An unusual infection, an unusual outcome--Fonsecaea pedrosoi cerebral granuloma

Phaeohyphomycosis is caused by pigmented fungi that are not normally pathogenic. Fonsecaea is a rare cause of cerebral infections, most of which are caused by F. monophora. Brain infections caused by F. pedrosoi are very rare, and there are only a few case reports describing this. Most infections take the form of abscesses (epidural or intracerebral). The authors report a rare case of a contained fungal granuloma caused by F. pedrosoi. The patient presented with epilepsy, which was treated as a case of extratemporal lesion-related epilepsy. The diagnosis was made after resection. The authors describe the clinical course of this patient.     

Total Phenolics and Total Flavonoids in Selected Indian Medicinal Plants

Plant phenolics and flavonoids have a powerful biological activity, which outlines the necessity of their determination. The phenolics and flavonoids content of 20 medicinal plants were determined in the present investigation. The phenolic content was determined by using Folin-Ciocalteu assay. The total flavonoids were measured spectrophotometrically by using the aluminium chloride colorimetric assay. The results showed that the family Mimosaceae is the richest source of phenolics, (Acacia nilotica: 80.63 mg gallic acid equivalents, Acacia catechu 78.12 mg gallic acid equivalents, Albizia lebbeck 66.23 mg gallic acid equivalents). The highest total flavonoid content was revealed in Senna tora which belongs to the family Caesalpiniaceae. The present study also shows the ratio of flavonoids to the phenolics in each sample for their specificity.     

Transmission of dapsone-resistant leprosy detected by molecular epidemiological approaches

Drug resistance surveillance identified six untreated leprosy patients in the Philippines with Mycobacterium leprae folP1 mutations which confer dapsone resistance. Five patients share a village of residence; four who carried the mutation, Thr53Val, were also linked by M. leprae variable-number tandem repeat (VNTR) strain types. In India, folP1 mutations were detected in two relapse patients with a history of dapsone treatment. Mutations were not found in the rifampin target gene rpoB. These findings indicate that dapsone resistance is being transmitted.     

Synaptic Inhibition,Excitation, and Plasticity in Neurons of the Cerebellar Nuclei

Neurons of the cerebellar nuclei generate the non-vestibular output of the cerebellum. Like other neurons, they integrate excitatory and inhibitory synaptic inputs and filter them through their intrinsic properties to produce patterns of action potential output. The synaptic and intrinsic features of cerebellar nuclear cells are unusual in several respects, however: these neurons receive an overwhelming amount of basal and driven inhibition from Purkinje neurons, but are also spontaneously active, producing action potentials even without excitation. Moreover, not only is spiking by nuclear cells sensitive to the amount of inhibition, but the strength of inhibition is also sensitive to the amount of spiking, through multiple forms of long-term plasticity. Here, we review the properties of synaptic excitation and inhibition, their short-term plasticity, and their influence on action potential firing of cerebellar nuclear neurons, as well as the interactions among excitation, inhibition, and spiking that produce long-term changes in synaptic strength. The data provide evidence that electrical and synaptic signaling in the cerebellar circuit is both plastic and resilient: the strength of IPSPs and EPSPs readily changes as the activity of cerebellar nuclear cells is modified. Notably, however, many of the identified forms of plasticity have an apparently homeostatic effect, responding to perturbations of input by restoring cerebellar output toward pre-perturbation values. Such forms of self-regulation appear consistent with the role of cerebellar output in coordinating movements. In contrast, other forms of plasticity in nuclear cells, including a long-term potentiation of excitatory postsynaptic currents (EPSCs) and excitation-driven increases in intrinsic excitability, are non-homeostatic, and instead appear suited to bring the circuit to a new set point. Interestingly, the combinations of inhibitory and excitatory stimuli that potentiate EPSCs resemble patterns of activity predicted to occur during eyelid conditioning, suggesting that this form long-term potentiation, perhaps amplified by intrinsic plasticity, may represent a cellular mechanism that is engaged during cerebellar learning.     

