Therapeutic Options for Management of Pharyngoesophageal Corrosive Strictures

Introduction  

Pharyngoesophageal strictures due to corrosive injury raise difficult therapeutic problems due to the site of stricture, the possible association with laryngeal injury and the presence of downstream esophageal strictures. We present here our approach to management of 51 consecutive patients with pharyngoesophageal strictures seen over a 30-year period.     

In vivo peritoneal antiangiogenesis and in vitro antiproliferative properties of some bischalcone derivatives

In this study, three, bisarylidene cyclopentanones (curcumin analogs) 3a–c are synthesized by Claisen Schmidt condensation reaction. Antiangiogenic effects of the compounds were studied in Ehrlich ascites tumor (EAT) cells transplanted mouse in vivo. Antiangiogenic effect of 3a–c showed reduction in ascites volume, cell number, and induced apoptotic bodies in EAT cells in tested animals. The antiproliferative effects of the 3a–c were determined at different concentrations by MTT assay on HepG2 and HeLa cells. The compounds showed significant antiproliferative activity at 40 μM concentration. Compound 3a (fluoro derivative) showed highest antiproliferative effect with the IC50 value 39 and 48 μm for HeLa and HepG2, respectively. Growth inhibition of the HeLa cells and antiangiogenesis was mediated by promoting apoptosis which was confirmed by DNA fragmentation study.     

Cotton bud and ear cleaning--a loose tip cotton bud?

Complications that arise from self-cleaning the external ear canal are common. This is a prospective study using standard questionnaire on the practice of ear cleaning in 50 subjects. A loose tip cotton bud was also shown to them to assess if it was acceptable to replace their current cotton bud. Thirty six percent of them clean their ears by introducing an object into the ear canal once or more a day. The commonest reason to clean the ears was the presence of earwax. Only 6% used a cotton bud to mop fluid from the ear canal. Almost all (92%) the subjects used a cotton bud to clean the ear. A complication rate of 2% was noted. A loose tip cotton swab was shown to the subjects. Despite explaining that it is safer and better, only 24% of the subject were willing to change to this loose tip cotton bud. Seventy four percent of the subjects cleaned their ear regularly because of earwax. The misconception of needing to clean the ear canal by introducing an object into the ear is rampant. This practice should be avoided and health care providers can play an important role in this.     

Effect of time delay on survival in patients with non-small cell lung cancer--a Malaysian study

The prognosis of lung cancer remains poor with overall five year survival figures varying between five and 10% worldwide, However, it has been shown that surgery in patients with early stage disease in non-small cell lung cancer can achieve five year survival rates up to 80%, suggesting that early or delay diagnosis can influence prognosis. Nevertheless, studies addressing this have been inconclusive and mostly derived from Western countries.     

A role for endoglin in coupling eNOS activity and regulating vascular tone revealed in hereditary hemorrhagic telangiectasia

Decreased endothelial NO synthase (eNOS)-derived NO bioavailability and impaired vasomotor control are crucial factors in cardiovascular disease pathogenesis. Hereditary hemorrhagic telangiectasia type 1 (HHT1) is a vascular disorder associated with ENDOGLIN (ENG) haploinsufficiency and characterized by venous dilatations, focal loss of capillaries, and arteriovenous malformations (AVMs). We report that resistance arteries from Eng+/- mice display an eNOS-dependent enhancement in endothelium-dependent dilatation and impairment in the myogenic response, despite reduced eNOS levels. We have found that eNOS is significantly reduced in endoglin-deficient endothelial cells because of decreased eNOS protein half-life. We demonstrate that endoglin can reside in caveolae and associate with eNOS, suggesting a stabilizing function of endoglin for eNOS. After Ca2+-induced activation, endoglin-deficient endothelial cells have reduced eNOS/Hsp90 association, produce less NO, and generate more eNOS-derived superoxide (O2-), indicating that endoglin also facilitates eNOS/Hsp90 interactions and is an important regulator in the coupling of eNOS activity. Treatment with an O2- scavenger reverses the vasomotor abnormalities in Eng(+/-) arteries, suggesting that uncoupled eNOS and resulting impaired myogenic response represent early events in HHT1 pathogenesis and that the use of antioxidants may provide a novel therapeutic modality.     

Lot quality assurance sampling of sputum acid-fast bacillus smears for assessing sputum smear microscopy centers

Assessment of 12 microscopy centers in a tuberculosis unit by blinded checking of eight sputum smears selected by using a lot quality assurance sampling (LQAS) method and by unblinded checking of all positive and five negative slides, among the slides examined in a month in a microscopy centre, revealed that the LQAS method can be implemented in the field to monitor the performance of acid-fast bacillus microscopy centers in national tuberculosis control programs.     

Organ specific complement proteins inhibition can reduce the risk of antiphospholipid antibodies mediated fetal loss

Antiphospholipid syndrome is a pregnancy related, systemic autoimmune disorder in which antibodies directed against cell membrane phospholipids with multiple venous/arterial thromboses. Though the etiology of antiphospholipid syndrome has not been identified exactly, experimental evidences suggest the possible mechanisms involved in the pathogenicity of this syndrome. Antiphospholipid antibodies mediate deposition of complement proteins in placenta and over expression of tissue factor on the surface of neutrophils which are reported to be the prominent cause of prothrombotic phenotype. The activation complement components C3 and C5 by antiphospholipid antibodies would eventually activates blood coagulation pathway that leads to thrombosis. Inhibition of activated complement components C3a and C5a by anticomplement agents protects from antiphospholipid antibody mediated fetal loss. Since the interference of complement pathway may lead to deleterious effects, we hypothesis that local inhibition of complement proteins C3a and C5a at placenta would reduce the risk of antiphospholipid antibody mediated placental thrombosis and pregnancy complications.     

The accuracy of transrectal ultrasonography supplemented with computer-aided ultrasonography for detecting small prostate cancers

OBJECTIVE

To determine the extent to which computer‐aided ultrasonography of the prostate (HistoScanning^TM, Advanced Medical Diagnostics, Waterloo, Belgium) can identify tumour foci that correspond to a volume of ≥0.50 mL.

PATIENTS AND METHODS

Between September 2004 and February 2006, 29 men were HistoScanned before scheduled radical prostatectomy. The three‐dimensional raw (grey‐scaled) data required for HistoScanning analysis were acquired by transrectal ultrasonography, and analysed using organ‐specific tissue‐characterization algorithms which form the core of the HistoScanning technology. The HistoScanning analysis results were compared with the histology of the whole‐mounted prostate, step‐sectioned sagittally at 5‐mm intervals, and each slide analysed by 5 × 5 mm grid analysis.

RESULTS

Of 29 patients, 13 had histology unknown to those evaluating the HistoScanning data. With 0.50 mL as the lower threshold for delineating and visualizing cancer volume, HistoScanning correctly predicted the presence of all 12 lesions that were subsequently confirmed to occupy ≥0.50 mL. In addition three lesions were predicted as being present and of ≥0.50 mL. These three lesions were subsequently confirmed to be present but were ≤0.50 mL on histopathological review. Thus, using the clinically accepted volume threshold of 0.50 mL, the sensitivity, specificity, positive and negative predictive value of HistoScanning were 12/12, 13/16 (82%), 12/15 (80%) and 12/12, respectively, for the cancer foci analysed.

CONCLUSIONS

In this preliminary study, HistoScanning accurately detected cancer foci of ≥0.50 mL; these encouraging results will need to be verified in a larger group of patients.