turkish patients ages 46 , 61  and 24  who experienced similar operations were rehabilitated with maxillary obturators. The situations was ideal for patient no 1. Patient no 2 could not receive an immediate obturator and patient no 3 rejected using permanent obturator. The paper describes the advantages of a surgical obturator which is constructed before operation and inserted immediately following partial maxillectomy and expresses long term complications when neglecting the use of definite obturator prosthesis, in the light of three cases.The primary objective of oral-maxillofacial and plastic surgeons and prosthodontists when treating tumors is to eliminate disease and to improve the quality of life including the facial contours which influences the psychological condition of patient. Neglecting immediate obturator construction may cause serious facial appearance problems due to soft tissue contracture. When permanent obturator is rejected, serious contracture of soft tissues and facial disharmony is inevitable. Prostodontic rehabilitation of maxillectomies is the preferred treatment in most centers over autogenous tissue reconstructions -5. It reThe following case reports illustrate the benefits of obturator prostheses by emphasizing the advantages of the obturator that was constructed before operation and inserted immediately following maxillary surgery. Denial of using permanent obturator is also demonstrated.46-year old male patient presented to his local dentist complaining of pain and swelling associated with his upper teeth. Routine dental diagnostic procedures and periapical radiographs failed to determine the origin of swelling and he was referred to the department of Oral & Maxillofacial Surgery at Suleyman Demirel University, Faculty of Dentistry. A firm swelling was seen to involve on the left side of the maxillae. An incisional biopsy was performed and this revealed the mass to be a Squamous Cell Carcinoma (SCC). The decision following the consultation was to resect the tumor and to obturate the defect with an immediate prosthesis. The patient was informed about the treatment procedure and the immediate obturation which would minimize the alteration of his appearance. Prior to surgery impressions of the maxilla and mandible were obtained and the cast models were attached to a semiadjustable articulator. The predicted excision was performed on the maxillary model. An immediate obturator with 1 cm extension into the resected side was constructed with adams retention clasp on the right second molar teeth in the preserved side. Under general anesthesia the left side of the maxillae was resected together with the lower third of the nasal septum. After the removal of the tumor, tissue conditioning material was placed over the extension of the immediate obturator to fit the surgical defect accurately and to support the defect area and split-skin grafts Fig.  which wa61 years old male patient was sent to the department of Maxillofacial Surgery with the suspicion of a malign neoplasm in the left side of maxillae due to causeless mobility of left molar teeth and swelling. The biopsy revealed a Squamous Cell Carcinoma (SCC) and hemimaxillectomy was planned for the patient. The patient preferred to receive the surgical operation and adjuvant radiotherapy in a different city where his children lived. The patient returned for prosthetic rehabilitation after 3 months. The history revealed that he has used neither an immediate nor an interim prosthesis. A definitive prosthesis was constructed following an interim obturator for 3 weeks period. The adversely contracted soft tissues did not permit an ideal prosthetic rehabilitation Fig. .24 years old female patient was referred with a swelling localized on her left cheek Fig. . The bioNeglecting timely prosthodontic cooperation may cause inappropriate facial contour which is almost impossible to reconstruct ,9,14. InThe borders of the defect may collapse more rapidly if support of the immediate obturator is neglected and in a few weeks after surgery – the healing period – especially the anterior and lateral border of the defect migrates towards the center of the defect causing facial aesthetic problems. Supporting soft tissues prevents the continuing of the migration and collapse of the soft tissues. Long term lack of support leads to slower migration but bigger problems which is hard or nearly impossible to treat or reconstruct. For the patient no 3 Levator Anguli Oris and Levator Labi Superior muscles may have been contracted and elevated the comissura as they originate from the maxilla which is already resected. Zygomaticus Major and Minor muscles may also have an effect on the elevation of the comissura considering the surgical procedure. Nevertheless the problem is more than an elevation of the comissura but a collapse of the left mid facial region which even causes the deviation of the nose hip. Therefore lack of support and soft tissue contraction due to radiotherapy is thought to have been more effective on the facial deformity.Immediate prosthetic replacement is a successful and time-saving procedure that may afford many advantages in the surgical and postoperative management of the patient . ServingThe use of immediate obturators is essential for the optimum rehabilitation of oral functions and cosmetics with prosthetics as well as the maintenance of definitive prosthesis. Immediate obturators support soft tissues after surgery and minimize scar contracture and disfigurement that may have a positive effect on the patients' psychology. Avoiding immediate obturator construction may cause serious facial appearance problems due to soft tissue contracture. When wearing the permanent obturator is neglected, the dynamics of non-supported soft tissues change towards serious contracture and facial disharmony.Written informed consent was obtained from the patients for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.The authors declare that they have no competing interests.TB and MAA operated the patients no 1 & 3. TB also diagnosed the patient no 2. ST and MMO constructed the prosthesis for both three patients and prepared draft manuscript. All authors read and approved the final manuscript.


The growth in mice of subcutaneous isografts of any of 5 methylcholanthrene-induced fibrosarcomas was associated with macrophage stimulation, reflected in an increased incidence of DNA-synthesizing cells among marcophages in the uninjected peritoneal cavity. This occurred at some stage with 4 tumours that induced concomitant immunity and one that did not. Some degree of splenomegaly also occurred with all 5 tumours. The spleens of all the tumour-bearing mice showed histological evidence of increased haemopoietic activity. Histological changes in the lymphoid elements of the spleen were very different with different tumours, ranging from lymphoid stimulation to lymphoid atrophy. The lymph nodes draining the sites of primary isografts which induced concomitant immunity showed signs of stimulation in the paracortical areas, followed by plasmacytopoiesis in the medullary areas. Stimulation of the paracortical areas was not detected in the nodes draining sites of injection of a tumour not inducing concomitant immunity. Nodes draining the sites of challenge isografts in mice exhibiting concomitant immunity showed plasmacytopiesis.


A method is presented to evaluate the influence of statistical errors and inherent variation on the determination of mitotic and labelling indices of human tumours. In most of the experiments reported here, sufficient cells were counted to yield a statistical error which is small in comparison to the inherent differences in the proliferative indices, both between different sites in the same tumour and between different tumours of the same histological type. These inherent fluctuations are, theefore, a critical factor in cell kinetic studies of human tumours.


In a study of three socio-economic groups in Hong Kong, the high income group had a high faecal concentration of bile acids, especially the dihydroxy bile acids, compared to the low income group. The faecal bile acids were also more highly degraded. The faecal flora contained more bacteroides and fewer eubacteria. Very few of the clostridia able to dehydrogenate the steroid nucleus were isolated. An epidemiological study based on street blocks indicated that the high income group also have a higher incidence of cancer of the large bowel and of the breast. The results are discussed in terms of theories on the aetiology of large bowel cancer.


