Antibody response in pulmonary tuberculosis against recombinant 27kDa (MPT51, Rv3803c) protein of Mycobacterium tuberculosis

The objective of this study is to evaluate the recombinant 27kDa (MPT51, Rv3803c) antigen of M. tuberculosis H37Rv, expressed in E. coli in enzyme linked immunosorbent assays (ELISA) to estimate the IgG, IgA and IgM levels in sera from adult pulmonary tuberculosis patients and control groups. Sera from smear and culture positive tuberculosis patients (S + C +) were positive for anti-MPT51 IgG, IgA and IgM, with a sensitivity of 57%, 47% and 13%, respectively. The sensitivity of the test improved to a level of 71% for IgG+IgA without significantly compromising the specificity (IgG of 98%, IgG+IgA of 95%). Addition of IgM results did not enhance the sensitivity appreciably, over and above that of IgG+IgA (72% vs 71%). Among the smear-negative but culture-positive cases (S-C+), 34% were positive for IgG, while in smear and culture-negative but X-ray-positive cases (S-C-), 42% were positive for IgG. Polyethylene glycol precipitation (PEG) of the circulating immune complex (CIC) in sera was carried out. The CIC-bound antibodies to MPT51 were assessed using ELISA. Measuring the IgG+IgA combination positivities of the CIC-bound antibodies gave a poor sensitivity of 21%, 18% and 10%, respectively. The specificity of the assay by these combinations was maintained at 94%.     

Fine needle aspiration findings in malignant ameloblastoma: A case report and differential diagnosis

We present a case of malignant ameloblastoma presenting in the posterior mandible and cervical lymph nodes of an African American child. This case is somewhat unusual in that the patient was an adolescent and presented with metastatic disease. This partly clinical as well as cytologic diagnosis was facilitated by the presence of typical ameloblastoma cytology in multiple cervical lymph nodes adjacent to the histologically confirmed intraosseous ameloblastoma. Although cytology is helpful in diagnosing ameloblastoma, its features are by no means definitive as there are several cytologic mimics. A high index of suspicion is therefore necessary to confirm or exclude ameloblastoma when evaluating any jaw lesion and/or adjacent enlarged lymph nodes by cytologic examination. Adequate sampling is paramount to accurate diagnosis, and is especially important when attempting to distinguish ameloblastoma from ameloblastic carcinoma. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

Design and in vitro testing of a floatable gastroretentive tablet of metformin hydrochloride

Metformin hydrochloride, which is better absorbed in the upper intestine, was formulated as a floating (buoyant) matrix tablet using a gas generating agent (sodium bicarbonate) and a gel forming hydrophilic polymer (hydroxypropyl methylcellulose). The formulation was optimized on the basis of floating ability and in vitro drug release. The resulting formulation produced robust tablets with optimum hardness, consistent weight uniformity and low tablet friability. All tablets but one exhibited satisfactory (gradual and near complete) drug release and buoyancy. In vitro drug release tests of these tablets indicated controlled sustained release of metformin hydrochloride and 96-99% released at the end of 8 h. Two formulations of fabricated tablets containing metformin hydrochloride (500 mg), sodium bicarbonate (75 mg), hydroxypropyl methylcellulose-K 4M (170-180 mg), citric acid (between 15 and 20 mg) and polyvinyl pyrrolidone K90 (32-40 mg) with hardness between 6.8 to 7.5 kg/cm2 showed a floating time of more than 8 h and promising drug release results. The release followed the Higuchi kinetic model, indicating diffusion dominated drug release.     

Laparoscopic ureterocystoplasty before kidney transplantation

PURPOSE: To describe the technique of total laparoscopic ureterocystoplasty. MATERIALS AND METHODS: Laparoscopic ureterocystoplasty was performed to optimize the bladder function before kidney transplantation in a 23-year-old man. This patient had undergone bilateral cutaneous ureterostomy with fulguration of a posterior urethral valve at the age of 11 months. He underwent open surgical removal of multiple renal stones at age 10. He progressed to chronic renal failure at the age of 20, at which time hemodialysis was initiated. Because of grade IV vesicoureteral reflux and a poorly compliant bladder, the patient underwent laparoscopic ureterocystoplasty. RESULTS: The patient's lower urinary tract symptoms improved, and a urodynamic study performed after 6 months revealed a compliant bladder. Subsequently, a right nephrectomy and a live-donor renal transplantation from his mother were performed. At 1-year follow-up, his renal parameters were within normal range, he does not have any significant residual urine or urinary symptoms. CONCLUSION: Laparoscopic ureterocystoplasty is an excellent option for a poorly compliant bladder, especially when a patient has had multiple open surgeries and is awaiting renal transplantation.     

