Tobacco control practices in 25 schools of West Bengal

Information about tobacco use prevalence, knowledge and attitude was assessed among school personnel in schools of West Bengal. Statistical analysis was done using SUDAAN and the C-sample procedure in Epi-Info. The school response rate was 100%. Current any smoking and smokeless tobacco use was reported by 30.9% and 13.1% school personnel, respectively. Current daily smoking, and smokeless tobacco use reported by 20.4%, and 5.8% school personnel respectively. Men reported significantly more for all kinds of daily tobacco use as compared to women. School tobacco control policy on three scales was reported poor (17.7-30%). However most of the school personnel felt need for such policies (82.7-93.6%). Teaching and training on tobacco was reported low (29.9%-50.4%). However most of the school personnel (79.1-93.6%) were supportive on different measures of tobacco control. Training of school personnel may provide students with essential tools to help them adopt and maintain a smoke free lifestyle.     

Remarkable improvement of myocardial metaiodobenzylguanidine uptake after surgery in a patient with pheochromocytoma-a case report

A patient with pheochromocytoma showed remarkable improvement of myocardial metaiodobenzylguanidine (MIBG) uptake within a short time after surgical resection of the tumor. Myocardial MIBG findings in this case may contribute to an interpretation of the kinetics of MIBG in the human heart.     

Effect of milk on intestinal fluid accumulation and renal injury following mercuric chloride ingestion in rats

To investigate the effect of milk on intestinal fluid accumulation and renal injury following mercuric chloride (HgCl(2)) ingestion, 10 ml kg(-1) of saline or 10 mg kg(-1) of HgCl(2) dissolved in 10 ml kg(-1) of water or raw milk was administered enterally to rats and the mercury content in biological samples was determined by cold vapour atomic absorption spectrometry. Three hours after administration, the intestinal water content in rats that received HgCl(2) in water (group S2) was significantly higher than in rats that received saline (group S1) (P < 0.01) or HgCl(2) in milk (group S3) (P < 0.01). The amount of mercury detected per gram dry weight of small intestine was higher in group S2 than in group S3 (P < 0.05). Seventy-two hours after administration, both the serum urea nitrogen and creatinine concentrations in rats that received HgCl(2 )in milk (group L3) were significantly higher than in rats that received saline (group L1) (P < 0.05) or HgCl(2) in water (group L2) (P < 0.05). Mercury levels in many of the biological samples in group L3 were higher than in group L2 (P < 0.05). Milk may reduce the intestinal cytotoxicity of mercury but it promotes its absorption, which may lessen intestinal fluid accumulation but worsen renal injury.     

Determination and analysis of single nucleotide polymorphisms and haplotype structure of the human carboxylesterase 2 gene

Carboxylesterases are members of the serine esterase super family important in the metabolism of a wide variety of substrates, including xenobiotics and prodrugs. There are two known carboxylesterases expressed in human liver, small intestine and other tissues, carboxylesterase 1 (CES1) and carboxylesterase 2 (CES2). The aim of this study was to identify polymorphisms in the CES2 gene and determine whether these polymorphisms affect expression levels of CES2 or rate of metabolism of irinotecan (7-ethyl-10-[4-(1-piperidino)-1-piperidino] carbonyloxy-camptothecin). Microsome samples prepared from liver tissues of 78 normal individuals were used to determine the rate of hydrolysis of irinotecan and procaine (an anaesthetic hydrolysed by CES2 but not CES1). The rate of hydrolysis of irinotecan is highly variable among individuals, ranging from 2.7-138 pmol/mg protein/h (mean +/- SD 26.0 +/- 22.9). Fifteen single nucleotide polymorphisms (SNPs) were identified, one is in an exon, 9 are in introns, three are in the 3'-untranslated region (UTR), and two are in the 5'-flanking region. Eight of the 15 SNP loci have rare allele frequencies greater than 5%, of which three were greater than 20%. Genotyping of samples from the SNP Consortium demonstrated different distributions among African-Americans, Asian-Americans and European-Americans. We also analysed the haplotype structure and estimated linkage disequilibrium (LD). A SNP located in the 5'-UTR (5'-UTR-363) was found in LD with loci in intron 1 (Intron1 + 947, Intron1 + 1361, Intron1 + 1643). Haplotypes with homozygous rare alleles on these loci exhibit lower mRNA levels as determined by real time polymerase chain reaction (P < 0.01) and the incorporation of rare alleles in haplotypes correlate with reduced mRNA (P = 0.03). The 5'-UTR-363 SNP is located in one of the three promoters of CES2. However, we did not observe significant differences in CES2 activities (irinotecan and procaine hydrolysis) among individuals with different haplotypes.     