The prevalence of diabetes mellitus has reached epidemic proportions, this condition may result in multiple and chronic invalidating long term complications. Among these, the diabetic foot, is determined by the simultaneous presence of both peripheral neuropathy and vasculopathy that alter the biomechanics of the foot with the formation of callosity and ulcerations. To diagnose and treat the diabetic foot is crucial to understand the foot complex kinematics. Most of gait analysis protocols represent the entire foot as a rigid body connected to the shank. Nevertheless the existing multisegment models cannot completely decipher the impairments associated with the diabetic foot.A four segment foot and ankle model for assessing the kinematics of the diabetic foot was developed. Ten normal subjects and 10 diabetics gait patterns were collected and major sources of variability were tested. Repeatability analysis was performed both on a normal and on a diabetic subject. Direct skin marker placement was chosen in correspondence of 13 anatomical landmarks and an optoelectronic system was used to collect the data.Joint rotation normative bands (mean plus/minus one standard deviation) were generated using the data of the control group. Three representative strides per subject were selected. The repeatability analysis on normal and pathological subjects results have been compared with literature and found comparable. Normal and pathological gait have been compared and showed major statistically significant differences in the forefoot and midfoot dorsi-plantarflexion.Even though various biomechanical models have been developed so far to study the properties and behaviour of the foot, the present study focuses on developing a methodology for the functional assessment of the foot-ankle complex and for the definition of a functional model of the diabetic neuropathic foot. It is, of course, important to evaluate the major sources of variation (true variation in the subject's gait and artefacts from the measurement procedure). The repeatability of the protocol was therefore examined, and results showed the suitability of this method both on normal and pathological subjects. Comparison between normal and pathological kinematics analysis confirmed the validity of a similar approach in order to assess neuropathics biomechanics impairment. The chronic hyperglycemia of diabetes, a highly widespread chronic disease, is associated with long-term damage, dysfunction, and failure of various organs. In particular, patients experience neuropathy and blood vessels degeneration. These two complications develop into the foot disease which alters the biomechanics of gait and eventually leads to the formation of callosity and ulcerations.The social and economic burden of the diabetic foot can be reduced through early diagnosis and treatment. Diabetic neuropathy is present in 25% of the patients after 10 years of disease, and it is the most significant risk factor for the development of foot ulcers. It consists in the distal symmetrical polyneuropathy which affects the motor and sensitive systems, both involved in the pathogenesis of the diabetic foot . Callus st metatarsophalangeal and subtalar joints y = Vabs , and aftClick here for file


Hormone measurements during the menstrual cycle were assessed in six premenopausal women undergoing breast cancer surgery and ten controls to determine whether the stress of diagnosis and surgery influenced cycle characteristics. There was hormonal evidence for normal ovulation in all cancer and control women, although the length of the luteal phase of the cycle was prolonged because of a delay in menstruation in two cancer patients. The timing of surgery in the cycle did not influence the hormonal data. The hormonal characteristics of the menstrual cycle thus appear to be normally preserved in women during the month in which breast cancer surgery is performed.


When a virus infects a cell, it must contend with a hostile environment and host machinery that is intrinsically antiviral. One of the hallmarks of herpes simplex virus (HSV) infection is the dramatic reorganization of the infected cell nucleus leading to the formation of large globular replication compartments in which gene expression, DNA replication, and encapsidation occur . During The formation of replication compartments follows an ordered assembly process, resulting in a drastic remodeling of the nucleus Remodeling of the nucleus also involves the reorganization of the cellular PQC machinery, including cellular chaperone proteins  and components of the 20S proteosome Herpesviruses have also evolved a complex relationship with host DNA damage response pathways  and the single-strand binding protein (ICP8) interact with each other, are recruited to replication compartments, and are essential for efficient virus production (During the earliest stages of viral infection, HSV transforms the cellular environment from one that is hostile to virus infection to one that supports virus growth. Work in this area has only scratched the surface in terms of defining the mechanisms by which ICP0 and other viral proteins manipulate cellular pathways and create environments that promote lytic infection. Elucidating how cellular homeostatic pathways limit viral infections will be important to our understanding of the delicate balance between lytic and latent infection and to aid in the development of new antiviral therapies.


The authors report a case of hormonally silent duodenal somatostatinoma. The main clinicalfeatures, the natural history and the currently available therapies of these rare neoplasms aredescribed on the basis of this case and of the scientific literature. Although the antiblastictherapies are still debated, the patient showed a surprising outcome following chemotherapy.


Positive selection of host proteins that interact with pathogens can indicate factors relevant for infection and potentially be a measure of pathogen driven evolution.Our analysis of 1439 primate genes and 175 lentivirus genomes points to specific host factors of high genetic variability that could account for differences in susceptibility to disease and indicate specific mechanisms of host defense and pathogen adaptation. We find that the largest amount of genetic change occurs in genes coding for cellular membrane proteins of the host as well as in the viral envelope genes suggesting cell entry and immune evasion as the primary evolutionary interface between host and pathogen. We additionally detect the innate immune response as a gene functional group harboring large differences among primates that could potentially account for the different levels of immune activation in the HIV/SIV primate infection. We find a significant correlation between the evolutionary rates of interacting host and viral proteins pointing to processes of the host-pathogen biology that are relatively conserved among species and to those undergoing accelerated genetic evolution.These results indicate specific host factors and their functional groups experiencing pathogen driven evolutionary selection pressures. Individual host factors pointed to by our analysis might merit further study as potential targets of antiretroviral therapies. Pan troglodytes troglodytes) gave rise to the HIV-1 groups M, N and O  range. The same procedure was repeated on the positively selected genes inferred in the human-chimp comparison and correlated to the viral gene ranking based on the HIV-1/SIVcpz alignment.The interactions were grouped into bins defined by viral gene ranking. The ranks of host genes within bins were averaged. Bins of different sizes were slid along the viral gene ranking scale, advancing from one gene to adjacently ranked gene in each step. For each bin size we calculated the correlation between viral gene ranks and the averaged host gene ranks. Because of the small number of viral genes (18) a symmetrical approach of averaging over viral gene ranks was not performed. We tested all 18 possible bin sizes. We then used the permutation procedures described below to test for the significance of the correlation obtained for the averaged binned ranks of each bin size.host-oriented test consists of retaining the degree of each of the host gene nodes in the network and randomly sampling a corresponding number of interacting viral genes from the set of all viral genes. The virus-oriented test consists of retaining the degree of each viral gene node and randomly sampling a corresponding number of interacting host genes. Performing two different permutation tests allowed us to test if certain results were due to the differing numbers of interactions reported for different host and viral proteins. We developed additional permutation tests allowing for random node degrees in the network and found the permutation tests conserving aspects of the network topology to be more stringent in assessing the statistical significance of our observations. We therefore used the host- and virus-oriented tests to assess statistical significance of the results of our analyses.In order to assess the statistical significance of previous analyses we developed permutation tests of the HIV-human interactions. The HIV-human interaction data can be represented by a bipartite graph with nodes representing host and viral proteins and edges connecting interacting host and viral proteins. We designed two procedures of permuting the host-virus interaction network. The KB and TL conceived this project and wrote the manuscript. KB designed the study, and collected and analyzed the data. All authors read and approved the final manuscript.list of all analyzed genes, scores and annotations.Click here for filedetailed results of the GO term enrichment tests.Click here for fileinformation on the alignment quality.Click here for file


Based on the analysis of the drafts of the human genome sequence, it is being speculatedthat our species may possess an unexpectedly low number of genes. The quality of thedrafts, the impossibility of accurate gene prediction and the lack of sufficient transcriptsequence data, however, render such speculations very premature. The complexity ofhuman gene structure requires additional and extensive experimental verification oftranscripts that may result in major revisions of these early estimates of the numberof human genes.


To evaluate the clinical significance of serum levels of hepatocyte growth factor (HGF) in colorectal cancer patients, we measured the venous and portal concentrations of HGF in 60 patients. The tissue concentrations in the tumour and adjacent normal mucosa were also determined. The serum HGF concentration for the peripheral venous blood of the patients was significantly higher than that in normal controls. The content of HGF in cancer tissue was also significantly higher than that in normal mucosa, and it was correlated with the serum HGF concentration for the peripheral venous blood. The serum concentration of HGF reflected pathological features, including tumour size and lymph node or liver metastasis, and it showed an association with various preoperative nutritional parameters and the preoperative haemoglobin level. The serum HGF concentration was also correlated with the serum concentrations of immunosuppressive acidic protein and interleukin-6, indices of the host's immunological condition. Serum HGF seems to be a useful index of the disease status of patients with colorectal carcinoma.


