Hyaluronan, CD44, and cyclooxygenase-2 in colon cancer

Carcinomas arising from colon epithelia develop or progress in a stromal microenvironment that is elevated in hyaluronan; interactions between elevated hyaluronan and the CD44 receptors on epithelial tumor cells activate an HA-receptor tyrosine kinase-mediated cell survival pathway. In this review we provide evidence that the hyaluronan-ErbB2-PI3kinase/AKT-ss-catenin-COX-2 signaling axis leads to intestinal epithelial and colon tumor cell division and proliferation. This review includes a summary of the authors work over the past years as well as citations of specific reviews related to role of hyaluronan in the pathogenesis of colon cancer.     

Lyme-associated parkinsonism: a neuropathologic case study and review of the literature

Neurological complications of Lyme disease include meningitis, encephalitis, dementia, and, rarely, parkinsonism. We present a case of striatonigral degeneration, a form of multiple system atrophy, in Lyme-associated parkinsonism. A 63-year-old man presented with erythema migrans rash, joint pains, and tremors. Serum and cerebrospinal fluid antibodies and polymerase chain reaction for Borrelia burgdorferi were positive. Clinical parkinsonism was diagnosed by several neurologists. Despite treatment, the patient continued to decline, with progressive disability, cognitive dysfunction, rigidity, and pulmonary failure. At autopsy, the brain showed mild basal ganglia atrophy and substantia nigra depigmentation, with extensive striatal and substantia nigral neuronal loss and astrogliosis. No Lewy bodies were identified; however, ubiquitin-positive glial cytoplasmic inclusions were identified in striatal and nigral oligodendroglia. There were no perivascular or meningeal infiltrates, the classic findings of neuroborreliosis. To our knowledge, this is the first report of striatonigral degeneration in a patient with B burgdorferi infection of the central nervous system and clinical Lyme-associated parkinsonism.     

Primary T-cell-rich B-cell lymphoma masquerading as a meningioma

Primary dural lymphoma is rare, and few of the small number of cases reported to date have been classified using immunohistochemical techniques. To our knowledge, we report the first case of T-cell-rich B-cell lymphoma (diffuse mixed small cell and large cell) presenting as a solitary intracranial dural mass. Cytologic and frozen sections prepared during intraoperative consultation revealed a polymorphic population of lymphocytes suspicious for an inflammatory process. Permanent sections of the dura showed a diffusely infiltrating mass composed of mature lymphocytes peppered with large atypical lymphocytes. Immunohistochemical stains identified the small lymphocytes as T cells (CD3 and CD43) and the large atypical lymphocytes as B cells (CD20). Evidence of rearranged immunoglobulin heavy-chain genes demonstrated B-cell monoclonality. Differentiating between inflammatory and neoplastic lymphocytic masses of the dura obviously has important therapeutic and prognostic significance and may require immunohistochemical and molecular techniques.     

Molecular Detection of Reticuloendotheliosis Virus (REV) Integration in Avian Poxvirus in North Eastern India

Avipoxviruses are responsible for decreased egg production, reduced growth and increased mortality in poultry. The disease has re-emerged as a new threat to poultry farmers as a number of outbreaks have been reported worldwide. Several workers have characterized the field strains of fowlpox virus and found incorporation of reticuloendotheliosis (REV) provirus in their genome. Here, the authors present the cases of poxvirus infection in three avian species viz., poultry, turkey and pigeon in north eastern India and found REV genes within the genome of poxvirus isolated from poultry and turkey. The presence of REV in the flocks of the region need to be further investigated as it reflects the emerging threats to the poultry industry at large and poultry rearing in the region in particular.     

Antibiotic susceptibility patterns of Pseudomonas aeruginosa at a tertiary care hospital in Gujarat, India

Objectives:

The present study was undertaken to assess the antibiotic susceptibility patterns of Pseudomonas aeruginosa at a tertiary care hospital in Gujarat, India. Due to significant changes in microbial genetic ecology, as a result of indiscriminate use of anti-microbials, the spread of anti-microbial resistance is now a global problem.

Materials and Methods:

Out of 276 culture positive samples, 56 samples of Pseudomonas aeruginosa were examined and 10 different types of specimen were collected. Microbial sensitivity testing was done using disk diffusion test with Pseudomonas species NCTC 10662, as per CLSI guidelines.

Results:

The highest number of Pseudomonas infections was found in urine, followed by pus and sputum. Pseudomonas species demonstrated marked resistance against monotherapy of penicillins, cephalosporins, fluoroquinolones, tetracyclines and macrolides. Only combination drugs like Ticarcillin + Clavulanic acid, Piperacillin + Tazobactum, Cefoperazone + Sulbactum, Cefotaxime + Sulbactum, Ceftriaxome + Sulbactum and monotherapy of amikacin showed higher sensitivity to Pseudomonas infections; however, the maximum sensitivity was shown by the Carbapenems.

Conclusion:

From the present study, we conclude that urinary tract infection was the most common hospital acquired infection. Also, co-administration of β -lactamase inhibitors markedly expanded the anti-microbial sensitivity of semi-synthetic penicillins and cephalosporins. The aminoglycoside group of antibiotics - amikacin - demonstrated maximum sensitivity against pseudomonas species. Therefore, use of amikacin should be restricted to severe nosocomial infections, in order to avoid rapid emergence of resistant strains. Periodic susceptibility testing should be carried out over a period of two to three years, to detect the resistance trends. Also, a rational strategy on the limited and prudent use of anti-Pseudomonal agents is urgently required.     

Angiographic management of pseudoaneurysms of gastroduodenal artery following endoscopic sphincterotomy

Gastrointestinal bleeding follows endoscopic sphincterotomy in 1 % to 10 % of patients. We report two cases of bleeding from pseudoaneurysms of the gastroduodenal artery occurring as a complication of endoscopic sphincterotomy.