Establishment of a human hepatocellular carcinoma cell line releasing hepatitis B virus surface antigen

A new hepatocellular carcinoma cell line, DELSH-5, derived from operative wedge biospy from a HBsAg sero- and tissue-positive patient, has been continuously propagated in vitro for nearly 22 months. The cells not only resemble hepatocytes on light and electron microscopic examination but also possess biosynthetic markers of the latter such as albumin and alpha-foetoprotein which were demonstrated in the supernatant medium as well as in the tumour cell cytoplasm. Karyology of cloned cells shows moderate aneuploidy, the major model chromosome number being 61. Though in the initial few passages HBsAg could not be detected, from the 13th passage onwards this viral component could be consistently demonstrated in small amounts in the concentrated supernatant medium by the macro- and micro-ELISA techniques. The immunohistochemical techniques as well as electron microscopy have failed to demonstrate any virus component inside the cell. The cell line reported here is the third of its kind which will act as a useful laboratory model to obtain pure HBsAg and to study the hepatitis-B-virus--liver-cell interaction with particular reference to the oncogenic potential of the virus.     

Hypoxic pulmonary vasoconstriction is heterogeneously distributed in the prone dog

Hypoxic pulmonary vasoconstriction (HPV) is thought to protect gas exchange by decreasing perfusion to hypoxic regions. However, with global hypoxia, non-uniformity in HPV may cause over-perfusion to some regions, leading to high-altitude pulmonary edema. To quantify the spatial distribution of HPV and regional PO2 (PRO2) among small lung regions (approximately 2.0 cm3), five prone beagles (approximately 8.3 kg) were anesthetized and ventilated (PEEP approximately 2 cm H2O) with an F1O2 of 0.21, then 0.50, 0.18, 0.15, and 0.12 in random order. Regional blood perfusion (Q), ventilation (VA) and calculated PRO2 were obtained using iv infusion of 15 microm and inhalation of 1 microm fluorescent microspheres. Lung pieces were clustered by their relative blood flow response to each F1O2. Clusters were shown to be spatially grouped within animals and across animals. Lung piece resistance increased as PRO2 decreased to 60-70 mmHg but dropped at PRO2's < 60mmHg. Regional ventilation changed little with hypoxia. HPV varied more in strength of response, rather than PRO2 response threshold. In initially homogeneous VA/Q lungs, we conclude that HPV response is heterogeneous and spatially clustered.     

Schwannoma of the nose and paranasal sinuses

Sckhwannoma is a benign tumor arising from the Schwann cells of nerve sheath.Through they arise more commonly in the head and neck than other regions, a through search in the liturature including medline revealed only about 47 reported cases of schwannoma in the paranasal sinuses of which the maxillary sinus involvement is more common. We report three cases of schwannoma arising from unusual sites in the paranasal sinuses with different modes of presttation each requiring a specific approach for surgical excision Transnasal endoscopic approach in combination with vonventional approaches is of immense value in the surgical management of these benign lessions of the paranasal sinuses.     

Familial nephrotic syndrome: clinical spectrum and linkage to chromosome 19q13

BACKGROUND: Familial nephrotic syndrome (NS) has both autosomal dominant and recessive forms of inheritance. Recent studies in families with an autosomal dominant form of focal segmental glomerulosclerosis (FSGS) have been at odds concerning linkage to chromosome 19q13 (Mathis et al, Kidney Int 53:282-286, 1998; Winn et al, Kidney Int 55:1241-1246, 1999), suggesting genetic heterogeneity. This study examines the clinical features and confirms linkage to chromosome 19q13 in a family with autosomal dominant NS. METHODS: DNA samples were obtained from 16 of 17 family members. Genomic DNA was isolated, and polymerase chain reaction was performed for five markers spanning the area of interest on chromosome 19q13. Data were evaluated using two- and six-point linkage analysis. RESULTS: Clinical features included presentation of NS in childhood, steroid unresponsiveness, and slow progression to renal failure. Renal biopsy in affected family members showed lesions ranging from minimal change to mesangial proliferative glomerulonephritis to FSGS. Linkage was confirmed between the disease state and chromosome 19q13, with a maximum logarithm of odds (LOD) score of 2.41. Linkage was observed for a 7 cM region on chromosome 19q13, defined by markers D19S425 and D19S220. CONCLUSIONS: This study confirms the Mathis et al report of linkage to chromosome 19q13 in a family with autosomal dominant NS. However, there were notable differences in the presenting clinical and histopathologic features of our affected family members compared with those of Mathis et al. This suggests that the gene on chromosome 19q13 may be responsible for considerable phenotypic heterogeneity and variable expression in both clinical presentation and renal histopathology.     

Myocutaneous v/s micro vascular free flaps in oral cavity reconstruction - a comparative study

Micro vascular free tissue transfer scores over the traditional myocutaneous flaps by providing better cosmesis and function. However, the increased operating tine and costs and the necessity for two operating teams sometimes, negate these advantages and even where this facility is freely available, myoentancous flaps continue to be widely used. To determine the ideal choice of reconstruction in patients after oral resection, we compared our experience with these two methods of reconstruction. Since 1997, when we first started micro vascular reconstruction, 17 patients have undergone this procedure for oral reconstruction. During this same period, 40 patients had pectoralis major myocutaneous flap reconstruction of the oral cavity. These two groups are compared with regard to cosmetic and functional results (as measured by patient’s level of satisfaction) operating time, duration of hospitalization, cost and complications. Results: Eightv seven percent of the patients in the micro vascular group and 75% in the myocutaneous group were satisfied with the cosmetic and functional results. In the microvascular group, average operating time was increased by 4 hours; hospitalization by 3 days and average cost of treatment was doubled. Flap failures and re-explorations were significantly higher in the micro vascular group. Based on these results, we would like to suggest the ideal method of reconstruction of the oral cavity in specific subgroups of patients in a corporate hospital setting.     

Absence of inferior pancreaticoduodenal artery compensated by dorsal pancreatic artery: A case report

Consideration of new aspects of vascular anatomy of the pancreaticoduodenal region is required for further improvement of surgical procedures. Awareness of variations in arteries supplying the duodenum and pancreas can help in minimizing the blood loss during surgery. We report the absence of inferior pancreaticoduodenal artery, which was compensated by a large dorsal pancreatic artery arising from proximal part of the splenic artery. This artery replaced inferior pancreaticoduodenal artery and formed a large loop of anastomosis with the gastroduodenal artery. Key words: Variation, Splenic artery, Dorsal pancreatic artery, Inferior pancreaticoduodenal artery, Pancreas.     

Automatic identification of diabetic maculopathy stages using fundus images

Diabetes mellitus is a major cause of visual impairment and blindness. Twenty years after the onset of diabetes, almost all patients with type 1 diabetes and over 60% of patients with type 2 diabetes will have some degree of retinopathy. Prolonged diabetes retinopathy leads to maculopathy, which impairs the normal vision depending on the severity of damage of the macula. This paper presents a computer-based intelligent system for the identification of clinically significant maculopathy, non-clinically significant maculopathy and normal fundus eye images. Features are extracted from these raw fundus images which are then fed to the classifier. Our protocol uses feed-forward architecture in an artificial neural network classifier for classification of different stages. Three different kinds of eye disease conditions were tested in 350 subjects. We demonstrated a sensitivity of more than 95% for these classifiers with a specificity of 100%, and results are very promising. Our systems are ready to run clinically on large amounts of datasets.