The potential applications of operative laparoscopy have expanded with improvements in technology and instrumentation. With newly developed techniques to complete both pelvic and paraaortic lymph node dissection, the use of the laparoscope has increased in patients with pelvic malignancies. Gynecologic oncologists are currently incorporating the techniques of operative laparoscopy in the management of patients with cervical, endometrial, and ovarian cancer. Multicenter prospective clinical trials are necessary to further define the role of laparoscopy in gynecologic oncology.


Cystic lesions of the pancreas are relatively uncommon.We describe the case of a young man with acomplex cystic mass located within the head of thepancreas. The patient underwent exploration withresection of the mass. Pathology revealed a ciliatedepithelial cyst, a rare cystic lesion of the pancreas.


We report a case of severe weight loss secondary to anorexia nervosa causing bilateral superficial peroneal nerve entrapment in a young female patient who was treated successfully by bilateral surgical decompression. Among entrapment neuropathies, superficial peroneal nerve (SPN) entrapment is relatively rare -8 and onSevere weight loss, as a result of anorexia nervosa, associated with common peroneal nerve entrapment is very rare -17 and SHerein we report a case of severe weight loss secondary to anorexia nervosa causing bilateral SPN entrapment in a young female patient who was treated successfully by bilateral surgical decompression.A 20-year-old, female university student presented to our outpatient orthopaedic clinic with a two month history of vague pain on the outer border of both legs, and numbness over the dorsum of the feet and big toes. Her symptoms were exacerbated by walking and running and partially relieved by elevation. She had to stop to rest after 30 minutes of walking because of intolerable pain.There was neither history of trauma or surgery to the lower limb nor history of lower back problems. There was, however, a history of severe weight loss of (30 kg) during the previous six months and the patient was diagnosed with anorexia nervosa using criteria from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD).Physical examination revealed bilateral tender points approximately 11 cm proximal to the ankle joint on the outer surface of the leg, Tinel sign was also positive bilaterally. There were sensory deficits on the dorsum of both big toes but no muscle weakness or abnormal reflexes.Examination of the lumbar spine and lower limbs revealed no clinical abnormalities in the joints and there was neither suspicion of nerve root compression at the level of the lumbar spine nor nerve entrapment at the neck of the fibula.Radiographic examination of the lumbar spine, legs and feet were normal and EMG studies were positive for bilateral entrapment neuropathy of the SPN proximal to the ankle joint with no abnormality of the common peroneal nerves or of the proximal nerve roots.After preoperative assessment, the patient was admitted for surgical treatment with the diagnosis of SPN entrapment. The operation was done under general anaesthesia, using pneumatic tourniquet. Bilateral explorations of the site of tenderness revealed adhesions of both SPNs to the fascia with perineural fibrosis. Careful dissections were done to free the nerves and neurolysis was successfully performed Figure . The nerSymptoms of bilateral peroneal nerve entrapment were relieved immediately and completely in the postoperative period. Physiotherapy was started immediately to prevent postoperative adhesions. No recurrence was observed in the first year following the operation.Superficial peroneal nerve syndrome is an entrapment neuropathy that usually results from mechanical compression of the nerve at or near the point where the nerve pierces the fascia to travel within the subcutaneous tissue.A thorough and accurate knowledge of the course of the SPN and its relationships is essential to understand the pathophysiology, and a thorough and careful physical examination is important for diagnosing this condition. Stephens et al. described a physical sign to identify the distal subcutaneous course of the SPN below the skin, primarily by means of plantar flexion and inversion of the ankle and foot and, secondarily by a passive flexion of the fourth toe .In his study Styf, described 3 provocative tests for nerve compression at rest at rest following exercise . In the Electrophysiological studies are helpful for the diagnosis, however, normal conduction velocity may be found especially at rest which does not exclude compression of the superficial peroneal nerve .Injection of the nerve with lidocaine or Marcaine just above the site of involvement may be the most valuable diagnostic tool. The patient can define the extent of relief obtained from such an injection, which can be helpful in defining the zone of injury and expected relief from surgical release or excision.Entrapment of the superficial peroneal nerve has traumatic and non traumatic causes. Local trauma and compression are the most common causes of nerve entrapment. This may be due to recurrent stretch injuries or certain positions like prolonged kneeling and squatting, which cause perineural fibrosis ,18. OedeNontraumatic causes of SPN entrapment are commonly due to anatomical variations such as fascial defects, with or without muscle herniation about the lateral lower leg, where the nerve is entrapped as it emerges into the subcutaneous tissue or a short peroneal tunnel proximally. Nerve compression in patients with fascial defects is explained by the normal increase in muscle relaxation pressure and intramuscular pressure at rest during and after exercise. This increase is sufficient to cause herniated muscle tissue and this can impinge upon or compresses the nerve .Lowdon reported a case of an abnormally long course of the SPN nerve through the deep fascia which was thought to have caused compression. Exercise may have exacerbated the symptoms by producing mechanical irritation or by raising the pressure in the peroneal compartment and thus increasing compression of the nerve .In our case, the bilateral involvement forced us to think about a systemic cause of SPN entrapment. The patient had severe loss of weight in a period of few months due to previously undiagnosed anorexia nervosa which may have caused changes in the subcutaneous tissues that led to adhesions and perineural fibrosis. Although the exact cause is unknown; SPN entrapment should be kept in mind especially in patients with severe weight loss and changes in body habits.The authors declare that they have no competing interests.


Increasingly mRNA expression patterns established using a variety of molecular technologies such as cDNA microarrays, SAGE and cDNA display are being used to identify potential regulatory genes and as a means of providing valuable insights into the biological status of the starting sample. Until recently, the application of these techniques has been limited to mRNA isolated from millions or, at very best, several thousand cells thereby restricting the study of small samples and complex tissues. To overcome this limitation a variety of amplification approaches have been developed which are capable of broadly evaluating mRNA expression patterns in single cells. This review will describe approaches that have been employed to examine global gene expression patterns either in small numbers of cells or, wherever possible, in actual isolated single cells. The first half of the review will summarize the technical aspects of methods developed for single-cell analysis and the latter half of the review will describe the areas of biological research that have benefited from single-cell expression analysis.