Control of transient,resurgent, and persistent current by open-channel block by Na channel β4 in cultured cerebellar granule neurons

Voltage-gated Na channels in several classes of neurons, including cells of the cerebellum, are subject to an open-channel block and unblock by an endogenous protein. The Na_Vβ4 (Scn4b) subunit is a candidate blocking protein because a free peptide from its cytoplasmic tail, the β4 peptide, can block open Na channels and induce resurgent current as channels unblock upon repolarization. In heterologous expression systems, however, Na_Vβ4 fails to produce resurgent current. We therefore tested the necessity of this subunit in generating resurgent current, as well as its influence on Na channel gating and action potential firing, by studying cultured cerebellar granule neurons treated with siRNA targeted against Scn4b. Knockdown of Scn4b, confirmed with quantitative RT-PCR, led to five electrophysiological phenotypes: a loss of resurgent current, a reduction of persistent current, a hyperpolarized half-inactivation voltage of transient current, a higher rheobase, and a decrease in repetitive firing. All disruptions of Na currents and firing were rescued by the β4 peptide. The simplest interpretation is that Na_Vβ4 itself blocks Na channels of granule cells, making this subunit the first blocking protein that is responsible for resurgent current. The results also demonstrate that a known open-channel blocking peptide not only permits a rapid recovery from nonconducting states upon repolarization from positive voltages but also increases Na channel availability at negative potentials by antagonizing fast inactivation. Thus, Na_Vβ4 expression determines multiple aspects of Na channel gating, thereby regulating excitability in cultured cerebellar granule cells.     

Inhibition of ovarian cancer by RGD-P125A-endostatin-Fc fusion proteins

Previous studies have shown that a single point mutation in endostatin at position 125 (P125A) can improve the biological activity of endostatin. Addition of an integrin-targeting moiety, R-G-D, resulted in better localization to tumor vasculature and improved the antiangiogenic activity of endostatin. Because endostatin has relatively shorter serum half-life, frequent dosing was required for inhibiting tumor growth. In our study, we have genetically fused RGD-P125A-endostatin to Fc of IgG4 isotype and evaluated its antiangiogenic and antitumor effects in athymic mice. Two genetic constructs were made, RGD-P125A-endostatin-Fc (RE-Fc) and P125A-endostatin-RGD-Fc (ER-Fc). Both constructs were cloned and expressed in mammalian cells. Purified fusion proteins inhibited endothelial cell migration and proliferation better than yeast-derived P125A-endostatin. Both RE-Fc and ER-Fc inhibited ovarian cancer growth and were found to be as effective as Bevacizumab treatment. Fusion protein showed marked increased half-life. Combination treatment with Bevacizumab and ER-Fc showed additive inhibition of ovarian cancer growth. These studies demonstrate that genetic fusion with human IgG4-Fc increases the half-life of P125A-endostatin and can be used along with Bevacizumab to improve antiangiogenic and antitumor activities.     

Maximum tolerated dose in a phase I trial on adaptive dose painting by numbers for head and neck cancer

Purpose

To determine the maximum tolerated dose (MTD) in a phase I trial on adaptive dose-painting-by-numbers (DPBN) for non-metastatic head and neck cancer.

Materials and methods

Adaptive intensity-modulated radiotherapy was based on voxel intensity of pre-treatment and per-treatment [¹⁸F]fluoro-2-deoxy-d-glucose positron emission tomography (¹⁸F-FDG-PET) scans. Dose was escalated to a median total dose of 80.9 Gy in the high-dose clinical target volume (dose level I) and 85.9 Gy in the gross tumor volume (dose level II). The MTD would be reached, if ?33% of patients developed any grade ?4 toxicity (DLT) up to 3 months follow-up.

Results

Between February 2007 and August 2009, seven patients at dose level I and 14 at dose level II were treated. All patients completed treatment without interruption. At a median follow-up for surviving patients of 38 (dose level I) and 22 months (dose level II) there was no grade ?4 toxicity during treatment and follow-up but six cases of mucosal ulcers at latency of 4-10 months, of which five (36%) were observed at dose level II. Mucosal ulcers healed spontaneously in four patients.

Conclusions

Considering late mucosal ulcers as DLT, the MTD of a median dose of 80.9 Gy has been reached in our trial.