Prediction of reflex sympathetic dystrophy in hemiplegia by evaluation of hand edema

OBJECTIVE: To determine the predictive value of measurements of hand edema for the development of reflex sympathetic dystrophy (RSD). DESIGN: Cohort study. SETTING: Departments of rehabilitation medicine in 3 general hospitals and 1 rehabilitation hospital in Japan. PARTICIPANTS: Thirty-four stroke patients. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Measurement of the circumference of the middle finger was used to evaluate hand edema. The degree of hand edema was expressed by the ratio of circumference of the middle finger (RCMF) in the affected side to that in the uninvolved extremity. RESULTS: Eight of 34 patients developed clinical RSD from 2 to 4 months after stroke. Hand edema showed a significant relationship to the development of RSD (ie, the patients who had an RCMF of above 1.06 at 4 weeks poststroke had significantly higher incidence of RSD than those with a lower RCMF; P=.0127). CONCLUSION: It is possible to predict the development of RSD in hemiplegia by measuring hand edema 4 weeks poststroke.     

Arsenic in drinking water and skin lesions: dose-response data from West Bengal,India

BACKGROUND: Over 6 million people live in areas of West Bengal, India, where groundwater sources are contaminated with naturally occurring arsenic. The key objective of this nested case-control study was to characterize the dose-response relation between low arsenic concentrations in drinking water and arsenic-induced skin keratoses and hyperpigmentation. METHODS: We selected cases (persons with arsenic-induced skin lesions) and age- and sex-matched controls from participants in a 1995-1996 cross-sectional survey in West Bengal. We used a detailed assessment of arsenic exposure that covered at least 20 years. Participants were reexamined between 1998 and 2000. Consensus agreement by four physicians reviewing the skin lesion photographs confirmed the diagnosis in 87% of cases clinically diagnosed in the field. RESULTS: The average peak arsenic concentration in drinking water was 325 microg/liter for cases and 180 microg/liter for controls. The average latency for skin lesions was 23 years from first exposure. We found strong dose-response gradients with both peak and average arsenic water concentrations. CONCLUSIONS: The lowest peak arsenic ingested by a confirmed case was 115 microg/liter. Confirmation of case diagnosis and intensive longitudinal exposure assessment provide the basis for a detailed dose-response evaluation of arsenic-caused skin lesions.     

Chronic dissection of the left subclavian artery with pseudocoarctation

Surgical management of a dissection of the subclavian artery is sparsely reported in the literature because of its rare occurrence. Recently, we treated a patient who had presented with a huge left subclavian artery dissection, a small right subclavian artery aneurysm with pseudocoarctation of the aorta, and a small perimembranous ventricular septal defect. Surgical management of the left subclavian artery dissection and correction of the pseudocoarctation of the aorta were achieved effectively. That unusual combination of pathologic conditions prompted us to report this case.     

Nonsyndromic mental retardation and cryptogenic epilepsy in women with doublecortin gene mutations

DCX mutations cause mental retardation in male subjects with lissencephalypachygyria and in female subjects with subcortical band heterotopia (SBH). We observed four families in which carrier women had normal brain magnetic resonance imaging (MRI) and mild mental retardation, with or without epilepsy. Affected male subjects had SBH or pachygyria-SBH. In two families, the phenotype was mild in both genders. In the first family, we found a tyr138his mutation that is predicted to result in abnormal folding in the small hinge region. In the second family, we found an arg178cys mutation at the initial portion of R2, in the putative beta-sheet structure. Carrier female subjects with normal MRI showed no somatic mosaicism or altered X-inactivation in lymphocytes, suggesting a correlation between mild mutations and phenotypes. In the two other families, with severely affected boys, we found arg76ser and arg56gly mutations within the R1 region that are predicted to affect DCX folding, severely modifying its activity. Both carrier mothers showed skewed X-inactivation, possibly explaining their mild phenotypes. Missense DCX mutations may manifest as non-syndromic mental retardation with cryptogenic epilepsy in female subjects and SBH in boys. Mutation analysis in mothers of affected children is mandatory, even when brain MRI is normal.     

Mutation of the doublecortin gene in male patients with double cortex syndrome: somatic mosaicism detected by hair root analysis

The molecular basis of double cortex syndrome was investigated in 2 male patients. Magnetic resonance imaging of the patients' heads showed diffuse subcortical band heterotopia, as is seen in female patients. We found a heterozygous mutation for Asp50Lys or Arg39Stop in both patients. Microsatellite polymorphism analysis revealed that both patients had inherited a single X chromosome from their mothers. Restriction enzyme analysis using DNA extracted from the hair roots of each patient showed four different patterns in the combination of cells carrying wild and mutant alleles, which strongly suggest somatic mosaicism. We conclude that somatic mosaic mutations in the doublecortin gene in male patients can cause subcortical band heterotopia, and that molecular analysis using hair roots is a useful method for detecting somatic mosaicism.