Infant feeding by HIV-infected mothers has been a major global public health dilemma and a highly controversial matter. The controversy is reflected in the different sets of WHO infant feeding guidelines that have been issued over the last two decades. This thematic series, 'Infant feeding and HIV: lessons learnt and ways ahead' highlights the multiple challenges that HIV-infected women, infant feeding counsellors and health systems have encountered trying to translate and implement the shifting infant feeding recommendations in different local contexts in sub-Saharan Africa. As a background for the papers making up the series, this editorial reviews the changes in the guidelines in view of the roll out of prevention of mother to child transmission (PMTCT) programmes in sub-Saharan Africa between 2001 and 2010. The papers in this thematic series highlight the multiple challenges to infant feeding that have surfaced within the framework of postnatal prevention of mother to child transmission of HIV (PMTCT). The focus is in particular on the implementation of the global HIV and infant feeding guidelines at the local level in various settings in sub-Saharan Africa. The symposium which preceded this publication dwelt on lessons learnt through the past decade of experiences with the implementation of the PMTCT programme. The symposium took place between 2 and 4 September 2008, in Rosendal, western Norway and was an interdisciplinary endeavour with students and scholars from eastern and southern Africa, Canada and Norway. The event offered an opportunity for dissemination of results from Masters, PhD and post-doctoral studies on the PMTCT challenge. The seven research papers included in this issue report on the experiences of women and their partners, of PMTCT counsellors and of policy makers in selected countries in sub-Saharan Africa between 2001 and 2009. During this period the WHO 2001 HIV and infant feeding guidelines . 7. 3], anWith the current knowledge and technology most cases of postnatal MTCT are preventable through antiretroviral (ARV) drugs and modifications in infant feeding practices. During the last decade an increasing number of HIV-infected women have gained access to antiretroviral treatment or prophylaxis effectively reducing transmission during pregnancy and birth , but theThe initial standard PMTCT programme package which was implemented in most sub-Saharan settings between 2001 and 2009 was exclusively preventive. The sole aim of all interventions including medication of the mother was to prevent the baby from acquiring HIV. The services included voluntary and later routine counselling and testing (VCT/RCT), different regimens of ARV prophylaxis to mother and child around the time of birth, and infant feeding counselling based on the 2001 WHO guidelines [The issue of infant feeding has been particularly challenging in a PMTCT context because the options available, breastfeeding or not breastfeeding, both involve risks to child health and survival. How to weigh the benefits of breastfeeding against the risk of HIV infection is an issue that has been vigorously debated. The dilemma becomes particularly acute since the greatest proportion the global burden of HIV and AIDS lies in sub-Saharan Africa where the major causes of infant death are malnutrition and infectious diseases . BreastfWithin PMTCT programmes, research on how to make breastfeeding safer identified the increased risks of mixed feeding . The cusThe WHO HIV and infant feeding guidelines have been shifting with developments in knowledge and technology. The WHO in collaboration with UNAIDS and UNICEF have to our knowledge produced 16 documents, possibly more, on infant feeding guidelines for HIV-infected women over the last quarter century ,16-29. TIn 1997-98 the WHO published new infant feeding guidelines which advised that all mothers should be counselled about possible feeding options and thus be allowed to make their own decision about infant feeding. This was interpreted as a major policy shift towards the promotion of replacement feeding. Based on this shift the distribution of free infant formula to HIV positive women enrolled in PMTCT programmes was initiated in some countries [With the rapidly emerging evidence of the challenges of replacement feeding in low income contexts the WHO, in 2001  were intAccording to this guideline the decision about whether or not to breastfeed should be made by every mother based on full information of the options available. The guiding principle was that HIV-infected mothers should be supported in making an informed decision about how to best feed their infants . This poAlthough the 2001 guidelines brought in the AFASS criteria which promoted an assessment of each woman's situation and choice, they still strongly communicated that replacement feeding was the first choice of infant feeding method for HIV positive women, and that exclusive breastfeeding should be discontinued as soon as replacement feeding was AFASS. Major challenges have been that both exclusive breastfeeding and replacement feeding have been found to be extremely difficult to adhere to for the large majority of the HIV-infected mothers -36, and In 2006, after strong evidence of the risks of childhood infections and malnutrition associated with replacement feeding, and with the path-breaking documentation of a higher HIV free survival rate among exclusively breastfed than among replacement fed infants , the WHOIn 2009, WHO launched the so-called Rapid Advice  building• Mothers known to be HIV-infected should exclusively breastfeed their infants for the first six months of life, introducing appropriate complementary food thereafter, and continue breastfeeding for the first 12 months of life;• Mothers who decide to stop breastfeeding should stop gradually within one month; stopping breastfeeding abruptly is not advisable;• Mothers known to be HIV-infected should only give commercial infant formula milk as a replacement feed to their HIV uninfected infants or infants who are of unknown status, when specific conditions are met (referred to as AFASS);• Mothers known to be HIV-infected should be provided with lifelong antiretroviral therapy or antiretroviral prophylaxis interventions.The 2001 and the 2010 guidelines each produced in response to the existing evidence available, stand in sharp contrast to one another both in terms of the recommended first choice of feeding method ; breastfeeding cessation  and in terms of the principle of informed choice . It is however predominantly the 2001 version promoting replacement feeding as the first choice and exclusive breastfeeding only if replacement feeding is not AFASS that has informed training and infant feeding counselling in PMTCT programmes across sub-Saharan Africa during the past decade. The HIV epidemic coupled with the assumed benefits of infant feeding formula for all HIV-infected mothers have in complex ways changed public ideas about infant feeding, and has introduced an important threat to well established breastfeeding practices.The pace, frequency, and characteristics of the changes have been influenced by continuing weaknesses in the scientific understanding of the mechanisms and risks of infection, but also by failure in early political leadership to demand timely funding to conduct research to properly address these weaknesses . The suiThe history of the shifting WHO guidelines on HIV and infant feeding in the period 1998-2010 can be seen as a history of retreat from recommendations based on narrow medical research and on ideologies of individual choice, to recommendations recognising the importance of local social and cultural context as well as local knowledge on breastfeeding and survival. Most significantly the shifts in infant feeding recommendations in the 2010 guidelines promoting exclusive breastfeeding for six months as the method of choice, and complementary feeding after six months are thus more in line with the public health recommendations to the general population. They are also more in line with customary infant feeding practices in sub-Saharan Africa. The move away from replacement feeding as first choice brings breastfeeding back as the prime way of feeding an infant and implies a major gain in public health. Moreover it is expected that the new formulation will also protect HIV-infected women from suspicion and stigma attached to non-normative infant feeding practices. In the long run the most important outcome will be to protect the general public against spill-over effects from the replacement feeding promotion that indirectly has taken place through PMTCT infant feeding counselling [The papers included here look back on the past decade of PMTCT implementation and discuss the lessons learnt. They reveal different dimensions of the PMTCT guidelines and how they enter into action across national and local settings. They present glimpses of the intricate challenges encountered by the targets of global policy guidelines - the HIV-infected mothers, the PMTCT counsellors, local policy makers and peer supporters. The papers add to and challenge the strictly defined biomedical evidence, and bring to the forefront experience-based and context bound knowledge.et al.'s paper from Malawi [The problems involved in translating the 2001 WHO HIV and infant feeding guidelines to national policy and programming are dealt with in Chinkonde m Malawi . In a com Malawi . The lacet al.'s paper describes the confusion and fear that Ethiopian mothers face trying to adhere to the advice given by the nurse-counsellors [The confusion in relating to the guidelines is more concretely revealed in the powerful accounts of HIV-infected mothers who have to handle their own HIV positive status while at the same time struggling with the possibility of transmitting the virus to their infant through breastfeeding. Koricho nsellors . The intnsellors .et al.'s paper from Uganda where both exclusive breastfeeding and exclusive formula feeding were deemed inappropriate and unsatisfactory by the study participants [The lack of local applicability of the PMTCT guidelines is also revealed concretely in Engebretsen icipants . The papicipants . Such laThe acknowledgement of the importance of partner involvement in PMTCT programmes has led to a strong call for partner disclosure. A woman's disclosure of positive HIV status to her partner at the vulnerable time of pregnancy or after birth has however been experienced as highly problematic. Njunga and Blystad's paper describes the implications of partner disclosure within a matrilineal and matrilocal kinship structure in Malawi . Men in et al's study from Malawi demonstrates the many obstacles of emotional, practical and economic kind that HIV-infected women experience in their attempts to wean their children abruptly and at a very early age [et al. describes the demands of the PMTCT programme as a 'downloading of responsibility' onto HIV-positive mothers who are unable to secure the baby a safe transition to other foods without support [At the core of the 2001 guidelines lies the concept of early and rapid cessation of exclusive breastfeeding at six months. But extended breastfeeding and mixed feeding is normative in large parts of the world. Levy arly age . Mothers support .et al.'s study from Uganda describes how highly the women in the study valued the support for exclusive breastfeeding from the peer educators and how this became decisive for their ability to adhere to exclusive breastfeeding [The modifications of customary infant feeding practices required in order to adhere to the 2001 WHO guidelines have been very complex and challenging. There has been a growing recognition that without support for the women who must relate to difficult infant feeding regimes there is little chance that they will succeed. A number of different initiatives of support have been launched in the past decade and include projects like mother to mother support groups, home based care, peer education and peer counselling. Nankunda tfeeding . The peetfeeding .However, peer PMTCT support programmes as well as other support initiatives operate in a context fraught with tension and fear. The peer counsellors are left with the challenge of convincing HIV-infected mothers that either exclusive breastfeeding or exclusive replacement feeding is a safe and feasible way of feeding a baby and of reducing the risk of HIV transmission. This is not an easy task. Nkonki and Daniels's paper from South Africa demonstrates how the counsellors struggled to 'sell their service' to a sceptical group of potential recipients through a continuous negotiation of their own credibility . Nkonki The papers together highlight some of the key challenges that emerged in the wake of WHO's 2001 HIV and infant feeding guidelines. They reveal the complexity of dilemmas and the adverse effects that can be generated by global policy guidelines that are very distant from local lives.The WHO infant feeding guidelines have changed considerably since the studies in this issue were carried out. In light of new evidence, operational experiences and increased availability of ARV both for prophylaxis and treatment, one may ask how relevant the results in the present papers are to current and future PMTCT programme implementation. Recent guidelines have a broader approach than the 2001 version. The protection of maternal prenatal and postnatal health, viral load and CD4 status have been included in addition to HIV-free survival of the child . The infThe authors declare that they have no competing interests.KMM, AB and MDP wrote the first draft of the paper. DS contributed to subsequent drafts. PVE was a key person during the workshop and wrote a summing up paper that was drawn upon in the introduction. SCL commented on later drafts. All authors approved the final paper.


