Long-term follow-up of a child with primary lymph node gastrinoma and Zollinger-Ellison syndrome

A 10-year-old child with Zollinger-Ellison syndrome and primary lymph node gastrinoma is reported to emphasize the difficulties encountered in management and the value of long-term follow-up. The gastrinoma was present in a lymph node close to the greater curvature of the stomach. Primary lymph node gastrinomas are relatively rare in children and, to the best of our knowledge, have not previously been reported at this location.     

BapC autotransporter protein of Bordetella pertussis is an adhesion factor

Bordetella pertussis, the causative agent of whooping cough, attaches to mucosal surfaces in upper respiratory tract, where it produces, a variety of surface-associated and secreted molecules. Among various secreted products, some of the proteins belonging to autotransporter family; pertactin (Prn), bordetella resistance to killing (BrkA) and a newly identified member, bordetella autotransporter protein-C (BapC), are investigated in this study for their adherence potential to various respiratory and non-respiratory tract specific cell lines. Our results reveal that BapC and Prn mutants adhere significantly less (p < 0.0001 and p < 0.05) respectively to human non-respiratory (HeLa-229) and murine macrophages (P-388 D-1) cells compared to their wild-type strains. Prn, BrkA and BapC share no homology in their passenger domains except existence of common motifs arginine-glycine-asparctic (RGD) and glycosaminoglycan binding site (SGXG). We have shown that RGD and SGXG motifs are present in the coiled region in Prn and BrkA proteins with the exception in BapC where R (463) of RGD and S (597) of SGXG motif were observed in beta sheet of the modeled protein structures. Therefore, there is possibility that such arrangement of motifs can confer greater probability of BapC in better selective adherence to binding sites on the HeLa-229 and P-388 D-1 cell lines.     

A proposed new international convention supporting the rights of pregnant women and girls and their newborn infants

For a multitude of eminently modifiable reasons, death rates for pregnant women and girls and their newborn infants in poorly resourced countries remain unacceptably high. The concomitant high morbidity rates compound the situation. The rights of these vulnerable individuals are incompletely protected by existing United Nations human rights conventions, which many countries have failed to implement. The authors propose a novel approach grounded on both human rights and robust evidence-based clinical guidelines to create a 'human rights convention specifically for pregnant women and girls and their newborn infants'. The approach targets the 'right to health' of these large, vulnerable and neglected populations. The proposed convention is designed so that it can be monitored, audited and evaluated objectively. It should also foster a sense of national ownership and accountability as it is designed to be relevant to local situations and to be incorporated into local clinical governance systems. It may be of particular value to those countries that are not yet on target to meet the Millennium Development Goals (MDGs), especially MDGs 4 and 5, which target child and maternal mortality, respectively. To foster a sense of international responsibility, two additional initiatives are integral to its philosophy: the promotion of twinning between well and poorly resourced regions and a raising of awareness of how some well-resourced countries can damage the health of mothers and babies, for example, through the recruitment of health workers trained by national governments and taken from the public health system.     

Molecular mechanisms of working memory

Working memory is a process for temporary active maintenance of information and the role of prefrontal cortex in this memory has been known since the pioneering experiments of Fulton in the early 20th century. Sustained firing of prefrontal neurons during the delay period is considered the neural correlate of working memory. Evidence in literature suggests the involvement of areas beyond the frontal lobe and illustrate that working memory involves parallel, distributed neuronal networks. Prefrontal cortex is part of a complex neural circuit that includes both cortical and subcortical components and many of these regions play vital roles in working memory function. In this article, we review the current understanding of the neural mechanisms of memory maintenance in the brain.     

Presence and association of sub clinical hypothyroidism in subjects with metabolic syndrome

AimsTo determine the prevalence of subclinical hypothyroidism (SCH) among subjects with metabolic syndrome and to find out the relationship of subclinical hypothyroidism with different components of metabolic syndrome.Materials and methodsThe study was conducted in the Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka during the period of April 2008–March 2009. One hundred and seventy three subjects with metabolic syndrome (according to IDF criteria) aged 20–69 years were included in the study. After primary selection, FPG and lipid profile were done. Those who had FPG ≥ 100 mg/dl or dislipidemia were selected for routine investigations such as SGPT, S. creatinine, TC, DC, ESR, HB%, ECG, and Ultrasonography of whole abdomen to exclude liver disease, renal disease, acute illness and cardiac disease respectively. Patients having normal investigations were finally selected for serum level of FT₄ and TSH.ResultsA total of 173 subjects (105 male, and 68 female,) with metabolic syndrome were studied. Among them 14.3% (n = 15) of male and 19.1% (n = 13) of female had SCH. SCH was found more in obese subjects (BMI ≥ 25 kg/m² vs. BMI < 25 kg/m²). There was no significant difference among different parameters of metabolic syndrome in subjects with or without SCH. Although SCH was more prevalent in those who had hypertrigyceridemia and hypertension, there was no association between presence of fatty liver and SCH.ConclusionsAmong the study subjects 14.3% male and 19.1% female had SCH. SCH is more prevalent in 41–60 years age group. No significant association was found among different parameters of MetS with SCH, however, when they constitute metabolic syndrome; there was a significant association between MetS and SCH.     

Effects of time-variable exposure regimes of the insecticide chlorpyrifos on freshwater invertebrate communities in microcosms

The present study compared the effects of different time-variable exposure regimes having the same time-weighted average (TWA) concentration of the organophosphate insecticide chlorpyrifos on freshwater invertebrate communities to enable extrapolation of effects across exposure regimes. The experiment was performed in outdoor microcosms by introducing three different regimes: a single application of 0.9?μg active ingredients (a.i.)/L; three applications of 0.3?μg a.i./L, with a time interval of 7?d; and continuous exposure to 0.1?μg a.i./L for 21?d. Measurements showed that the TWA(21d) concentration in the continuous-exposure treatment (0.098?μg/L) was slightly lower than in the three-application (0.116?μg/L) and single-application (0.126?μg/L) treatments. The application of chlorpyrifos resulted in decreased abundances in the arthropod community, with the largest adverse effects reported for the mayfly Cloeon dipterum and cladocerans Daphnia gr. longispina and Alona sp., while smaller effects were observed for other insects, copepods, and amphipods. At the population level, however, the mayfly C. dipterum only responded to the single-application treatment, which could be explained by the toxicokinetics of chlorpyrifos in this species. At the end of the experimental period the invertebrate community showed approximately the same effect magnitude for all treatment regimes. These results suggest that for this combination of concentrations and duration of the TWA, the TWA concentration is more important for most species than the peak concentration for the assessment of long-term risks of chlorpyrifos.