HLA antigens and non-insulin-dependent diabetes mellitus in young South African Indians

HLA, A, B and C antigens were determined in 84 South African Indian patients with non-insulin-dependent diabetes mellitus (NIDDM) in whom age of onset was under 35 years and in 760 healthy Indian controls. Increased frequencies of Aw24, B15 and Bw61 were seen in the patients, but the corrected P value was not significant. Among Indians of North Indian origin, however, there was a significant association between B15 and NIDDM (corrected P less than 0,012; relative risk 4,8). In Indians of South Indian origin no clear association with any specific HLA antigens was seen, although there was a slight increase in the frequency of Aw24 (uncorrected P less than 0,007; corrected P greater than 0,05). The findings in this study serve to emphasize the heterogeneity of diabetes mellitus, since no association between NIDDM and HLA antigens has been noted in whites.     

Evaluation of a new binary system of grading oral epithelial dysplasia for prediction of malignant transformation

The aim of this paper is to assess the reproducibility of a novel binary grading system (high/low risk) of oral epithelial dysplasia and to compare it with the WHO classification 2005. The accuracy of the new system for predicting malignant transformation was also assessed. Ninety-six consecutive oral epithelial dysplasia biopsies with known clinical outcomes were retrieved from the Oral Pathology archives. A pilot study was conducted on 28 cases to determine the process of classification. Four observers then reviewed the same set of H&E stained slides of 68 oral dysplastic lesions using the two grading systems blinded to the clinical outcomes. The overall inter-observer unweighted and weighted kappa agreements for the WHO grading system were K_s = 0.22 (95% CI: 0.11–0.35), K_w = 0.63 (95% CI: 0.42–0.78), respectively, versus K = 0.50 (95% CI: 0.35–0.67) for the new binary system. Interestingly, all pathologists showed satisfactory agreement on the distinction of mild dysplasia from severe dysplasia and from carcinoma in situ using the new WHO classification. However, assessment of moderate dysplasia remains problematic. The sensitivity and specificity of the new binary grading system for predicting malignant transformation in oral epithelial dysplasia were 85% and 80%, respectively and the accuracy was 82%. The new binary grading system complemented the WHO Classification 2005 and may have merit in helping clinicians to make critical clinical decisions particularly for the cases of moderate dysplasia. Histological grading of dysplasia using established criteria is a reproducible prognosticator in oral epithelial dysplasia. Furthermore, the present study showed that more consensus scoring on either the degree of dysplasia, assessment of risk or the presence of each morphological characteristic by a panel should be encouraged.     

Chronic low-dose administration of nicotine facilitates recovery and synaptic change after focal ischemia in rats

The current study examines the effects of chronic administration of nicotine on motor behavior after focal stroke in rats. Animals were trained in a tray-reaching task for 2weeks and then they were divided into: (1) control+saline (2) control+nicotine (3) stroke+saline, and (4) stroke+nicotine groups. Lesions were produced by devascularization of the surface blood vessels of the sensorimotor cortex contralateral to the forepaw used for reaching. Forty-eight hours after the lesions, and for a total of 12days, animals received two daily injections of either nicotine (0.3mg/kg) or saline (0.9%). Animals were tested in a motor battery 1week after the lesions and every other week for a total of 7weeks. Pyramidal cells in forelimb and cingulate areas were then examined for dendritic length and branching using a Golgi-Cox procedure. Behavioral results demonstrated that by the end of the testing stroke+nicotine animals showed significant behavioral improvement relative to stroke+saline animals. Stroke+nicotine animals showed an increase in dendritic length and branching in pyramidal cells of the forelimb and cingulate areas. The results suggest that the behavioral enhancement in the stroke+nicotine group might be attributable to the enhanced dendritic growth in residual cortical motor regions.     

Filling the assessment gap: using a learning portfolio in international development courses

PURPOSE: The purpose of this research is to describe an action research project that proposed, monitored and evaluated the introduction of a learning portfolio used to replace examinations that were formerly used to assess the core courses. DESIGN/METHODOLOGY/APPROACH: An action research project was undertaken to find out whether the introduction of a portfolio was successful and what could be improved in the process of its implementation. FINDINGS: The findings indicate that portfolios are effective to support and assess the academic development of international students. ORIGINALITY/VALUE: The introduction of a portfolio to replace written examinations in the NCIHD was welcomed by all concerned.     

Dynamic contour tonometry: principle and use

Interindividual variability of central corneal thickness has been found to be a source of error for conventional Goldmann applanation tonometry. The dynamic contour tonometer represents a potentially new technology for non-invasive and direct intraocular pressure (IOP) measurement, and has been proposed to accurately measure the true IOP irrespective of the corneal thickness. It is based on the principle that when the tip of the device exactly matches the contour of the cornea, the pressure measured by a transducer placed on its tip is an accurate indicator of the true IOP. This device is also capable of measuring the ocular pulse amplitude, a variable that has controversial significance in the diagnosis and management of glaucoma. Even though this technique seems to be very promising, further studies are required to conclusively determine the effectiveness of the dynamic contour tonometer in patients having an abnormal or irregular corneal contour.     

Angina pectoris: Effects of lidoflazine on exercise tolerance and chest pain

In a double-blind study involving 24 patients, treatment with lidoflazine in comparison with placebo was associated with a significant improvement in exercise tolerance; the median increase in work performed was 62 percent. This increase was significant at the 6th week of assessment. Ten patients were followed up for a further 2 years. Lidoflazine therapy was associated with a significant improvement in work done over that period. Lidoflazine was well tolerated and apparent adverse effects were minor.