The details of surgical techniques for laparoscopic removal of endometriosis and adenomyosisare described briefly in textbooks and gynaecological journal articles. We have described awide variety of techniques for the various procedures required in the treatment of endometriosisand adenomyosis, excluding hysterectomy. The principles are based upon those usedin removal of primary cancer lesions. The limitations of thermal ablation are discussed, andevidence of improved results after excision of lesions have been submitted for publication.


Sir,The majority of us who routinely practice fine needle aspiration biopsy (FNAB) understand the value of immediate on-site evaluation of adequacy/triage and interpretation of this procedure.–3 The cl4Since the October 2009 National Coding Corrective Initiative (NCCI) policy manual publication, many of us have faced repeated inquiries about the appropriateness of using the CPT code 88172 pertaining to this immediate cytologic evaluation. The queset al. found that on-site interpretations consume between 35 and 56 min, exceeding the average time required for frozen section evaluations by approximately 16 min.[et al. documented that without on-site evaluation, the rate of inadequate aspirates would increase, resulting in substantial institutional cost for repeat procedures and testing.[The body of evidence is strong that the time required for on-site assessments by cytopathologists is well spent. In a comprehensive cost analysis, Layfield y 16 min. Not surp testing. While biGiven this background and the related questions and uncertainty, it is worth noting that the College of American Pathologists (CAP) recently added a specific question about immediate adequacy assessments and initial interpretations and their documentation in the Laboratory Accreditation Program cytopathology section checklist effective June 2009 (# CYP. 05325). The cytopathology community has the obligation to clearly advocate for reimbursement policies that support cost-effective cytopathology services for patients. It is our hope that this editorial will encourage individual pathologists, our professional organizations and the greater medical community to adequately support cost-effective cytopathology services. Because of widespread confusion on the current correct billing among payers and members, the ASC and CAP submitted a proposed change to the CPT for code 88172 to more clearly define the unit of service.The Economic and Government Affairs Committee of the American Society of Cytology strongly supports a clear definition of the unit of service for CPT code 88172 that allows the appropriate use of multiple units when multiple procedures are separately evaluated to assure adequacy of the material for diagnosis. As of this writing, the Center for Medicare Services (CMS) is expected to issue additional written guidance on the issue around the November of 2010.No competing interest to declare by any of the authors.http://www.icmje.org/#author Each author participated sufficiently in the work and takes public responsibility for appropriate portions of the content of this article.Each author acknowledges that this final version was read and approved. All authors qualify for authorship as defined by ICMJE


To study the impact of these factors, we measured the uptake of fluorochrome-labelled IgG using confocal laser scanning microscopy, interstitial fluid pressure by the ‘wick-in-needle’ technique, vascular structure by stereological analysis, and the content of the extracellular matrix constituents collagen, sulfated glycosaminoglycans and hyaluronan by colourimetric assays. The impact of the microenvironment on these factors was studied using osteosarcomas implanted either subcutaneously or orthotopically around the femur in athymic mice. The uptake of IgG was found to correlate inversely with the interstitial fluid pressure and the tumour volume in orthotopic, but not subcutaneous tumours. No correlation was found between IgG uptake and the level of any of the extracellular matrix constituents. The content of both collagen and glycosaminoglycans depended on the site of tumour growth. The orthotopic tumours had a higher vascular density than the subcutaneous tumours, as the vascular surface and length were 2–3-fold higher. The data indicate that the interstitial fluid pressure is a dominant factor in controlling the uptake of macromolecules in solid tumours; and the site of tumour growth is important for the uptake of macromolecules in small tumours, extracellular matrix content and vascularization.© 2001 Cancer Research Campaign


The authors present an unusual case of a polar mass in the frontal lobe of the brain, causing acute monocular visual loss in a 50-year-old woman with history of breast carcinoma treated with surgery, radiation and chemotherapy. Neuroimaging demonstrated herniation of the gyrus rectus into the suprasellar cistern resulting in compression of the anterior visual pathway. Frontal lobe tumors often produce impairment in cognitive and motor functions of the patient. They can produce visual loss either from chronic papillaedema or by direct compression of the optic nerve and chiasm. The latter is often caused by tumors located in the posterior part of the inferior surface of the frontal lobe. We reporA 50-year-old nondiabetic and nonhypertensive woman complained of painless, progressive loss of vision in her left eye (OS) of one week duration. She did not have any history suggestive of raised intracranial pressure. There was no history of trauma. One year back she had undergone radical mastectomy for breast carcinoma followed by radiotherapy and chemotherapy. Ophthalmic examination OS showed visual acuity of no light perception. There was an afferent pupillary defect. Examination of the ocular motility and fundus was unremarkable. Examination of the right eye including visual field by confontration method showed no abnormalities. Systemic examination revealed ascites and hepatomegaly. Magnetic Resonance Imaging (MRI) of the brain showed a rounded mass in the polar region of the left frontal lobe with significant edema in the surrounding region . The lefet al.[Our patient was a known case of breast carcinoma with metastasis to the frontal lobe, liver and peritoneum. The frontal mass was located near the anterior end of the frontal lobe and did not cause any neurological deficit. MRI of the brain showed considerable edema of the medial aspect of the frontal lobe and herniation of right gyrus rectus in the suprasellar cistern causing its obliteration. The extensive edema around the mass had apparently extended to the gyrus rectus causing it to herniate into the suprasellar cistern with compression of intracranial part of optic nerve and anterior chiasma. Clinically, the patient demonstrated only features of optic nerve compression. Careful examination of the visual field OD did not show any defect despite apparent anterior optic chiasmal compression. Herniatiet al. reportedUsually, the prognosis in cases of brain metastasis following breast carcinoma is poor. In our case, the radiological findings of significant edema around the lesion and the previous history of surgery, radiotherapy and chemotherapy for breast carcinoma led to a provisional diagnosis of brain metastasis. In many cases, patients are not forthcoming about previous history of malignancy leading to delays in the diagnosis. Our case emphasizes the fact that visual loss can result from a tumor of the frontal lobe located some distance away from the anterior visual system, and the importance of obtaining detailed clinical information including history of previous malignancies in arriving at the right diagnosis and for timely management.