Role of receptors of advanced glycation end‐products (RAGE) in type 2 diabetic and non‐diabetic individuals with chronic periodontal disease: an immunohistochemical study

Aim: The relationship between diabetes and periodontal disease is well established. It has been shown that advanced glycation end‐products might exert noxious effects on several tissues of the body through its receptor. Evidence for the role of receptors of advanced glycation end‐products in periodontal disease for diabetes is limited, and their presence in human gingival tissues has been demonstrated in few studies. In this study, we demonstrate the presence of receptors of advanced glycation end‐products in patients with chronic periodontitis, with and without type 2 diabetes. Methods: Gingival biopsies from 19 patients with both type 2 diabetes and chronic periodontitis, and 18 healthy controls with chronic periodontitis, were immunohistochemically stained for receptors of advanced glycation end‐products. Results: On immunohistochemical analysis, positive staining for receptors of advanced glycation end‐products was seen in the endothelium and the basal and spinous layers of the inflamed gingival epithelium in both type 2 diabetes and non‐diabetes tissue, with a statistically‐significant difference between both groups (P < 0.05). Conclusions: There was a significant difference in receptors of advanced glycation end‐product immune reactivity between both groups. Receptors of advanced glycation end‐product increase in type 2 diabetes gingival tissue might indicate possible involvement of this receptor in periodontal destruction in individuals with type 2 diabetes.     

Nanobiomaterial applications in orthopedics.

Advancements in nanobiotechnology are revolutionizing our capability to understand biological intricacies and resolve biological and medical problems by developing subtle biomimetic techniques. Nanocomposites and nanostructured materials are believed to play a pivotal role in orthopedic research since bone itself is a typical example of a nanocomposite. This article reviews current strategies using nanobiomaterials to improve current orthopedic materials and examines their applications in bone tissue engineering. Preliminary investigations support the potential of nanobiomaterials in orthopedic applications; however, significant advancements are necessary to achieve clinical use. Overall, current trends in nanobiotechnology foreshadow a bright future through the use of nanobiomaterials in the orthopedic domain.     

A Phase II Study of Telisotuzumab Vedotin in Patients With c–MET-positive Stage IV or Recurrent Squamous Cell Lung Cancer (LUNG-MAP Sub-study S1400K,NCT03574753)

IntroductionLung-MAP S1400K was designed to evaluate the response to telisotuzumab vedotin, an antibody-drug conjugate targeting c-MET, in patients with c-MET–positive squamous cell carcinoma (SCC).Patients and MethodsPatients with previously treated SCC with c-MET–positive tumors (H score ≥ 150, Ventana SP44 assay) were enrolled into 2 cohorts: Cohort 1 (immune checkpoint inhibitor-naive) and Cohort 2 (immune checkpoint inhibitor refractory). Telisotuzumab vedotin 2.7 mg/kg was administered intravenously every 3 weeks until disease progression or unacceptable toxicity. Response assessments were performed every 6 weeks. The primary endpoint was response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. Secondary endpoints included progression-free survival, overall survival, response within cohort, duration of response, and toxicities. Interim analysis was planned after 20 evaluable patients, with ≥ 3 responses needed to continue enrollment.ResultsForty-nine patients (14% of screened patients) were assigned to S1400K, 28 patients enrolled (15 in Cohort 1 and 13 in Cohort 2), and 23 were eligible. S1400K closed on December 21, 2018 owing to lack of efficacy. Two responses (response rate of 9%; 95% confidence interval, 0%-20%) were reported in cohort 1 (1 complete and 1 unconfirmed partial response), whereas 10 patients had stable disease, with a disease control rate of 52%. The median overall and progression-free survival was 5.6 and 2.4 months, respectively. There were 3 grade 5 events (2 pneumonitis, in Cohort 2, and 1 bronchopulmonary hemorrhage, in Cohort 1).ConclusionTelisotuzumab vedotin failed to meet the pre-specified response needed to justify continuing enrollment to S1400K. Pneumonitis was an unanticipated toxicity observed in patients with SCC.