Laparoscopic vaginoplasty: using a sliding peritoneal flap for correction of complete vaginal agenesis

In this technique of peritoneal neo-vaginoplasty, the recto-vesical space is dissected through the vulva under synchronous laparoscopic monitoring. Then the cranial limit of the pelvic peritoneum is incised circumferentially by laparoscopic approach and the two circular edges sutured sequentially. The isolated pelvic peritoneal sleeve is opened inferiorly and sutured to introital mucosal flaps.     

Growth characteristics and selenium status changes of yeast cells with inorganic and organic selenium supplementation: selenium,a chemopreventive agent

We attempted to determine the level and form of selenium (Se) that yielded the maximum Se status of yeast cells, for their evaluation as a source of Se for chemopreventive action. The influence of various Se concentrations from organic (selenomethionine) and inorganic (sodium selenite) Se compounds on growth pattern and cell viability and the alterations in the antioxidant enzyme system of yeast were evaluated. A continuous decrease in cell and colony-forming units counts was observed with increasing concentrations of Se from either source. Increasing Se status of yeast cells was found with increasing concentrations of Se with both forms, with much greater uptake for organic Se at maximum Se concentrations. A continuous increase in glutathione peroxidase (GSH-Px) activity with increasing Se concentrations in both forms revealed an active Se response in terms of antioxidant activity, with a more pronounced percentage increase with selenomethionine. A highly significant increase in total glutathione was observed with selenomethionine supplementation, compared with sodium selenite. A decreasing trend in reduced glutathione was observed with increasing organic or inorganic Se concentrations. An increasing trend in glutathione-S-transferase activity was observed with increasing Se concentrations for both forms. Significantly higher values of glutathione-S-transferase were associated with the organic form at higher Se concentrations. There was normal activity of Se in mammalian cells. The results showed that an organic Se source more greatly enhances the Se status of yeast cells and hence could help in chemoprevention if consumed by the population.     

How patient involvement in care is improving service provision

An emphasis on public and service-user involvement runs through the core initiatives of the modernisation agenda as outlined in The NHS Plan (Department of Health, 2000) and related policy documents. This article discusses problems that have prevented the NHS from being responsive to the views of service users and what the implementation of policies can offer in terms of overcoming such problems. In addition, initiatives and other ways of identifying and delivering public or patient needs are considered.     

Mitochondrial electron transport chain complexes in aging rat brain and lymphocytes

Several lines of evidence suggest thatmitochondria not only plays a key role in thecausation of aging, but it is also the mostadversely affected organelle during aging. Theaim of the present study was to examine therole of mitochondria in the aging process bydetermining whether the activities of various`electron transport chain' (ETC) complexes aredeleteriously affected during aging in the ratbrain and lymphocytes. The enzyme activity ofETC complexes I–V, and citrate synthase (CS)were assayed from discrete brain areas viz.,cerebral hemisphere (CH), cerebellum (CB),brain stem (BS) and diencephalon (DC), along withthe lymphocytes from four different age groups ofrats, namely, 1-month-old rats, 3–4-month-oldadults, 12-month-old adults and24-month-old aged rats. Significant decline wasobserved in all the enzyme activities in 12 and24-month-old rats as compared to 3–4-month-oldadult rats. Moreover, one-month-old ratsshowed lower levels of ETC complexes ascompared to three to four-month-old rats. Lymphocytes anddiscrete brain areas showed a parallel patternof age-related alterations in the mitochondrialETC complexes and CS. The analysis of suchalterations is important in determining theultimate basis of neuronal dysfunctionassociated with aging, and defining thenature of these changes may also help to developtherapeutic means to cure not only the elderly butalso individuals suffering from certain organicor psychiatric disorders.     

Distribution of protein nitrotyrosine in synovial tissues of patients with rheumatoid arthritis and osteoarthritis

OBJECTIVE: Because nitric oxide related species have been found in the inflamed joints of patients with arthritis, we investigated whether protein nitrotyrosine (a marker of tissue exposure to peroxynitrite) is present in their synovial tissues. METHODS: Protein nitrotyrosine was detected immunohistochemically and by Western blot analysis. Synovial tissues removed surgically from 12 patients with rheumatoid arthritis (RA) (mean age 63.7 yrs) and 20 with osteoarthritis (OA) (mean age 66.6 yrs) were studied. RESULTS: Nitrated proteins were detected immunohistochemically in all of 18 tissues examined. Diffuse staining of the stroma was seen in all patients, with more extensive staining in RA than OA (p = 0.008). Intense staining was detected in some lymphocytes, but not in others, even within a single lymphoid aggregate. Neutrophils did not stain for nitrotyrosine. Vascular endothelial cells stained for nitrotyrosine but adjoining smooth muscle cells did not. Both cytoplasmic and nuclear staining was seen in macrophages, endothelial cells, and lymphocytes. Numerous bands of nitrated proteins were detected by Western blot analysis of 15 synovial tissue extracts. Inducible nitric oxide synthase (iNOS) was detected immunohistochemically in endothelial cells, macrophages, vascular smooth muscle cells, and synoviocytes. CONCLUSION: Nitrotyrosine-containing proteins were found in essentially all synovia from RA and OA patients. The most prominent site of nitration in all cases was the stroma. iNOS, the likely source of the nitrating species, was found in a variety of cell types.     

People's perception of leprosy--a study in Delhi

Leprosy is considered to cause more social than medical problems. The present study focussed on this aspect in order to investigate the level of awareness among people--about their attitude towards the disease and the afflicted. The results are based on interviews with 104 persons in Delhi. The sample data revealed that the level of knowledge of leprosy was inadequate. The cause of the disease was known to 44.2% of those interviewed, while 31.7% were completely ignorant; 6.7% believed it to be the consequence of an individual's past misdeeds, and 1.9% believed it to have been caused by divine curse. 63.1% were aware that the disease is curable. 73.1% of the persons interviewed sympathised with leprosy-afflicted beggars. 61.5% favoured leprosy patients to stay with their families and within their communities. 67.3% felt that the cured could marry, while 25% felt that the leprosy-afflicted should stay in leprosy colonies away from the society. 54.8% were reluctant to employ the leprosy-afflicted as domestic help, and 31.7% were reluctant to establish matrimonial relationship with a family having a leprosy-afflicted person. The data call for intensification ofpublic awareness regarding the aetiology of leprosy. Positive and scientific information should be disseminated to minimize the social prejudices associated with the disease.