The prehistory of African trypanosomiasis indicates that the disease may have been an important selective factor in the evolution of hominids. Ancient history and medieval history reveal that African trypanosomiasis affected the lives of people living in sub-Saharan African at all times. Modern history of African trypanosomiasis revolves around the identification of the causative agents and the mode of transmission of the infection, and the development of drugs for treatment and methods for control of the disease. From the recent history of sleeping sickness we can learn that the disease can be controlled but probably not be eradicated. Current history of human African trypanosomiasis has shown that the production of anti-sleeping sickness drugs is not always guaranteed, and therefore, new, better and cheaper drugs are urgently required. Trypanosoma that live and multiply extracellularly in blood and tissue fluids of their mammalian hosts and are transmitted by the bite of infected tsetse flies (Glossina sp.). The distribution of trypanosomaisis in Africa corresponds to the range of tsetse flies and comprises currently an area of 8 million km2 between 14 degrees North and 20 degrees South latitude . Co. Co27]. f Uganda ,20. The f cancer , but wasAt the turn of the millennium, the scale of sleeping sickness had almost reached, yet again, the levels of the epidemics seen at the beginning of the century Fig.  27,32].,32.27,32Glossina species [2) infested with only one tsetse fly species, the PATTEC initiative has to deal with a vast area of sub-Saharan Africa (~10 million km2) inhabited by at least 7 different Glossina species recognised as vectors for transmission of sleeping sickness. Therefore, many scientists are sceptical that the PATTEC project will succeed as similar eradication campaigns failed in the past because the tsetse fly infested areas could not be isolated [In 2001, the Organisation of African Unity (OAU) launched a new initiative, the Pan African Tsetse and Trypanosomiasis Eradication Campaign (PATTEC) to eliminate the tsetse fly from Africa . It was  species . The ste species . Howeverisolated . The hugisolated .The only new drug candidate currently in development for treatment of sleeping sickness is the diamidine pafuramidine (DB289). In January 2007, pafuramidine had completed enrolment for Phase III clinical trials in the Democratic Republic of Congo and Angola ,38 whichThere is also an urgent need for accurate tools for the diagnosis of human African trypanosomiasis. The existing tests for diagnosis are not sensitive and specific enough, due to the characteristically low number of parasites found in the blood of sleeping sickness patients. Therefore, the Foundation for Innovative New Diagnostics (FIND) and the WHO launched, in 2006, a new initiative for the development of new diagnostic tests to support the control of sleeping sickness . It is eth century one can learn that a concerted approach of systematic case detection and treatment is the appropriate method for the control of sleeping sickness and that discontinuation of these control measures will lead to re-emergence and spread of the disease. History has also shown that African trypanosomiasis always prevented the introduction of stock farming in endemic areas. A consequence of this is that much of tropical Africa is still present today and has not been converted into grassland for cattle breeding.The history of African trypanosomiasis gives an example of how a disease not only affected the evolution of humans but also the cultural and economic development of people in sub-Saharan regions. From the historical events of the 20The author declares that he has no competing interests.


Exactly five years ago a little flower in the garden of wisdom blossomed as the Hair Research Society of India. Early in 2004, when I registered to participate in the "World of Hair"- fourth intercontinental meeting of hair research societies in Berlin, I was asked to contact the hair research society of my country for a letter of recommendation. Having discovered that such an organization did not exist in my country, I sought the help of my teacher Prof. Patrick Yesudian who had been a "lead kindly light" in all my endeavors. Giving no room for second thought said he, "why not we?" The seed sown by him was nurtured into a sapling by Prof. S. Shivakumar and enthusiastic colleagues with the thirst for knowledge.On 13 June 2004, from the land of diverse culture, history and mystery the Hair Research Society of India was started with the aims of gaining and disseminating the knowledge of hair with the transformation of the same into safe and ethical practices in order to abolish quackery and promote science. It was decided to conduct quarterly meetings with guest lectures by inter-disciplinary specialists, clinical case discussions and to publish a newsletter which would carry the proceedings of the meeting."when confronted with matters genetic; inclined to be somewhat frenetic; thought to be archaic; invokes a mosaic; with Blashco becomes energetic", wanted the Hair Research Society of India to be a "Growing Hair Society" and not simply a hair-growing society.It was Prof. Rudolph Happle, the king of limericks who Our Indian hair newsletter used to be like a sumptuous dinner with a starter of a short note on the current trichological delicacy by our president Prof. Patrick Yesudian, a main course of a highly informative guest lecture and a cool dessert of challenging clinical hair disorders. Prof Urlike Blume-Peytavi, the past president of the European Hair Research Society (EHRS) appreciated our intention of stimulating our colleagues with the knowledge of trichology and encouraged photo documentation of clinical hair disorders in the Indian scenario.International Journal of Trichology, the world′s first dedicated peer-reviewed journal for hair. The journal is fortunate to have a genius like Prof. Desmond J Tobin to be the executive editor who had designed the creative cover page of the journal so meticulously. The editorial board glitters with the luminaries in trichology across the globe.Having conducted 20 quarterly meetings and published 20 newsletters, the Hair Research Society of India has reached yet another milestone in the journey of academic pursuit with the launch of the Thiruvalluvar says in Thirukural, a repertory of universal thoughts and truths, "As deep you dig the sand spring flows; As deep you learn the knowledge grows."Inspired by the EHRS, the Mecca of hair science, the Hair Research Society of India has come a small way in this half a decade. At this moment I thank the presidents, members, researchers, colleagues and patients from whom we learn. The joy of learning continues as saint


Variations in the position of the bifurcation of the common carotid artery and the origin or branching pattern of the external carotid artery are well known and documented. Here, we report the trifurcation of the right common carotid artery in a male cadaver aged about 55 years. The right common carotid artery was found to divide into the external and internal carotids and the occipital artery. High division of bilateral common carotid arteries and a lateral position of the right external carotid artery at its origin were also observed in the same cadaver. There were two ascending pharyngeal arteries on the right side - one from the occipital artery and another from the internal carotid artery. The intraarterial approach is one of the most important routes for the administration of anticancer drugs for head and neck cancers. A profound knowledge of the anatomical characteristics and variations of the carotid artery such as its branching pattern and its position is essential to avoid complications with catheter insertion. The right common carotid artery originates in the neck from the brachiocephalic trunk while the left arises from the aortic arch in the thoracic region. The cervical portions of the common carotids resemble each other very closely. The common carotid artery is contained in a sheath known as the carotid sheath, which is derived from the deep cervical fascia and also encloses the internal jugular vein and vagus nerve, the vein lying lateral to the artery and the nerve between the artery and vein on a plane posterior to both. At approximately the level of the fourth cervical vertebra, the common carotid artery bifurcates into an internal carotid artery and an external carotid artery in the carotid triangle. The external carotid artery lies anteromedial to the internal carotid artery at its origin but becomes anterior and lateral as it ascends. In the neck, the external carotid artery gives off six branches: superior thyroid, lingual, facial and occipital, ascending pharyngeal and posterior auricular arteries. Variations of the common carotid artery include the rare absence of the common carotid artery,2 the higThe carotid system of arteries were observed for variations in 25 cadavers for the period of 3 years from 2004-2007, in routine educational dissection for undergraduate students. In the academic year of 2006-2007 in our department, this variation of right common carotid was observed in a male cadaver aged about 55 years. The right common carotid artery divided into the external and internal carotids and the occipital artery. High termination of both common carotid arteries and the lateral position of the right external carotid artery at the origin were also observed in the same specimen. The branching pattern was also different in the right external carotid artery.In the male cadaver, on the right side, the common carotid artery divided at the higher level coinciding with the level of the tip of the hyoid bone. The length of the right common carotid artery was 10.5 cm . At its et al.[et al.[et al.[et al.[The origin of the occipital artery from the carotid bifurcation has been reported by Quain, Livini, Gurburz et al. In a larl.[et al. studied l.[et al. observedl.[et al.The position of the carotid bifurcation reflects the degree of embryological migration of the external carotid artery and is variable. Huber reports The first report of a lateral position of the external carotid artery was that of Hyrtl in 1841.et al.[Lasjaunias et al. have deset al.[Furthermore, Lasjaunias et al. believe Carotid endarterectomy is the main treatment for atherosclerotic plaques of the cervical internal carotid artery. The branches of the external carotid artery are the key landmarks for adequate exposure and appropriate placement of cross-clamps on the carotid arteries. It is necessary to understand the surgical anatomy of the carotid arteries to carry out successful removal of plaques and minimize postoperative complications in a bloodless surgical field. Transcatheter embolization procedures in the external carotid artery are largely used on hypervascular tumors, epistaxis and traumaThe patterns of variability in the branches of the carotid artery are of paramount importance not only in clinical practice but also in theoretical considerations. Among th


We present a case of simultaneous dorsal perilunate dislocation of both wrists, without a history of fall on outstretched hands. In contrast, it appeared that the mechanism was reverse. His hands were held in radial deviation with wrists in full palmar flexion. The forearms were in neutral position and elbows in mid-flexion. The wrists were suddenly and forcibly pronated. The radiographs of both wrists showed dorsal perilunate dislocation with avulsion fracture of the tip of ulnar styloid process and avulsion fracture of posterior horn of lunate. Radial translation of the carpal bones was also noted. The mechanism is proposed and discussed. Fractures or dislocations of carpal bones usually result from a fall on outstretched hands with wrists in hyperextension. This usually happens in motor vehicle accidents. Dorsal perilunate dislocation of wrist is one of the commonest patterns.13The present concept of the mechanism of dorsal perilunate dislocation in literature is a fall on outstretched hand causing dorsiflexion and axial impaction of the carpal bones on the forearm bones with ulnar deviation and supination of the wrist over the fixed pronated forearm.A 25-year-old man, an apprentice welder in a heavy steel industry, was returning home after watching a late-night movie show. When he was walking alone, before he realized two robbers followed and stopped him for money. Then the two robbers one on each side twisted his arms toward his back. They held his forearms in neutral and elbows in 90° flexion. His wrists were forced in full volar flexion, radial deviation, and pronation. The situation was simulated in the diagram . While hFor the first time, MouchetIn the present case, the mechanism of posterior perilunate dislocation is contrary to what is being taught and described in books. The hands in this case, held in radial deviation with wrist in full volar flexion, were forcibly pronated over steadily held forearms in neutral position. Because of this maneuver, the ulnar collateral ligament becomes tight and dorsal intercarpal ligaments with capsule get stretched. On the volar aspect of the wrist, the tough radioscaphocapitate and radiolunate ligaments along with other intercarpal ligaments with capsule become lax. If the hand in such a position is forcibly pronated, it results in the avulsion of ulnar collateral ligament of the wrist with or without fracture of the tip of ulnar styloid process. Further pronation of the hand causes rotation of the head of the capitate in lunate producing avulsion of the dorsal lunocapitate with avulsion fracture of the posterior lip or horn of lunate. Finally, the same pronation force produces tear of the scapholunate ligaments, which results in the posterior dislocation of the carpi to lie on the posterior surface of the lunate and distal articular margin of the radius.Posterior perilunate dislocation of the wrist could also happen if the individual falls forwards on the dorsum of the radially deviated hand with wrist in full volar flexion and on outstretched opposite hand, to result in forcible pronation twist of the wrist with hand in radial deviation.Unrelated to the trauma, a persistent bilateral posterior perilunate dislocation due to generalized laxity in case of Marfan syndrome was reported.


Exocrine cells of the pancreas of male rats bearing the Walker carcinoma show a striking accumulation of stainable neutral lipid in the form of small aggregated droplets in the base of the cells. In several cases, epithelial cells of small ducts also contained fat. Stainable lipid is sometimes present in cells of the pancreas of normal rats and in rats in which the Walker tumour has failed to grow: lipid in duct cells was confined to tumour-bearing animals.


Twenty-eight mammary carcinomata were maintained in organ culture in the presence of various hormones. The effects of the hormones have been assessed histologically by estimation of total dehydrogenases activity of the pentose glycolytic pathway and by the incorporation of tritiated thymidine or uridine into DNA or RNA. No significant effects on tumour cell activity due to hormones have been observed.


A 66-year-old man underwent abdominoperineal resection for advanced rectal cancer. On day 3 post surgery, a decompression tube was placed for postoperative ileus. Symptoms associated with ileus immediately disappeared. On day 7 post surgery, the patient vomited large amounts of fresh blood and became hemodynamically unstable. An emergency angiography revealed active bleeding from the stump of the superior rectal artery communicating with the third portion of the duodenum. Complete obliteration of the stump by proximal coil embolization was performed to achieve successful hemostasis. The postclinical course was uneventful and the patient was discharged on day 40 post surgery. The ligation of the inferior mesenteric artery (IMA) or superior rectal artery (SRA) is required for the complete dissection of regional lymph nodes in rectal cancer. Here we report a case of delayed hemorrhage arising from the stump of the SRA after abdominoperineal resection for rectal cancer. Postoperative bleeding in colorectal surgery has been commonly reported in cases of hemorrhage arising from pseudoaneurysm of the pelvirectal vessels . Our casA 66-year-old man underwent abdominoperineal resection of the rectum for advanced rectal cancer after preoperative chemoradiotherapy. During the operation, the root of the inferior mesenteric artery (IMA) was not ligated. The IMA was tagged and preserved, separating the nervous and lymphatic tissues from the root to a site just peripheral of the confluence of the left colic artery (LCA), then the superior.rectal artery (SRA) was ligated . On day One of the rare points in the present case is the site of bleeding. Delayed postoperative hemorrhage in colorectal surgery has rarely been reported. All reports, including Japanese case reports, have demonstrated that the usual source of hemorrhage is a pelvirectal space associated with pseudoaneurysm of the ramification of the iliac artery and that the mechanism for formation of pseudoaneurysm was violation or exposure of the tunica adventitia of these vessels caused by lymph node dissection or postoperative anastomotic leakage –4. In thIn the present case, the patient developed delayed postoperative hemorrhage 4 days after placement of the decompression tube for postoperative ileus. Although we could not identify the formation of pseudoaneurysm on the emergency CT or angiography, it is assumed that exposure of the tunica adventitia of the IMA and contact between the decompression tube and the stump of the SRA caused a pseudoaneurysm of the stump.To avoid this severe complication, we should improve surgical procedures including the reduction of the clearance of peritoneum, expansion of mobilization of the left colon to the splenic flexure, leading to withdrawal of over spasticity in the stump of the SRA, the mesenteric root, and the duodenum.


The Inter-Regional Epidemiological Study of Childhood Cancer included 43 cases of soft tissue and 30 cases of bone sarcomas, together with their 146 matched controls. Analysis of a wide range of aetiological factors revealed few risk factors relating to events during the index pregnancy, the earlier medical experiences of the case child, or parental medical, occupational and smoking history. Associations which did emerge included: lower birth weight in children with Ewing's tumour, an excess of mothers of children with soft tissue sarcoma with symptoms of toxaemia in pregnancy; and more children with rhabdomyosarcoma who received antibiotics soon after birth. There was some evidence that mothers of children with soft tissue sarcoma may have had reduced fertility with a significant excess of the case mothers having no other pregnancies. Slight excesses of congenital malformations in the case children and of malignant and benign/borderline neoplastic disease in the older mothers were consistent with the existence of a degree of genetic predisposition in the development of the tumours in this series.


In an attempt to rationalize the use of intraperitoneal drainage of the subhepatic space after simple,elective cholecystectomy, a prospective study was designed to compare the post-operative course withand without drainage. There was a higher incidence of postoperative fever of unknown origin andwound infection in the drained group. In the group without drainage the hospital postoperative stay wasshorter and there were no complications. The results suggest that routine surgical drainage afteruncomplicated cholecystectomy is unnecessary and could be a source of postoperative fever and a higherincidence of wound infection.


Dermatosis neglecta is an often misdiagnosed and under-diagnosed condition. In dermatosis neglecta, a progressive accumulation of sebum, sweat, keratin and other dirt and debris, occurs due to inadequate local hygiene resulting in a localized hyperpigmented patch or a verrucous plaque. Vigorous rubbing with alcohol-soaked gauze or soap and water results in a complete resolution of the lesion. This is the first case of dermatosis neglecta reported in a patient with multiple traumatic injuries.We report a case of a 35-year-old male Caucasian of Pakistani origin, with multiple fractures, neurological deficit and immobility sustained in a fall, leading to the development of dermatosis neglecta of the left hand.Early and prompt clinical recognition of this condition eliminates the need for aggressive diagnostic and therapeutic procedures. The term dermatosis neglecta was first coined by Poskitt et al. in 1995 to denote a condition in which formation of a localized hyperpigmented lesion occurs as a consequence of lack of cleanliness of a particular body part or region, usually due to some disability [The lesion forms due to a combination of tallow, sebum, sweat, keratin and bacteria in the unclean area. The time of evolution is usually 2 to 4 months and the patients usually have an associated chronic disease characterized by pain or immobility [A 35-year-old man presented with a 3-week history of progressive blackish discoloration of the dorsum of the left hand along with increased verrucosity and scaling over his palm Figure . There wThe patient had sustained multiple fractures of the left humerus and metacarpals, along with dislocation of the left shoulder and radial nerve palsy, in a fall about 2 months previously which had left the limb immobile and numb. He was gradually recovering the motor and sensory functions but still handled the limb very gingerly.Considering the history and clinical examination, a diagnosis of dermatosis neglecta was made. The area over the dorsum of the hand was cleaned with a methanol swab, revealing completely normal skin underneath. The patient was prescribed a keratolytic ointment for the palmer surface and advised to maintain better hygiene of the affected area despite the disability. Upon follow-up examination two weeks later, the hand was completely devoid of any pigmentation or verrucosity Figure .The term dermatosis neglecta is used to describe a condition in which localized hyperpigmentation and scaling of the skin occurs as a consequence of poor hygiene of a particular body part and the lesion can be easily rubbed off using soap and water or an alcohol soaked swab. The lack of cleanliness is usually a result of hyperesthesia or prior trauma of the affected region ,3. TerraClinically, the patient presents with a hyperpigmented patch or plaque with a variable degree of scaling and verrucosity. Adherent cornflake-like scaling has been described . The patCases have previously been described at the site of pacemaker insertion, mastectomy surgery and radiotherapy ; and in Differential diagnosis includes dermatitis artefacta which is an act of commission rather than an act of omission as is the case in dermatosis neglecta , verrucoTreatment includes counselling and encouraging the patient to maintain appropriate hygiene of the affected region in spite of his or her disability. Daily lightly scrubbing of the affected area with soap and water or alcohol is effective in most cases. For more resistant and verrucous lesions, application of a keratolytic agent in combination with an emollient may be required.Dermatosis neglecta should be kept in mind in the differential diagnosis of all hyperpigmented localized lesions, especially in a patient with some accompanying disability, as its prompt recognition can eliminate the need for any elaborate diagnostic or therapeutic endeavours.Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in chief of this journal.The authors declare that they have no competing interests.SNRQ conceived the case report and prepared the initial draft of the manuscript. AE played an important role in the initial diagnosis, treatment and follow-up of the patient as well as in writing the manuscript. NR contributed significantly to the final draft of the manuscript and analysis of relevant literature. All authors read and approved the final manuscript.


Neisseria gonorrhoeae provides an example of relevance to the female genital tract. A review of the virulence factors of the gonococcus is presented to serve as an example of the variety of virulence properties associated with pathogenic bacteria. Molecular biology has begun to clarify one of the important paradigms of pathogenic bacteriology—that bacteria change their expression of virulence properties in response to their location within a host or to the stage of infection. Thus, infection involves  not only the possession of virulence factors, but also the carefully controlled use of those factors. Virulence is often controlled by the coordinate expression of many virulence-associated genes in response to one environmental signal. With regard to low-virulence organisms present in the female lower genital tract, we are beginning to identify some of their virulence attributes. Examples from the work of our laboratory include the hemolysin of Gardnerella vaginalis and an immunosuppressive mycotoxin produced by Candida albicans. Demonstrating the coordinate expression (or other control mechanisms) of virulence factors in these sometimes innocuous and sometimes inimical organisms represents the next frontier in the study of normal vaginal microbiology.The vast majority of infections involving female pelvic structures arise from organisms that are members of the normalflora. In addition, exogenous organisms that invade through the lower genital tract must interact with organisms that are part of the host's flora. In contrast to the concept that the normal flora is entirely innocuous, recent research has begun to identify what appear to be virulence attributes among these ordinarily low-virulence organisms. Most of our understanding of virulence has been derived from highly virulent organisms, of which


For the past 20 years thickness of the primary tumour has been accepted as the most important guide to prognosis for patients with primary cutaneous malignant melanoma. The changing epidemiology of melanoma with an increasing number of patients with thin tumours has necessitated a reappraisal of this, with particular reference to interactions among tumour thickness, the patients' sex and the presence or absence of ulceration of the primary tumour. All primary cutaneous malignant melanomas diagnosed in Scotland between 1979 and 1986 were used as the test group (1978 patients). The proportional hazards model was used on all potential risk factors in the database and their two-way interactions, and the resulting models based on stepwise procedures were subsequently validated on 289 melanoma patients first diagnosed in 1987 in the same geographic area. Four distinct subgroups of males and females with ulcerated or non-ulcerated lesions were identified. For females with ulcerated lesions, tumour thickness, mitotic count and anatomical site of primary all gave valuable prognostic information, whereas for females with non-ulcerated lesions only tumour thickness was of prognostic value. For males with ulcerated lesions, level of invasion was the only prognostic guide, while for males with non-ulcerated lesions both tumour thickness and level of invasion contributed significantly to prediction of prognosis. Prognosis markedly different across subgroups of the melanoma population, even to the extent that essential prognostic factors are not the same in the distinct subgroups. Verification of these prognostic guides derived from 1979-86 patients has been achieved for all patients diagnosed with melanoma in 1987 from the same geographic area. These data will therefore be useful aids for clinicians managing patients.


The lability of cell surface histocompatibility antigens of 2 murine lymphomata was examined. These 2 tumours differ greatly in their capacity to metastasize in syngeneic hosts. Cells of the metastatic lymphoma released histocompatibility antigens in vivo and in vitro at a greater rate than cells of the non-metastasizing lymphoma. Antigen/antibody complexes formed by the addition of allo-antiserum to intact cells disappeared more rapidly from the surface of cells of the metastatic line. We propose that the instability of surface antigens may be an integral feature of malignant cells and that there may be a quantitative relationship between the lability of membrane components and the capacity of the tumour to metastasize.